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Letters   |    
The Disease Analogy and Substance Abuse
Douglas B. Marlowe, J.D., Ph.D.; David S. DeMatteo, J.D., Ph.D.
Psychiatric Services 2004; doi: 10.1176/appi.ps.55.6.720-a
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In Reply: The thrust of our argument was that analogy is always an invalid form of logical or scientific reasoning, regardless of the substantive area. Not one of us can resist the temptation to selectively underscore those semblances that support our biases and ignore those that cause us discomfort. It is undoubtedly true that substance abuse, chronic medical illness, and antisocial behavior are all products of varying degrees of genetics, environment, and choice. Indeed, we would defy anyone to name a single complex human trait or condition that is not so influenced. But therein lies the problem. Because substance abuse is omnigenus (like everything else), we are all free to propose our own heuristic paradigm for the condition that fits our values. Dr. Scott is certainly free to choose a medical paradigm—"the old child psychiatry model"—for her practice and writings, but she offers no compelling reason why others must do the same.

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