Mainstream addiction science is today widely marked by an antinomy between a neurologically determinist understanding of the human brain ‘hijacked’ by the biochemical allure of intoxicants and a liberal voluntarist conception of drug use as a free exercise of choice. Prominent defenders of both discourses strive, ultimately without complete success, to provide accounts that are both universal and value-neutral. This has resulted in a variety of conceptual problems and has undermined the utility of such research for those who seek to (...) therapeutically care for people presumed to suffer from addictions. This article contrasts these two contemporary discourses to two others that played vital historical roles in initiating both scientific and popular concern for addiction. These are the Puritan and civic republican discourses that dominated scholarly discussions of addiction in the early modern era. In each case, the place of values in these discussions is highlighted. By comparing them to their early modern historical antecedents, this article seeks to reflexively explore and develop more intellectually sound and therapeutically relevant alternatives to the troubled attempts at universality and value-neutrality now fettering debates in mainstream addiction science. (shrink)

Advances in neuroscience are changing how mental health issues such as addiction are understood and addressed as a brain disease. Although a brain disease model legitimizes addiction as a medical condition, it promotes neuro-essentialist thinking and categorical ideas of responsibility and free choice, and undermines the complexity involved in its emergence. We propose a “biopsychosocial systems” model where psychosocial factors complement and interact with neurogenetics. A systems approach addresses the complexity of addiction and approaches free choice and moral responsibility within (...) the biological, lived experience and sociohistorical context of the individual. We examine heroin-assisted treatment as an applied case example within our framework. We conclude with a discussion of the model and its implications for drug policy, research, addiction health care systems and delivery, and treatment of substance use problems. (shrink)

The author comments on several articles on addiction. Recent developments in neuroscience suggest that addicted individuals have substantial impairments in the cognitive control of voluntary behavior. The author differs on the observations that addicts either act on desires that are not conducive to rational action. The author also states that addiction seems to be a prime manifestation of akrasia, in which one fails to be motivated to act in accordance with what one judges ought to be done. Accession Number: 24077920; (...) Authors: Viens, A. M. 1; Email Address: [email protected]; Affiliations: 1: University of Oxford, Hertford College, Oxford, United Kingdom; Subject: EDITORIALS; Subject: ADDICTIONS; Subject: COGNITION; Subject: DECISION making; Subject: AKRASIA; Subject: NEUROSCIENCES; Number of Pages: 3p. (shrink)