This ground-breaking book advances the fundamental debate about the nature of addiction. As well as presenting the case for seeing addiction as a brain disease, it brings together all the most cogent and penetrating critiques of the brain disease model of addiction (BDMA) and the main grounds for being skeptical of BDMA claims.
The idea that addiction is a brain disease dominates thinking and practice worldwide. However, the editors of this book argue that our understanding of addiction is undergoing a revolutionary change, from being considered a brain disease to a disorder of voluntary behavior. The resolution of this controversy will determine the future of scientific progress in understanding addiction, together with necessary advances in treatment, prevention, and societal responses to addictive disorders. This volume brings together the various strands of the contemporary debate about whether or not addiction is best regarded as a brain disease. Contributors offer arguments for and against, and reasons for uncertainty; they also propose novel alternatives to both brain disease and moral models of addiction. In addition to reprints of classic articles from the addiction research literature, each section contains original chapters written by authorities on their chosen topic. The editors have assembled a stellar cast of chapter authors from a wide range of disciplines – neuroscience, philosophy, psychiatry, psychology, cognitive science, sociology, and law – including some of the most brilliant and influential voices in the field of addiction studies today.
The result is a landmark volume in the study of addiction which will be essential reading for advanced students and researchers in addiction as well as professionals such as medical practitioners, psychiatrists, psychologists of all varieties, and social workers.
Nick Heather, Matt Field, Antony C. Moss, and Sally Satel
FOR THE BRAIN DISEASE MODEL OF ADDICTION
1. Introduction to Section I
Matt Field, Antony C. Moss, Sally Satel, and Nick Heather
2. Addiction is a brain disease, and it matters
Alan I. Leshner
(Reprinted from Science, 278, 45–47, 1997)
3. Neurobiologic advances from the brain disease model of addiction
Nora D. Volkow, M.D., George F. Koob, Ph.D., and A. Thomas McLellan, Ph.D.
(Reprinted from New England Journal of Medicine, 374, 363–371, 2016)
4. Time to connect: bringing social context into addiction neuroscience
Markus Heilig, David H. Epstein, Michael A. Nader and Yavin Shaham
(Reprinted from Nature Reviews Neuroscience, 17, 592–599, 2016)
5. Drug addiction: updating actions to habits to compulsions ten years on
Barry J. Everitt and Trevor W. Robbins
(Reprinted from Annual Review of Psychology, 67, 23–50, 2016)
6. Is addiction a brain disease? The incentive-sensitization view
Kent C. Berridge
7. Addiction is a brain disease (but does it matter?)
AGAINST THE BRAIN DISEASE MODEL OF ADDICTION
8. Introduction to Section II
Sally Satel, Nick Heather, Antony C. Moss, and Matt Field
9. Giving the neurobiology of addiction no more than its due
Wayne Hall, Adrian Carter, and Cynthia Forlini
10. The brain disease model of addiction: is it supported by the evidence and has it delivered on its promises?
Wayne Hall, Adrian Carter, and Cynthia Forlini
(Reprinted from Lancet Psychiatry, 2, 105–110, 2015)
11. Brain disease model of addiction: why is it so controversial?
Nora D. Volkow and George Koob
(Reprinted from Lancet Psychiatry, 2, 677–679, 2015)
12. Brain disease model of addiction: misplaced priorities?
Wayne Hall, Adrian Carter, and Cynthia Forlini
(Reprinted from Lancet Psychiatry, 2, 867, 2015)
13. Addiction and the brain-disease fallacy
Sally Satel and Scott O. Lilienfeld
(Reprinted from Frontiers in Psychiatry, 4, 141, 2014)
14. Recovery is possible: overcoming ‘addiction’ and its rescue hypotheses
Derek Heim and Rebecca L. Monk
15. Superpower rivalry, the American Grand Narrative, and the BDMA
Bruce K. Alexander
16. My brain disease made me do it: bioethical implications of the Brain Disease Model of Addiction
17. Addiction is a human problem, but brain disease models divert attention and resources away from human-level solutions
18. Before ‘rock bottom’? Problem framing effects on stigma and change among harmful drinkers
19. Brain change in addiction: disease or learning? Implications for science, policy, and care
20. Brains or persons? Is it coherent to ascribe psychological powers to brains?
21. The persistence of addiction is better explained by socioeconomic deprivation-related factors powerfully motivating goal-directed drug choice than by automaticity, habit or compulsion theories favored by the brain disease model
22. Addiction and criminal responsibility: the law’s rejection of the disease model
Stephen J. Morse
23. One cheer for the brain-disease interpretation of addiction
Gene M. Heyman
UNSURE ABOUT THE BRAIN DISEASE MODEL OF ADDICTION
24. Introduction to Section III
Nick Heather, Sally Satel, Matt Field, and Antony C. Moss
25. In search of addiction in the brains of laboratory animals
Serge H. Ahmed
26. Addiction treatment providers’ engagements with the Brain Disease Model of Addiction
Anthony Barnett, Michael Savic, Martyn Pickersgill, Kerry O’Brien, Dan I. Lubman, and Adrian Carter
27. Balancing the ethical and methodological pros and cons of the BDMA
Susanne Uusitalo and Jaakko Kuorikoski
28. The making of the epistemic project of addiction in the brain
Matilda Hellman and Michael Egerer
29. Addiction and the meaning of disease
30. The pitfalls of recycling substance-use disorder criteria to diagnose behavioral addictions
Maèva Flayelle, Adriano Schimmenti, Vladan Starcevic and Joël Billieux
ALTERNATIVES TO THE BRAIN DISEASE MODEL OF ADDICTION
31. Introduction to Section IV
Antony C. Moss, Matt Field, Sally Satel, and Nick Heather
32. Addiction is socially engineered exploitation of natural biological vulnerability
(Reprinted from Behavioural Brain Research, 386, 112598 Online, 2020)
