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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.
For much of the 20th century, theories of addictive behaviour and motivation were polarized between two models. The first model viewed addiction as a moral failure for which addicts are rightly held responsible and judged accordingly. The second model, in contrast, viewed addiction as a specific brain disease caused by neurobiological adaptations occurring in response to chronic drug or alcohol use, and over which addicts have no choice or control. As our capacity to observe neurobiological phenomena improved, the second model became scientific orthodoxy, increasingly dominating addiction research and informing public understandings of addiction. More recently, however, a dissenting view has emerged within addiction research, based partly on new scientific research and partly on progress in philosophical and psychological understandings of relevant mental phenomena. This view does not revert to treating addiction as a moral failure, but nonetheless holds that addictive behaviour is fundamentally motivated by choice and subject to at least a degree of voluntary control. On this alternative model of addiction, addictive behaviour is an instrumental means to ends that are desired by the individual, although much controversy exists with respect to the rationality or irrationality of these ends, the degree and nature of the voluntary control of addictive behaviour and motivation, the explanation of the difference between addictive and non-addictive behaviour and motivation, and, lastly, the extent to which addictive behaviour and motivation is correctly characterised as pathological or diseased. This research topic includes papers in the traditions of neuroscience, psychology, philosophy, law and social science that explore alternative understandings of addiction.
This book provides a framework for implementing a 21st century, effective, addiction treatment program. This non-12 step practice guide is inspired by research evidence about best practices and what actually works. The approach is humanistic and pragmatic and it facilitates natural recovery by empowering clients to make use of their innate strengths. Effective Addiction Treatment: The Minnesota Alternative incorporates cutting-edge, evidence-based best practices including mindfulness, cognitive behavioral strategies, neuroscience, individualized treatment planning, harm reduction, motivational and person-centered care. This succinct and very readable book clearly describes the successful Minnesota Alternative approach to 12 step programs. It is well-organized, well-written, and includes extensive Appendices. It is encyclopedic yet compact, positive and uplifting without minimizing the challenges of recovery, based on hard science and written with the contagious passion of a highly dedicated professional. Effective Addiction Treatment: The Minnesota Alternative is an excellent introduction to the emerging world of alternative recovery. AA/NA and other 12 step self-help groups have helped countless people recover and improve their lives. It works for many, many people. However, there are some people, who for various reasons, have not engaged in the self-help movement of AA and/or who have had unsatisfactory experiences with treatment programs using 12 step facilitation. Alternative approaches are needed.
Through the vivid, true stories of five people who journeyed into and out of addiction, a renowned neuroscientist explains why the "disease model" of addiction is wrong and illuminates the path to recovery. The psychiatric establishment and rehab industry in the Western world have branded addiction a brain disease. But in The Biology of Desire, cognitive neuroscientist and former addict Marc Lewis makes a convincing case that addiction is not a disease, and shows why the disease model has become an obstacle to healing. Lewis reveals addiction as an unintended consequence of the brain doing what it's supposed to do-seek pleasure and relief-in a world that's not cooperating. As a result, most treatment based on the disease model fails. Lewis shows how treatment can be retooled to achieve lasting recovery. This is enlightening and optimistic reading for anyone who has wrestled with addiction either personally or professionally.
In a book sure to inspire controversy, Gene Heyman argues that conventional wisdom about addiction—that it is a disease, a compulsion beyond conscious control—is wrong. Drawing on psychiatric epidemiology, addicts’ autobiographies, treatment studies, and advances in behavioral economics, Heyman makes a powerful case that addiction is voluntary. He shows that drug use, like all choices, is influenced by preferences and goals. But just as there are successful dieters, there are successful ex-addicts. In fact, addiction is the psychiatric disorder with the highest rate of recovery. But what ends an addiction? At the heart of Heyman’s analysis is a startling view of choice and motivation that applies to all choices, not just the choice to use drugs. The conditions that promote quitting a drug addiction include new information, cultural values, and, of course, the costs and benefits of further drug use. Most of us avoid becoming drug dependent, not because we are especially rational, but because we loathe the idea of being an addict. Heyman’s analysis of well-established but frequently ignored research leads to unexpected insights into how we make choices—from obesity to McMansionization—all rooted in our deep-seated tendency to consume too much of whatever we like best. As wealth increases and technology advances, the dilemma posed by addictive drugs spreads to new products. However, this remarkable and radical book points to a solution. If drug addicts typically beat addiction, then non-addicts can learn to control their natural tendency to take too much.
Drug abuse persists as one of the most costly and contentious problems on the nation's agenda. Pathways of Addiction meets the need for a clear and thoughtful national research agenda that will yield the greatest benefit from today's limited resources. The committee makes its recommendations within the public health framework and incorporates diverse fields of inquiry and a range of policy positions. It examines both the demand and supply aspects of drug abuse. Pathways of Addiction offers a fact-filled, highly readable examination of drug abuse issues in the United States, describing findings and outlining research needs in the areas of behavioral and neurobiological foundations of drug abuse. The book covers the epidemiology and etiology of drug abuse and discusses several of its most troubling health and social consequences, including HIV, violence, and harm to children. Pathways of Addiction looks at the efficacy of different prevention interventions and the many advances that have been made in treatment research in the past 20 years. The book also examines drug treatment in the criminal justice setting and the effectiveness of drug treatment under managed care. The committee advocates systematic study of the laws by which the nation attempts to control drug use and identifies the research questions most germane to public policy. Pathways of Addiction provides a strategic outline for wise investment of the nation's research resources in drug abuse. This comprehensive and accessible volume will have widespread relevanceâ€"to policymakers, researchers, research administrators, foundation decisionmakers, healthcare professionals, faculty and students, and concerned individuals.
In this interdisciplinary work, Kent Dunnington brings the neglected resources of philosophical and theological analysis to bear on the problem of addiction. Drawing on the insights of Aristotle and Thomas Aquinas, he formulates a compelling alternative to the two dominant models of addiction--addiction as disease and addiction as choice.
Drugs and Drug Policy: The Control of Consciousness Alteration provides a cross-national perspective on the regulation of drug use by examining and critiquing drug policies in the United States and abroad in terms of their scope, goals, and effectiveness. In this engaging text, authors Clayton J. Mosher and Scott Akins discuss the physiological, psychological, and behavioral effects of legal and illicit drugs; the patterns and correlates of use; and theories of the "causes" of drug use. Key Features: * Offers more coverage of drug policy issues than competitive books: This book addresses the number of significant developments over the last few decades that suggest the dynamics of drug use and policies to deal with drug use are at a critical juncture. The book also considers the issue of "American exceptionalism" with respect to drug policies through a detailed analysis of emerging drug polices in other Western nations. * Makes explicit comparisons between legal and illegal drugs: Due to their prevalence of use, this book devotes considerable attention to the use and regulation of legal drugs in society. The book illustrates that commonly prescribed medications are similar to drugs that are among the most feared and harshly punished in society and that drug-related problems do not necessarily result from particular drugs, but from how drugs are used. * Includes many pedagogical tools: With chapter opening photos and more photos throughout, this text presents material in a student- friendly fashion. Highlight boxes provide interesting examples for readers; encourage further emphasis on issues; and serve as important topics for in class writing exercises. In addition, Internet exercises and review questions reinforce key points made in the chapter and prompt classroom discussion.