Brain disease model Leshner

Question 1

Brain disease model

Answer 1

Describes addiction as a chronic relapsing disease, characterised by compulsive drug seeking and use, despite harmful consequences

Question 2

Neurological

Answer 2

For:
- All substances affect dopamine pathways involved in craving/habits
- Structural brain changes affecting top-down control (Pref. Insula, CC)
- These changes are long lasting and exist long after taking the drugs

Against:
- Some brain functions show recovery
- Brain dysfunctions are not sufficiently specific (however, not a realistic demand. Mostly helps reveal underlying mechanism)
- Just correlational evidence (Reason why animal studies are very important)
- More than just biological factors (not implied by this model, but framework to understand effect on neuro)

Question 3

Genetics

Answer 3

For:
- 50% heritability in twin studies
- Polygenetic risk factors are shared across substances

Against:
- Genetic predisposition is not a recipe for compulsion

Question 4

Chronic, relapsing disorder

Answer 4

For:
- Total abstinence is relatively rare
- Test-retest reliability is likely low in mild SUD. Severe SUD tends to show chronic relapse

Against:
- Many cases of spontaneous remission, often in young adults, wo receiving treatment (yet, mostly in Mild SUD)

Question 5

Stigmatization

Answer 5

For:
- Seeing it as illness helps people get treatment they deserve
- Biology based def. aims to alleviate moral judgment, discrimination and stigma associated w drug use.

Against:
- Some studies suggest that brain disease model has stigma as well. Doesn’t alleviate stigma, sometimes even worsen it
- Seeing it as a brain disease is not the only. way to change social stigma

Question 6

Brain-centric account

Answer 6

Should be avoided. Social and environmental factors play an important role and deserve careful investigation. Requires multidisciplinary research approach