33. Toward an ecological understanding of addiction
34. Addiction biases choice in the mind, brain, and behavior systems: beyond the brain disease model
Paul F. M. J. Verschure and Reinout W. Wiers
35. Multiple enactments of the brain disease model: which model, when, for whom, and at what cost?
Helen Keane, David Moore, and Suzanne Fraser
36. The social perspective and the BDMA’s entry into the non-medical stronghold in Sweden and other Nordic countries
Jessica Storbjörk, Lena Eriksson, and Katarina Winter
37. Beyond the medical model: addiction as a response to trauma and stress
38. Psychotherapeutic strategies to enhance motivation and cognitive control
39. Addiction is not (only) in the brain: molar behavioral economic models of etiology and cessation of harmful substance use
Samuel F. Acuff, Jalie A. Tucker, Rudy E. Vuchinich, and James G. Murphy
40. Understanding substance use disorders among veterans: virtues of the Multitudinous Self Model
Şerife Tekin, Alicia A. Swan, Willie J. Hale, and Mary Jo Pugh
41. How an addiction ontology can unify competing conceptualizations of addiction
Robert M. Kelly, Janna Hastings, and Robert West
42. Looping processes in the development of and desistance from addictive behaviors
43. Recovery and identity: a socially focused challenge to brain disease models
Beth Collinson and David Best
44. Replacing the BDMA: a paradigm shift in the field of addiction
Bruce K. Alexander
Nick Heather, Antony C. Moss, Matt Field, and Sally Satel
"This book is an exceptionally wide-ranging exploration of the contested terrain of human troubles labelled addiction. The distinguished editors have invited the best brains across the various fields that bear upon addiction -- those who advocate the brain disease view, those opposed, and those carving creative paths in between. It will stand as the definitive inter-disciplinary collection on the brain disease paradigm and its alternatives, providing lively, point-for-point debates about the nature of addiction and why this matters."
Craig Reinarman, University of California, Santa Cruz, USA
"This collection presents an excellent, well-balanced overview of different views on the brain disease model of addiction. Eminent international authors from a variety of theoretical and disciplinary perspectives discuss the emergence of the model and its growing popularity, challenges to the model and possible novel alternatives. Divided into four sections - for, against, unsure and innovative ideas – the book is informative, stimulating and a welcome reminder that the brain disease model is still far from universally accepted."
Betsy Thom, Middlesex University, UK
"What an exceptional book this is! Although understanding addiction as a ‘brain disease’ is accepted by many, it is in fact a controversial approach, contested by a large number of leading researchers, theoreticians and practitioners. This book offers a wonderfully encyclopaedic and yet very clear road map of this contested space. Divided into four stimulating sections (for, against, unsure, alternatives) the book brings together almost all of the leading figures in this debate, allowing all voices to be heard and yet also offering a clear set of statements from the Editors of the position that they hold. I strongly recommend this book to anyone interested in this area, from novices through to ‘experts’."
Richard Velleman, University of Bath, UK and Addictions Research Group, Sangath, India
"This book provides a rich compendium of seminal papers in the addiction field positioned alongside ground-breaking new contributions that consider the biopsychosocial, policy, and public health implications of a variety of models of addiction, as well as the specific benefits and downsides of the brain disease model. This book does way more than evaluate the brain disease model – it also provides a compelling retrospective and encourages introspection of our beliefs and attitudes about addiction. It also provides fascinating and thoughtful alternative models that have great potential to change how we study, treat, and frame addiction. Over the course of 44 chapters, Evaluating the Brain Disease Model of Addiction presents a paradigm shift and a call for us to reconsider how we study and conceptualize addiction. The overarching conclusion that is quite evident from reading this book is that, as a field, we have been asking the wrong questions. The chapters in this exceptionally curated book provide a plethora of ideas for alternative questions and conceptualizations that might ultimately reduce human suffering."
Katie Witkiewitz, University of New Mexico, USA
"As well as giving an excellent overview of the debate on how to conceptualize addiction, this book also raises questions about the essence of science. Rejecting a neopositivist view, according to which science is almost exclusively data driven, the debate on the brain disease model of addiction (BDMA) shows that science is about the interpretation of data and model building, and that these models can have a profound impact on the way we deal with social realities. While no pathognomonic brain lesions have been identified that can be used for diagnosing addiction, proponents of the BDMA have argued that understanding addiction as a brain disease would be helpful for overcoming stigma and improving treatment. However, 25 years after the first seminal paper introducing the BDMA, effects on treatment and public policies are, at best, modest, and the ‘othering’ associated with the BDMA apparently has unintended side effects. This book brings together a plethora of perspectives on the validity and utility of the BDMA from distinguished experts from addiction research as well as from the humanities, including proponents and critics of the model as well as authors who consider themselves ‘undecided’."
Gallus Bischof, University of Lűbeck, Germany