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You'll eventually die if you don't eat or drink, the alcoholic will survive without alcohol. Mark Kleiman noted that doctors with access to opiates sometimes get addicted, and they way they came up with to treat such doctors was... monitoring with swift consequences for slipping up.

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Bad example. In some extreme cases alcoholics genuinely *will* die without alcohol, and the only medically responsible treatment is *less* alcohol than they’ll voluntarily consume on their own rather than *no* alcohol.

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Well, that's kinda illustrating the point. Is the actual crux "if going without doesn't, in itself kill you" or is there some level of delayed, non-fatal, or indirect harm that's still sufficient to constitute "need"? Or is literally anything that can be endured/foregone without fatal consequences a preference?

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