Middle-aged; mid-life; mid-career. Party to the blessings – and the curses – of a young family. A sense that some things have been achieved, some are still to be achieved, while some, alas will probably not be. A feeling also that life’s funnel is narrowing. If hope, as I cannot remember who said, makes a great breakfast but a lousy dinner, then I am settling into the long hours after lunch. Such thoughts – late night thoughts by and large – go well with a glass of wine. Or several. Which brings me, circuitously, to my point. Over lunch recently a friend asked me what I thought were the moral harms of addiction. What was it about addiction, rather than the more regular satisfaction of ordinary appetites, that attracted a particularly moral unease? There is of course an extensive literature on the harms of the substances most liable to abuse. Physical harms; harms to health. The social costs are also high. Direct costs to the health service, less definable harms to the social fabric. No dispute here, on the whole, but not quite what we had in mind. To take only my life and the lives of those close to me, what is the nature of that fear, that bogey, that haunts us steady mid-life topers? Numberless, reader, are the times I have heard a friend, wine in hand, wonder whether her glass or two a night amount to addiction. So what I wonder is going on?

Mostly it has to do of course with a fear of losing agency, a fear that our autonomy, undermined from within, collapses, or at least starts to list heavily. If we get a little too fond then we might begin, systematically, to fail to do the thing – resist – that we know to be in our long-term interests. Addiction threatens to compromise our ability to lead a good life, our ability to form our life goals and to pursue them. What we risk is a self not unified in pursuit of its dreams but alienated, a self, in short, at war with itself. Alcohol though is woven into the fabric of my life and the lives of many, though not all, of my friends. “A good familiar creature if it be well used?” I would say so, although, as the playwright himself might have, said, in “well-used” lies the rub. The words were Iago’s, and therefore not from the most reliable of narrators, some might claim. Maybe so, but the mouths of villains are not always a stranger to the truth.

A good life, for all its pleasures, is founded on a deal of self-suppression. Work, love, families, kids: they all entail a long putting to one side of the self, or at least parts of it. And as the lighthouse invites the storm, so a life subject to constraints will periodically demand their relaxation. And so my friends and I, no more than ordinarily virtuous – not a moral saint in sight – we trim our dainty barques between the high and austere cliffs of duty and the whirlpool of self-forgetting, spread sheet in one hand, glass of wine in the other.

Julian Sheather is ethics manager, BMA. The views he expresses in his blog posts are entirely his own.