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The Purpose in Chronic Addiction.

Hanna Pickard¹

¹Oxford Centre for Neuroethics, University of Oxford, and Oxford Health NHS Foundation Trust.

AJOB Neuroscience

|June 23, 2012

Summary

Addiction is not a chronic disease but a chosen behavior, often resolving by age 30. Substance use may serve a purpose, particularly for individuals with co-occurring psychiatric disorders, suggesting a need for revised treatment approaches.

Area of Science:

Neuroscience
Psychiatry
Behavioral Science

Background:

The prevailing view defines addiction as a chronic, relapsing neurobiological disease.
National survey data indicate substance dependence rates peak in adolescence and early adulthood, declining thereafter.
Individuals with co-occurring psychiatric disorders present different patterns of substance use and relapse.

Purpose of the Study:

To challenge the neurobiological disease model of addiction.
To propose an alternative explanation for addiction as purposive action, particularly in comorbid psychiatric populations.
To identify factors contributing to addiction as a chosen behavior.

Main Methods:

Analysis of large-scale national survey data on substance dependence.

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Hypothesizing the functional role of substance use in alleviating psychological distress for psychiatric patients.

Delineation of five folk psychological factors explaining addiction.

Main Results:

Substance dependence rates naturally decline in individuals without comorbid psychiatric disorders, suggesting "maturing out".
Substance use may serve the rational purpose of alleviating psychological distress in patients with comorbid conditions.
Addiction can be explained by factors such as desire, willpower, motivation, functional role, and decision-making.

Conclusions:

The neurobiological disease model of addiction may be misguided.
Addiction can be understood as a chosen, purposive action rather than solely a compulsive disease.
Findings suggest a need for revised research and effective treatment strategies for addiction.