Addiction medicine has brought great benefits. But it is not without limits.

The term"medicalization" was popularized by the Catholic philosopher and social critic Ivan Illich. Illich was troubled by the way in which what was formerly regarded as deviant behavior had come to be the province of medicine, as well as with the prevalence of those harms he deemed"iatrogenic"—that is, caused by medical treatment itself—in another term popularized by Illich., was published in 1975, and is not nearly as widely discussed as it once was. .

Now, roughly 50 years later, addiction medicine has expanded vastly while Illich's work has become, as I have said, obscure. Nonetheless, it is worth reconsidering the achievements of addiction medicine from the point of view of Illich's work, or from the point of view of what Illich might have called the"medicalization of addiction.

Yet the specter of"medicalization" still looms. It is perhaps most clear when we consider addictions whose relationship to substances, and so to the traditional provinces of medicine, are more remote. In a 2011 article, the British physician Andrew Moscrop argued that"problem gambling" has increasingly come to be seen as a medical issue, with primary care physicians expected to serve as the first line for intervention with gamblers.

Moscrop therefore proposes that, for at least some addictions, we should exercise some caution in understanding them in medical terms. This does not require us to be Illichian skeptics about much of medicine, but it does call for a certain degree of humility about the medical enterprise. He writes:"Our patients present problems that are frequently neither physical nor psychological, but social or even.

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