Pedro Cabral Barata

Pedro Cabral Barata

University of Coimbra, Portugal

Title: Substance Dependence: where do we place volition?


Pedro Cabral Barata has completed his MD at the age of 25 from the Faculty of Medicine of the University of Coimbra. He is a Psychiatry Trainee, currently in his 4th of the 5 years of the portuguese Adult Psychiatry Medical Residency. He has a post-graduate diploma in Cognitive-behavioural Pschotherapy, having published 6 posters and presented 6 oral comunications – between National and International Congresses. He is an Associate member of the Portuguese Association of Psychiatry Interns and of the Portuguese Society of Psychiatry and Mental Health, being also a Member of the Editorial Team of the scientific journal “Psilogos”.


Substance dependence is a chronically relapsing disorder characterized by compulsion to seek and take the drug, loss of control in limiting intake and emergence of a negative emotional state (e.g. dysphoria, anxiety, irritability) when access to the drug is prevented1,2. The occasional but limited use of a drug with the potential for abuse or dependence is distinct from escalated drug use and the emergence of a chronic drug-dependent state1-3. There continues to be a debate on whether addiction is best understood as a brain disease or a moral condition. This dispute, which may influence the access to treatment, as well as the stigma attached to addiction, is often motivated by the question of whether and to what extent we can fairly hold addicted individuals responsible for their actions4,5. Besides, the diagnosis of addiction is very coloured by the negative moral and social values entailed with the illness. It is difficult to perceive that addicts have a disease; acts of will or volition are usually not accepted as diseases, because volition is an act of choice or free will. However, it has been argued that, if there is a common etiology for addiction, it should be one that is basic and fundamental to the healthy functioning of a human being – a disorder of volition6. While the issue of whether addiction is a disease has a medical and philosophical importance, it is of vital significance for the addict who still suffers from the disease of addiction. Recognizing that addiction is a disease should encourage research into treatments that are effective and that address the addict’s significant brain dysfunction, allowing the addict to receive the treatment that is required from the medical community6. It is, therefore, fundamental to reflect about the relationship between addiction and free will, publishing substantiated scientific information regarding the dichotomy addiction-volition that might help deconstructing prejudiced barriers to the treatment and social reintegration of addicted individuals.