Such an argument would be blatantly false if it had been made but those who

Such an argument would be blatantly false if it had

This preview shows page 5 - 6 out of 8 pages.

Such an argument would be blatantly false if it had been made but those who reject the BDMA repeatedly stress that addictive desires can be abnormally strong and extremely difficult to resist (e.g. Heather 2017a ). IV. The Heyman ( 2009 ) argument is that addiction self- cures and therefore is not compulsive-like. Yet it is also argued that relapse can occur at any time. So how can one ever be self-cured? The discrepancy between the established fact of high rates of natural recovery from addiction in the general population and its characterisa- tion as a relapsing condition is more apparent than real. Rates of natural recovery are high even though there is evidence that addicts may make many attempts to recover before they eventually succeed. V. The National Institutes of Health, the American Society of Addiction Medicine and a recent Surgeon General's report make the identical case based on scientific evi- dence of addiction as a brain disorder. Proponents of the BDMA often defend the model by referring to respected organisations that endorse it but this merely illustrates how influential advocates of the BDMA have been and that it has been unquestioningly accepted in many quarters. But this is not a good reason for dis- missing criticisms or alternative approaches. The pro- nouncements of these august bodies are precisely the views of addiction that should be challenged in the interests of a proper scientific understanding. It should go without saying that the debate about whether or not addiction is best seen as a chronic, relapsing brain disease should eventually be decided, or at least strongly influenced, by evidence and reasoned debate. Tactics used by supporters of the BDMA are sometimes inimical to this aspiration. It does no good to avoid proper scientific debate by claiming that the issue has already been decided or by implying that raising doubts about the validity of the BDMA is always irresponsible and inevitably dangerous to the health and welfare of persons labelled as addicts. Testing the brain disease model of addiction Reinout W. Wiers The BDMA has been proposed as a summary of the current scientific state of affairs (Leshner 1997 ; Koob and Volkow 2010 ; Volkow et al. 2016 ). This has been disputed by others, emphasising spontaneous recovery even after severe addic- tion (e.g. Heyman 2009 ; Lewis 2015 ). I argue that the BDMA is a testable hypothesis that remains to be (dis)proved. The BDMA states that addictive behaviours change the brain in various ways, which makes repeated relapse more likely, including changes in reward sensitivity (stronger sensitivity to the rewarding effects of the addictive sub- stance or behaviour, desensitisation of other rewards), stress reactivity and negative affect, and reduced cognitive control and self-regulation. There is strong evidence back- ing up these hypothesised changes, both from animal and human literatures (Koob and Volkow 2010 ); the question is whether this proves that addiction is a brain disease.
Image of page 5

Subscribe to view the full document.

Image of page 6

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern

Ask Expert Tutors You can ask 0 bonus questions You can ask 0 questions (0 expire soon) You can ask 0 questions (will expire )
Answers in as fast as 15 minutes