Addiction is not only brain chemistry – but it is not just bad choices

Consider someone addicted to alcohol, drugs or behavior like gambling. Why do they continue, even if they say they want to stop? This is a question that emphasizes the fundamental disconnection: the gap between intention and action.

This apparent contradiction is in line with Clinical definitions addiction and with brain disease modelswhich suggest that the repetitive utilize of the substance changes the function of the brain, causing compulsive and automatic utilize of drugs, bypassing conscious decision making. These brain adaptations lend a hand explain why addiction is so complex to overcome.

But there is another critical piece of the puzzle. People often utilize substances for reasons that make sense for them – feel good, alleviate stress or connect socially. These motivations do not disappear just because the substance becomes harmful.

However, over the past few decades this insight He was moved aside in learning addiction. Some critics jumped to this gap to argue with reduction, that addiction simply concerns people who choose pleasure: nothing more than “People take drugs because they like it. “

Both the brain disease model and the view “simply do not say” contain partial truths. But both are essentially defective.

Get your messages from real experts, straight to the inbox. Sign up to our daily newsletter to receive the latest reports from news and research in Great Britain, from politics and business to art and science. Join the conversation for free today.

The brain disease model has gained popularity partly because it seemed to offer two things: the basics of the development of novel treatment methods and a way to reduce the stigma. But that’s mainly It was not possible on both fronts. Despite the billions invested in Neuronauka, few novel drugs have appeared.

Meanwhile, the most effective treatment methods remain psychosocial: conversation therapies and damage reduction strategies that have existed for decades. Even worse, describing addiction as a chronic brain disease can Increase the mark and pessimismMaking recovery seems unlikely or out of reach.

In addition, studies show that addiction is not completely beyond voluntary control. People with addiction can reduce or stop using drugs in response to its consequences. This may be related to sensible changes in life – such as wedding, having children or starting a novel job – which can escalate costs or reduce perceived benefits further utilize.

These discoveries undermine the view that addiction is purely compulsive, emphasizing that people keep the agency, even in complex circumstances.

At the same time, these observations do not justify the cynical view that addiction is only hedonism or bad choices. More precise and more helpful, the framework considers how People make decisions and how Their environment shapes the value different selection options.

Neuroekonomy

At this point, insight with neuroekonomy-deals, how the brain makes decisions based on values-they are useful. For example, One found one examination That when people are hungry, they pay more attention to how food tastes, and less about how well it is, increasing unhealthy choices.

Similarly, alcohol users who wanted alcohol and were a negative mood shown to value alcohol More than food, changing your choices accordingly. Other research has found That the set of available alternatives strongly affects how attractive (or not) selection options become. According to addiction, when healthier or more satisfying options are circumscribed, the relative value of drugs increases.

This suggests that addiction is less about the loss of choice ability And more about how the context shapes the choice. When someone is in treatment, they can really want to stop using, because the environment emphasizes recovery, support and future goals. But when they return to the setting in which the drugs are straightforward to access, and attractive alternatives are not much, the relative value of drug utilize increases – and the relapse becomes more likely.

This perspective also helps to reconcile the role of brain changes in addiction. Neuroadaptations still matter: they can escalate hunger or hinder rewards – but they do not eliminate the ability to choose. Instead, these brain changes interact with a person’s environment to ensure some choices more likely than others.

Most importantly, this view also emphasizes why poverty is such a powerful motor of addiction. In devoid of settings, alcohol, drugs and gambling sockets They are often more availableWhile the possibilities of significant alternatives – employment, education, stable apartments – are scarce. These are deeply rooted structural problems and they are not straightforward to fix. But they matter.

Telling more hope, this model indicates novel paths with addiction. Instead of blaming people or pathologize them as damaged in the brain, we can focus on transforming environments so that alternatives other than deckchairs are more perceptible, available and valuable. This approach has less imprisonment and greater optimism: he considers people not so broken, but as people who can make decisions and react rationally to complex situations.

Yes, the psychology of making decisions makes addiction complex to overcome. But understanding how people weigh their options and improving the attractiveness and availability of alternatives to the utilize of substances, we can support real, lasting changes.