What neurobiology cannot tell us about addiction

Abstract

Molecular neurobiological studies have yielded enormous amounts of valuable information about neuronal response mechanisms and their adaptive changes. However, in relation to addiction this information is of limited value because almost every cell function appears to be involved. Thus it tells us only that neurons adapt to 'addictive drugs' as they do to all sorts of other functional disturbances. This information may be of limited help in the development of potential auxiliary agents for treatment of addiction. However, a reductionist approach which attempts to analyse addiction at ever finer levels of structure and function, is inherently incapable of explaining what causes these mechanisms to be brought into play in some cases and not in others, or by self-administration of a drug but not by passive exposure. There is abundant evidence that psychological, social, economic and specific situational factors play important roles in initiating addiction, in addition to genetic and other biological factors. Therefore, if we hope to be able to make predictions at any but a statistical level, or to develop effective means of prevention, it is necessary to devise appropriate integrative approaches to the study of addiction, rather than pursue an ever-finer reductive approach which leads steadily farther away from the complex interaction of drug, user, environment and specific situations that characterizes the problem in humans.

Scepticism and hope in a complex predicament: People with addictions deliberate about neuroscience

“…Proponents argue that acceptance of the BDMA will benefit addicted individuals by lessening stigma and self-blame, facilitate treatment seeking, and increase funding and development of more effective treatments. Critics argue that the BDMA reduces drug dependent persons' feelings of control, undermines their selfefficacy, promotes fatalism and leads policy-makers to neglect the role of social factors in the development and treatment of addiction (Dingel, Karkazis, & Koenig, 2011;Kalant, 2009;Levy, 2013;Midanik, 2004). M a n u s c r i p t 3 A growing literature has begun to examine the extent to which neuroscientific explanations of addiction have influenced the views of addiction held by the general public, addiction clinicians and neuroscientists, and addicted persons Dingel, et al, 2011;Hammer, Dingel, Ostergren, Nowakowski, & Koenig, 2012;Hammer, et al, 2013;Meurk, Hall, Morphett, Carter, & Lucke, 2013;Meurk, Partridge, et al, 2014;Netherland, 2011).…”

Addiction, choice, and criminal law

“…The neural mechanisms of addiction are debatable, but are being intensively investigated (Hyman 2007), and environmental variables play an important role in explaining addictive behavior (Kalant 2010). It is unsurprising that persistent use of brain altering substances changes both the brain and behavior.…”

Drug policy, harm and human rights: A rationalist approach

“…The first is that drug use is not always harmful to the capacity for rational action (Kalant, 2010;Levy, 2006). Indeed, drug intoxication may be one of those intended purposes for people who find it pleasurable.…”

“…Other have pointed out that addiction still lacks 'a truly uniform set of symptoms and a distinct site, source and course of pathology that are necessary and sufficient for the presence of disease in addiction' (Reinarman, 2005: 312). The reduction of addiction to neurobiology is over-simplistic (Kalant, 2010). It rests on a false dichotomy between the enslaved, diseased addict and the purely autonomous, abstinent self (Albert, 2010).…”