Interdisciplinary study of addiction is facilitated by relative unification of the concept. What should be sought is not formal unification through literal analytic definition, which would undermine practical flexibility within disciplines and intervention practices. However, leading controversies around whether addiction should be conceived as a ‘disease’, and over whether addiction is ‘chosen’ behavior, are made more difficult to resolve by failure to apply philosophical reflection on these general concepts. Such reflection should be sensitive to two kinds of constraint: coherence in description of empirical, including neuroscientific, observation, and utility in framing normative goals in treatment and policy design. Following review of various interpretations of addiction, disease, and choice across contributing disciplines, it is concluded that addiction is most plausibly viewed as a disease at the scale of public health research and policy, but not personal (e.g. clinical) management and intervention. Addicts must make choices to recover, and in that respect addiction is a ‘disorder of choice’. However, it is concluded that the most relevant sense of ‘disorder’ arises at the social rather than the personal scale.

概念的相对统一促进了成瘾的跨学科研究。应该寻求的不是通过字面分析定义的形式统一，这会破坏学科和干预实践中的实际灵活性。然而，关于成瘾是否应该被视为一种“疾病”以及成瘾是否是“选择的”行为的主要争议，由于未能对这些一般概念进行哲学反思而变得更加难以解决。这种反思应该对两种约束敏感：经验描述的连贯性，包括神经科学、观察和在治疗和政策设计中制定规范目标的效用。在审查了跨贡献学科对成瘾、疾病和选择的各种解释之后，结论是，在公共卫生研究和政策的范围内，成瘾最有可能被视为一种疾病，而不是个人（例如临床）管理和干预。成瘾者必须做出选择才能康复，在这方面，成瘾是一种“选择障碍”。然而，得出的结论是，最相关的“障碍”感出现在社会而非个人层面。