Chapter 34 Addiction biases choice in mind, brain and behavior systems: Beyond the brain disease model


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 the challenges faced by the BDMA, including its assumptions on the modular organization of the brain, its structure-function isomorphy and the links to behaviorism, and, by implication, the known problems this influential paradigm faced.

We agree with the BDMA that the mind and brain are influenced by addiction. However, rather than leading to a chronic brain disease, we argue that it induces biases in choice. Indeed, well-established addiction-related neuroadaptations can be understood from this perspective. We show that the structural and functional features of biased choice in addiction can be best understood in terms of the architecture of the minds and brains of embodied agents situated in their physical, social, and cultural environments.

Our model suggests a coherent multi-pronged approach towards addiction treatment from perception and memory to valuation and action, placing the voluntary goal-oriented agent at the center of our understanding of health and wellbeing.


Paul F. M. J. Verschure - ORCiD:

Reinout W. Wiers - ORCiD:


Evaluating the Brain Disease Model of Addiction is available from: