This page contains links to the chapter abstracts in the Alternatives section of the book: Evaluating the Brain Disease Model of Addiction.

  • Chapter 31 Introduction to Section IV
    Abstract In the final section of the book, we move on to a consideration of alternative perspectives on the nature of addiction - alternatives to both the brain disease and so-called moral models of addiction. Chapters include a consideration of fundamental issues about the way we frame our thinking about addiction – in essence, challenging […]
  • Chapter 33 Toward an ecological understanding of addiction
    Abstract This chapter argues that, while social contexts have long been understood to play an important role in addiction and recovery, the mechanisms through which contexts are currently said to influence addictive behavior are invariably cast either as mere cues, ‘secondary reinforcers,’ or as diverse types of incentives and disincentives that induce addictive behavior. As […]
  • Chapter 34 Addiction biases choice in mind, brain and behavior systems: Beyond the brain disease model
    Abstract We propose to shift the understanding of addiction from the standard biomedical Brain Disease Model of Addiction (BDMA) to a model of biased choice in goal-oriented, embodied, and situated agents. Also, given the lack of real-world impact of the BDMA, it is essential to pursue new models of addiction. We build our alternative on […]
  • Chapter 35 Multiple enactments of the Brain Disease Model: Which model, when, for whom and at what cost?
    Abstract This chapter draws on the work of science and technology studies scholar John Law to engage with the neuroscience of addiction as a set of ongoing socio-material practices that bring phenomena such as brains, drugs, compulsion, and addiction itself, into being. Rather than positing the brain disease model of addiction as the object of […]
  • Chapter 36 The social perspective and the BDMA’s entry into the non-medical stronghold in Sweden and other Nordic countries
    Abstract Sweden and the other Nordic countries have held an alternative way to many other countries of understanding and responding to substance use and addiction. The non-medical approach grew particularly strong in the 1960s, but this social perspective has, since the 1990s, become increasingly challenged. This chapter outlines the social understanding and the developments within […]
  • Chapter 37 Beyond the medical model: Addiction as a response to trauma and stress
    Abstract Theories focused on choice, chance or genetic predetermination leading to disease leave out the centrality of childhood adversity in creating the susceptibility for addictions, substance-related or not. When children do not receive consistent, secure interactions, or experience painfully stressing ones, maldevelopment may result, resulting in brains susceptible to addictions and minds seeking escape from […]
  • Chapter 38 Psychotherapeutic strategies to enhance motivation and cognitive control
    Abstract Addiction is viewed as a motivational problem with a cognitive solution. Drawing on findings from cognitive neuroscience, this chapter describes how these insights can focus and refine psychotherapeutic approaches to overcoming addiction. Identification of neural systems involved in alterations in reward processing and cognitive processing that characterize addiction are proposed as therapeutic targets. The […]
  • Chapter 39 Addiction is not (only) in the brain:  Molar behavioral economic models of etiology and cessation of harmful substance use
    Abstract This chapter summarizes the molar behavioral economic approach to studying harmful substance use and substance use disorder, a prevalent addictive behavior. General features of behavioral economics as a scientific framework for understanding behavior in context are described, followed by consideration of measurement issues involved in translating basic behavioral economic research findings to human behavior. […]
  • Chapter 40 Understanding substance use disorders among veterans: virtues of the Multitudinous Self Model
    Abstract The goal of this chapter is to evaluate the empirical efficacy of a theoretical model that has been previously called the Multitudinous Self Model, using a nationwide survey of post-9/11 Veterans receiving regular Department of Veterans Affairs (VA) care. It is asked what insights might be gleaned about the landscape of SUDs by using […]
  • Chapter 41 How an addiction ontology can unify competing conceptualizations of addiction
    Abstract Disagreement about the nature of ‘addiction’, such as whether it is a brain disease, arises in part because the label is applied to a wide range of phenomena. This creates conceptual and definitional confusions and misunderstandings, often leading to researchers talking past one another. Ontologies have been successfully implemented in other fields to help […]
  • Chapter 42 Looping processes in the development of and desistance from addictive behaviors
    Abstract Traditionally each branch of science has developed their theories of addiction within their fortresses. The integration of research results has, therefore, remained meagre, causing fragmentation and confusion about this concept and the leading models explaining it. This chapter aims to increase cross-disciplinary integration in this area by focusing on the loopings within and between […]
  • Chapter 43 Recovery and identity: A socially-focussed challenge to brain disease models
    Abstract This chapter is a socially focused challenge to the brain disease model of addiction. By exploring the cessation of substance use and pathways to recovery we are able to offer an understanding which is both empirically supported and both accessible to and understood by the wider population. We argue that the brain disease model […]
  • Chapter 44 Replacing the BDMA: A paradigm shift in the field of addiction
    Abstract Is addiction a maladaptive choice or an involuntary compulsion, or some amalgam of the two? This central “puzzle of addiction” has not been solved, despite intensive scientific investigation for over a century and serious consideration by philosophers that began in ancient times. Currently, the dominant Brain Disease Model of Addiction (BDMA) anchors addiction theory […]