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Addiction and Virtue -- Beyond the Models of Disease and Choice
by Kent Dunnington, Ph.D.
  2011 (IVP Academic, Downers Grove IL)  All rights reserved [199 pages].
[Answer 18 of 25 questions correctly to receive
9 hours of Continuing Education credit.]

Chapter 1 Addiction and Disease: Science, Philosophy, and Theology (p. 15-30)
1. The author does not believe that alcohol and drug addiction is a brain disease because
a. tolerance and withdrawal, which are usually considered necessary conditions for addiction, are experienced by many people who are not addicted, such as surgery patients who are prescribed a pain reliever.
b. some people on regular medication experience little to no tolerance or withdrawal symptoms.
c. even though studies show that drug abuse does change the structure and function of the brain, people still retain voluntary control over their behavior.
d. All of the above.

2. Given that the following is true:
People who have genes associated with addictions do exhibit more immediate and powerful attraction to the drug, and/or develop tolerance to the drug more quickly and severely and/or experience more acute withdrawal symptoms in the absence of the drug.
Which is NOT true concerning genetic influence on addiction?
a. Experiences of gratification, tolerance, and withdrawal do not directly cause addictive behavior. Rather, it depends upon the significance or meaning the person places upon those experiences as to whether or not addiction will occur.
b. The author believes it is only a matter of time before a single gene or group of genes is discovered that cause alcoholism and other drug addictions
c. Regardless of what gene variant someone has, everyone has the potential to become addicted.
d. Just because a human behavior pattern is influenced by genes does not make that pattern involuntary behavior.

3. Which is NOT true about treating addiction medically?
a. Most substance abusers do stop practicing their addictions and go on to lead lives free from addiction.
b. A large majority of addicts recover in a non-medical context.
c. A smaller percentage of patients relapse (return to their addiction) after medical treatment is over than those who are not in medical treatment
d. There is no evidence to suggest that medical treatment improves the chances of recovery from addiction.

Chapter 2 Addiction and Incontinence: Resources in Aristotle (p. 31-55)

4. What is the "paradox of addiction"?
a. That a person repeatedly does something he really doesn't want to do.
b. That addicted persons claim to be powerless over their addictive behavior, yet this admission itself is the inroad to regaining power over that same behavior.
c. That a person does not exert enough willpower over his addiction, while at the same time he exerts sufficient willpower in other areas of his life.
d. That a person will cause great harm to himself in order to satisfy his addiction.

5. The incontinent addicted person is one who
a. has the belief that the addictive behavior is bad for him and a corresponding desire not to engage in it, and who has some capacity to resist the behavior, but who nevertheless does engage in addictive behavior against his own better judgment.
b. is truly confused about whether or not an addictive behavior is good or bad.
c. believes the addictive behavior is bad for him, but has no capacity to resist the behavior.
d. usually has some serious mental deficiency.

6. Which is NOT true?
a. The first drink or the first hit of a drug does bring about a decisive constitutional change in the addicted person's body, a much more decisive change than that brought about when a non-addicted person takes a first drink or a first hit of a drug. This decisive constitutional change interferes with the addictive reasoning process.
b. Physical cravings can obstruct good judgment. Those that last for 5-8 days (like heroin withdrawal) make it "practically impossible to stop addictive behaviors" than those that last for a lesser time, like 12-24 hours.
c. The psychological cravings that accompany addiction make resistance to addiction difficult because they relentlessly and repeatedly bombard one's will until it gives in.
d. Relapse only occurs when people in recovery again start experiencing physical and/or psychological cravings that had gone away.

Chapter 3 Addiction and Habit: Resources in Aquinas (p. 57-81)

7. A habit is a relatively permanent acquired modification of a person that enables the person, when provoked by the relevant stimulus, to act consistently, successfully and ____ with respect to some objective.
a. intentionally
b. with ease
c. rationally
d. with deliberative reasoning

8. Which is NOT true about habits?
a. A habit is neither an instinct nor a disposition, but it mediates between the two.
b. Habitual actions can usually be stopped simply by performing an act of the will.
c. Habits usually cannot be changed without great effort.
d. If a behavior is not yet deeply entrenched and can be rooted out simply by recognizing that it is problematic, it is likely not a habit but a mere disposition.

