A Matter of Addiction: Brain Disease or Moral

FailingShirley Gedney-Rubel

Southern New Hampshire University

A Matter of Addiction:Brain Disease or Moral Failing

•Addiction is a serious public health issue

•Addiction affects personal functioning in many areas

What is the Cost of Addiction?

Figure 1. National Institute on Drug Abuse, 2008.

What is Addiction?• Addiction is a primary chronic disease of brain

reward

• Characteristics: Compulsive using and cravings with periods of recovery often followed by relapse

• Addiction is progressive and may result in disability or premature death

American Society of Addiction Medicine, 2015.

Moral Theories of Addiction

Moral Theories of Addiction

• Proposes that addiction is a personal choice

• Individuals lack willpower and moral principles

• Emphasizes punishment over rehabilitation

Capuzzi & Stauffer, 2012.

Moral Theories of Addiction• Heyman (2013) posits the brain disease model is not

upheld by research, stressing behavior and choice in addiction disorders

• Statistics show a low prevalence of addiction after the age of 30

• Therefore, most addicts quit because of cost/benefit analysis, without professional intervention

• Dismisses the possibility of early mortality with little evidence

Biological Theories of Addiction

Biological Theories of Addiction

•Genetic Models: Addiction is an inherited predisposition

•Neurobiological Models: Substance use causes changes in brain structure and neurochemistry that lead to addiction

Capuzzi & Stauffer, 2012.

Biological Theories of Addiction

• There are many biopsychological theories of addiction

• Commonalities include adaptations of neural pathways, changes in neurochemistry, craving, and relapse

• Of particular interest is the reward pathway and the neurotransmitter dopamine

Skinner & Aubin, 2010.

A Matter of Addiction:Brain Disease or Moral Failing

• The moral model fails to account for physical symptoms

• Brain imaging shows changes in structure and function

• Empirical studies support a biological basis for addiction

National Institute on Drug Abuse, 2012.

References• American Society of Addiction Medicine (ASAM). (2015). Definition of addiction.

[Web]. Retrieved Feb. 1, 2015, from http://goo.gl/YXD01

• Capuzzi, D., & Stauffer, M. (2012). Foundations of addictions counseling (2nd ed.). Upper Saddle River, NJ: Pearson Education, Inc.

• Heyman, G. M. (2013). Addiction and choice: Theory and new data. Frontiers in Psychiatry, 4. doi: 10.3389/psyt.2013.00031

• National Institute on Drug Abuse. (2012). Addiction science. [Web]. Retrieved Feb. 1, 2015, from http://goo.gl/HjBnY0

• National Institute on Drug Abuse. (2012). Drug abuse costs the United States economy hundreds of billions of dollars in increased health care costs, crime, and lost productivity (Chart). [Web]. Retrieved Feb. 1, 2015, from http://goo.gl/VTJnu9

• Skinner, M.D., & Aubin, H.-J. (2010). Craving’s place in addiction theory: Contributions of the major models. Neuroscience and Biobehavioral Review, 34, 606-623. doi:10.1016/j.neubiorev.2009.11.024