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.

section Section I|88 pages

For the Brain Disease Model of Addiction

chapter 4|15 pages

Time to Connect

Bringing social context into addiction neuroscience

chapter 5|24 pages

Drug Addiction

Updating Actions to Habits to Compulsions Ten Years On

chapter 6|13 pages

Is Addiction a Brain Disease?

The incentive-sensitization view

chapter 7|12 pages

Addiction is a Brain Disease

(But does it matter?)

section Section II|167 pages

Against the Brain Disease Model of Addiction

chapter 10|9 pages

The Brain Disease Model of Addiction

Is it supported by the evidence and has it delivered on its promises?

chapter 11|3 pages

Brain Disease Model of Addiction

Why is it so controversial?

chapter 12|2 pages

Brain Disease Model of Addiction

Misplaced priorities?

chapter 14|10 pages

Recovery is Possible

Overcoming ‘addiction’ and its rescue hypotheses

chapter 16|10 pages

My Brain Disease made me do it

Bioethical implications of the Brain Disease Model of Addiction

chapter 18|9 pages

Before ‘Rock Bottom’?

Problem framing effects on stigma and change among harmful drinkers

chapter 19|7 pages

Brain Change in Addiction: Disease or Learning?

Implications for science, policy, and care

chapter 20|13 pages

Brains or Persons?

Is it coherent to ascribe psychological powers to brains?

chapter 22|13 pages

Addiction and Criminal Responsibility

The law's rejection of the disease model

section Section III|83 pages

Unsure about the Brain Disease Model of Addiction

section Section IV|188 pages

Alternatives to the Brain Disease Model of Addiction

chapter 35|11 pages

Multiple Enactments of the Brain Disease Model

Which model, when, for whom, and at what cost?

chapter 37|13 pages

Beyond the Medical Model

Addiction as a response to trauma and stress

chapter 39|16 pages

Addiction is not (only) in the Brain

Molar behavioral economic models of etiology and cessation of harmful substance use

chapter 40|9 pages

Understanding Substance Use Disorders among Veterans

Virtues of the Multitudinous Self Model

chapter 43|11 pages

Recovery and Identity

A socially focused challenge to brain disease models

chapter 44|17 pages

Replacing the BDMA

A paradigm shift in the field of addiction