9. Which is NOT true about habits?
a. A habit mediates between the extremes of determinism and voluntarism.
b. A habit is like second nature because it proceeds from the agent effortlessly and without exertion of will, apparently "naturally."
c. A habit mediates between the voluntary and the involuntary.
d. Actions are things we make happen, and emotions are things that happen to us.

10. Which is NOT true?
a. The habituation of the cognitive estimation is the single most powerful component of addiction and the addictive experience.
b. Repetition of acts alone is sufficient to produce habits
c. Aquinas says that habits form when two conditions are met. First, the external act must be repeated. Second, there must be appropriate attention to the interior quality of the act, referring to one's intentions and desires.
d. Relapse can occur after years of sobriety if a person in recovery does not continue working the spiritual steps.

Chapter 4 Addiction and Intemperance: Sensory Pleasures and Moral Goods (p. 83-97)

11. It is simultaneously true that an addicted person loses direct control over his choices and yet still be held responsible for his actions. How can this be true?
a. Addicted persons are responsible for mastery habits, which are exercised only through rational consciousness or volition, but not for automation habits, which can be exercised in the absence of rational consciousness.
b. Although addicted persons lack the resources necessary to exercise enduring control over their addictive behavior, they possess the resources to act indirectly in such ways as to eventually develop the habits needed to make such enduring control a reality. This is in keeping with Alcoholics Anonymous which claims that addicted persons lack immediate control over their behavior and yet can regain that control.
c. An addicted person can at any time use his will to override automation habits, since actions that flow from automation habits are voluntary.
d. All of the above.

12. _____ is the inordinate love of certain objects for reasons other than sensory pleasure.
a. Addiction
b. Intemperance
c. Ambivalence
d. Indulgence

13. Sensory miseries such as memory loss, blackouts, vomiting, dry heaves, and being deathly ill, do not deter addicted persons from pursuing their addicted objects because these objects are believed to offer a type of moral and intellectual goods such as improving one's ability to communicate, being at ease with oneself, being unafraid, and being part of a community.
a. True
b. False

14. ____ pursues sensory goods, ____ pursues moral and intellectual goods.
a. Intemperance, hedonism
b. Hedonism, intemperance
c. Addiction, intemperance
d. Intemperance, addiction

15. Addictions are like virtues and vices in that both virtues and vices are habits which empower persons to pursue what they think is the good life.
a. True
b. False

Chapter 5 Addictions and Morality: The Addict as Unwitting Prophet (p. 99-123)

16. In contrast to the Greek
polis, modern life is characterized by the absence of
a. intellectual thought and discourse.
b. the importance of family life.
c. any mutually held account of the good life for persons.
d. participation in grass roots political activities.

17. Aristotle believed that the good life consisted of moral and intellectual virtues which have the ultimate goal of
a. serving and contemplating God.
b. having a loving family.
c. cultivating true friendships.
d. producing a harmonious and peaceful government.

18. Which statement would the author NOT agree with?
a. One reason why people get addicted is because modern life promotes too many arbitrary choices without any ultimate rationale for those choices.
b. One reason why people get addicted is because they are bored, and they are bored because they do not know what their purpose for living is.
c. One reason why people get addicted is because they don't have interesting hobbies.
d. One reason why people get addicted is because they are lonely.

19. For Aristotle, the primary benefit of friendship is _____.
a. growth in virtue.
b. affection.
c. the advancement of local commerce.
d. companionship, doing common activities together.

