Addiction is not a disease

Holden, Tim

doi:10.1503/cmaj.112-2033

“…Las conductas, por atípicas o autodestructivas que puedan parecer, no pueden ser consideradas enfermedades. Al fin y al cabo, ejecutar conductas no es algo que pueda trasmitirse ni contagiarse; ejecutar conductas no puede considerarse una respuesta autoinmune, ni se hereda, ni es degenerativa ni traumática (Holden, 2012). Existen muchos trabajos en la literatura científica que han desmontado de diferentes maneras la idea de adicción como enfermedad (Becoña, 2016;Heather, 2017;Levy, 2013;Lewis, 2016Lewis, 2018Ruiz y Pedrero, 2014, 2019Schaler, 2000) sin que el BMDA haya sido capaz de organizar una contraréplica fundamentada.…”

Section: Los Axiomas De La Controversiaunclassified

Efectos del enriquecimiento ambiental en la recuperación de la adicción: ni enfermedad, ni crónica ni recidivante

2022

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This paper critically analyses the axioms on which the brain disease model of addiction rests: i) it is a disease, ii) it is genetically determined, iii) it is irretrievably developed by drugs, iv) it is explained by the value placed on reward, and v) it is maintained by abstinence avoidance. It is argued that, in the light of scientific findings and under the prism of common sense, each of its axioms is falsifiable. The commonly held idea that self-administering drugs, eating an excess of palatable foods or persistently playing video games produces an incurable disease in people because their brains undergo irreversible changes after repeated performance of the habit is discussed. Subsequently, the classical definition of addiction as a chronic and relapsing disease is deconstructed by analysing the epidemiological data on the supposed chronicity and relapse, providing evidence of recovery as, in fact, the most probable spontaneous course. Finally, and as a common thread throughout the paper, environmental enrichment is proposed as a therapeutic approach and a precursor of the paradigm shift. It concludes with ideas on the need to build a better biopsychosocial model that substantially optimises the care response offered to people who have developed an addiction.

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“…Behaviors, no mat-ter how atypical or self-destructive they may seem, cannot be considered diseases. After all, performing behaviors is not something that can be transmitted or contagious; performing behaviors cannot be considered an autoimmune response, nor is it inherited, degenerative or traumatic (Holden, 2012). There are many works in the scientific literature that have dismantled in different ways the idea of addiction as a disease (Becoña, 2016;Heather, 2017;Levy, 2013;Lewis, 2016Lewis, 2018Pedrero, 2014, 2019;Schaler, 2000) without the BMDA having been able to organize a substantiated counter-reply.…”

Section: The Axioms Of the Controversymentioning

confidence: 99%

Effects of environmental enrichment on recovery from addiction: no disease, no chronic and no relapse

2022

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This paper critically analyses the axioms on which the brain disease model of addiction rests: i) it is a disease, ii) it is genetically determined, iii) it is irretrievably developed by drugs, iv) it is explained by the value placed on reward, and v) it is maintained by abstinence avoidance. It is argued that, in the light of scientific findings and under the prism of common sense, each of its axioms is falsifiable. The commonly held idea that self-administering drugs, eating an excess of palatable foods or persistently playing video games produces an incurable disease in people because their brains undergo irreversible changes after repeated performance of the habit is discussed. Subsequently, the classical definition of addiction as a chronic and relapsing disease is deconstructed by analysing the epidemiological data on the supposed chronicity and relapse, providing evidence of recovery as, in fact, the most probable spontaneous course. Finally, and as a common thread throughout the paper, environmental enrichment is proposed as a therapeutic approach and a precursor of the paradigm shift. It concludes with ideas on the need to build a better biopsychosocial model that substantially optimises the care response offered to people who have developed an addiction.

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“…La necesidad de ayudar y proporcionar tratamiento a personas con adicciones no está en duda, pero un problema social requiere intervenciones sociales". (Holden, 2012).…”

Section: ¿Qué Es Una Enfermedad?unclassified

El necesario cambio de paradigma en el estudio de la adicción: inconsistencias y falacias del modelo de enfermedad cerebral de la adicción

2022

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Addiction is not a disease

Abstract: sulting for acute respiratory infections (adjusted odds ratio = 5.94, 95% confidence interval 1.33-26.5).

Cited by 10 publications

References 3 publications

Efectos del enriquecimiento ambiental en la recuperación de la adicción: ni enfermedad, ni crónica ni recidivante

Efectos del enriquecimiento ambiental en la recuperación de la adicción: ni enfermedad, ni crónica ni recidivante

Effects of environmental enrichment on recovery from addiction: no disease, no chronic and no relapse

El necesario cambio de paradigma en el estudio de la adicción: inconsistencias y falacias del modelo de enfermedad cerebral de la adicción

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