Chapter 6 -- Addiction and Sin: Testing and Ancient Doctrine (p. 125-140)

20. The modern tendency within the addiction-recovery movement, Alcoholics Anonymous being one example, has been to replace the Christian language of sin with the language of disease and sickness. The author argues that this has been done for two reasons: (1) So recovering alcoholics who were not Christian or who were adverse to Christianity would not be put off from their recovery by the language of sin, and 2) So recovering alcoholics would not be tempted to think they could fix their own drinking problem through straightforward moral exertion.
Yet the author goes on to show how this change was based on a faulty understanding of the Christian doctrine of sin, that sin is something we ARE more than just things we DO. It is our nature to chose sin over goodness, while at the same time we are responsible for our sinning.
The author then describes a striking similarity between the Christian doctrine of sin and the testimonies of addicted persons. Which comparison does he make?
a. People with addictions claim that their addictive behavior is admittedly destructive yet, in some very real sense, beyond the immediate control of their willpower. Similarly, the doctrine of sin teaches that human beings act in ways that are destructive of right relationship with God yet those actions often flow out of habits and fundamental orientations that are not amenable to reform through immediate exertion of will.
b. Addicted persons do not merely perform certain kinds of actions but rather become certain kinds of people, acting out of bad habits. Similarly, the doctrine of sin claims that sinners are not merely people who commit sinful acts but are rather people whose character is sinful, acting out of sinful habits.
c. Persons with addictions claim that they are predisposed to addictions, that something about their material or psychological makeup inclines them toward addictive behavior prior even to the first addictive act. Similarly the doctrine of original sin teaches that sinners are not merely people who commit sinful acts, not merely even people who form sinful habits, but are people who are predisposed to sin.
d. All of the above.

21. The primary purpose in restoring the language of sin to the language of addiction is to show how addiction
a. damages our physiological functioning.
b. restricts our freedom.
c. disrupts our proper relation to God.
d. makes us unproductive members of society.

Chapter 7 Addiction and Worship: Caritas and Its Counterfeits (p. 141-167)

The author says that Aristotle argues that the best human life is to be achieved through the development of moral and intellectual virtues and the practical activities that these virtues facilitate -- activities like raising a family, developing friendships, and governing cities. Aristotle also declared that the only activity truly fitting to the life of human flourishing is the practice of theoria, the contemplation and service of the divine. But Aristotle fails to explain how to integrate the life of practical action with the contemplation and service of God, or to put it another way, how to integrate the human pursuit of immanent and transcendent happiness. The author states that our post-Christian modern world is either suspicious of or rejects transcendence and that the rise in addictions is a result of this rejection of transcendence, or the contemplation and service of God. The author says that Aquinas' answer to integrating the immanent with the transcendent is charity, which directs us to love God and to love other human beings.

22. Addiction is a counterfeit form of worship because
a. the addicted person organizes his entire life around his addiction.
b. to the addict, everything else in life makes sense only if it is accompanied by his addiction.
c. addicts do not pursue fulfillment though moderation, but they pursue ecstasy through excess.
d. All of the above.

23. The harder an alcoholic tries to exert control over her addiction, the more she solidifies and entrenches the addiction. The harder she tries not to drink, the more certain becomes her failure.
a. True
b. False

24. Working the twelve steps of recovery in Alcoholics Anonymous is effective not because A.A. promotes the direct use of willpower, but because A.A. helps the recovering person become the kind of person who no longer perceives the world in terms of alcohol. A.A. helps people not so much to quit drinking as how to live sober.
a. True
b. False

Chapter 8 Addiction and the Church: The Gospel and the Hope of Recovery (p. 169-194)
25. Is there anything the author would change about the Twelve Steps of Alcoholics Anonymous?
a. For addicts to stop admitting that they are helpless to overcome their addiction.
b. For recovering addicts to stop calling themselves "repentant sinners."
c. For addicts to stop confessing their sins to everyone they offended.
d. For addicts not to fashion a God "as we understand him", but to follow the triune God of Israel who became incarnate in Jesus of Nazareth.