To what extent can addiction be explained in terms of brain dysfunction?

Our world is changing really fast and scientists can now explore subjects that were previously unapproachable. For example, scientists can explore how the genes and environmental factors affect the brain, how the brain responds to drugs, and how drug abuse is driven and changes in the development of .

In order to find an explanation to the question “To what extent can addiction be explained in terms of brain dysfunction”, it will be necessary to provide the definition of the most important term and theory of addiction which will be used in this essay in order to clarify the account of the thesis. The work of Robert West (2008), Dr. Nora Volkow ( 2003) and O.J. Skog (2000) will be presented in order to find the explanation for this question.

The Major Biological Theory describes addiction based on the explanation that the main cause of addiction lies in genetic theory and disease model.

According to Robert West (2008), Disease Model of addiction proclaims that addiction engages pathological modification in the brain that results in overpowering urges. The disease model of addiction matches the medical explanation of the disorder which defines disorder as a form of irregularity or defection and disturbance. According to the diseases model of addiction, addiction can engage and affect the function of the Central Nervous System. (Gelkopf, 2002).

According to medical terminology the “disease” is a medical nonstandard condition of human beings which shows weak physical function or distinction, distress which can be related to specific signal and interaction of biological, social, physical, and psychological uncommon structure and function.

The disease model of addiction analyses the process of drug abuse as an illness which is in need of rehabilitation and therapy. According to disease model of addiction, the problem of addiction lies in environmental and biological factors, and is strongly related with genetic predispositions. According to ‘Disease Model’ of alcohol dependence, the addict does not have control over the addiction and is missing the choice because of the genetic predisposition.

The model also provides explanation of the individual differences of human beings, the weakness in the learning process and the vulnerability which needs improvement and regaining. In addition to the model there are three conditions of the rule in which an addict can be treated.

First is the “Loss of control” which states that an addict will show the motivation to stop taking the drug and engage in addictive behaviour but at the same time will continue to be involves in the addictive behaviour. Addicted person will often make self promises to stop taking drugs and will show the true potential to do so. But in reality, they will be not able to keep the agreement made with them self.

The process of loss of control starts from small things, for example a cigarette smoker will plan to smoke just four cigarettes a day from the next day and will most likely break the agreement by smoking more cigarettes than initially planned.

In addition to this, their way of thinking will start to change and the impact of not being able to stop will affect the overall behaviour in a way that the person will not able to refuse or refrain from being involved in the addictive behaviour. The loss of control will be expressed in a variety of ways, for example an addict will not be able to keep promises or continue with work or studies as he or she was able to do before their addiction.

The second condition of the disease model is the “importance of urge” which controls the addict in the process of addiction. The addictive person is extremely motivated to get the “next fix” and will do everything to succeed in it. The uncontrollable and unbearable craving cannot be stopped even in situations when the addict thinks that he or she has the choice but at the same time is not able to even consider it.

The third and last condition of the disease model is “self-cure” which reveals the situation in which an active addict stops engaging in addictive behaviour for a period of time and will never come back to it. Then again some addicts may not really be addicted to the drug in the first place as compared to a heavy user who stops for some time and relapses again.

The Disease Model of addiction states that an addict doesn’t have any control over their addiction and the ability to chose is not present.

However the new findings of Dr. Volkow states that drug addiction is a brain disease. It is not just loss of determination to fight the addiction but there is much more to it.

According to salience theory of dopamine, the neurochemical is released in brain when something unexpected but significant happens, for example if we unintentionally burn our hand. Dopamine is activated in our brain in a situation when we are paying full attention to the things which we want to remember because they are really important and cannot be forgotten. Throughout addiction there is superior activity in the dopamine which is involved in learning, motivation and memory process. The superior activity of dopamine is five times stronger in the time of drug use than in normal process of remembering. The increased dopamine activity pushes the brain motivational and attentional system to concentrate completely and only on the drug. During the addiction the addictive brain becomes accustomed to the dopamine and starts to reduce the system down.

From the evidence of dopamine theory of addiction, it seems that drug addiction is a brain disease expressed as compulsive behaviour. For those researches Dr. Volkow used the brain imaging technology called positron emission tomography (PET) of seventeen long- term addicts addicted to cocaine. Dr. Volkow found that the cocaine strength brought on high levels of excitement among the participants which was related to the cocaine capacity to block the dopamine transporter system. According to Dr. Volkow, the finding suggests that the brains thalamus region may have an addiction related level of functions.

All those findings support the view that addiction is a brain disease and the predisposition to become an addict are strongly determined by the biological and genetical tendency of the individual.

Dr. Volkow, in some of his researches, has indicated that addicts have smaller amount of dopamine receptor D2 which was found in the brain in the same place as the part which is involved in motivation and compensation behaviour. With the receptor D2, an addict is in strong need to take the drug over and over again.

In order to explain the account further, it is important and essential to explore the ‘Choice Theory of addiction’. The opposite view of biological approach will be presented to compare and contrast both of the theories to obtain clear answer to the question of this essay.

The work of O.J. Skog (2000), and his “Choice Theory of Addiction” presents the addiction in terms of choice which an addict makes more readily and willingly than urge. Skog highlights that an addicted person always has a choice and the choice has the main control over the addict. There is no other power which drives an addict’s behaviour to control the addiction. In this case addicts have control over the choice, and the control can change only when an addict simply changes their mind. The strength and steadiness of choice can change the consistency and addict can lose the strength of his performance.

Skog’s choice theory is missing the primary characteristic of behaviour which explains the behaviour just in the context of choice. The Choice theory explains that an addict always has the choice from the start, from the choice to choose the drug and the choice to engage in the addictive behaviour. According to the Choice theory for the addicted person, the most important issue is for the addict to recognise that he has choice, which means that all his actions can be controlled by the simple choice to engage in addictive behaviour.

This essay has considered explanations to the question “Can addiction be explained in term of brain dysfunction?” and has also presented the new scientific evidence of dopamine theory which has been compared to the basis choice theory.

It is clear that the understanding of the addiction will progress further in future and that the addictive personality is developing and changing. There are no magic pills in the world to cure addiction, and there are no perfect theories that will describe the exact process of becoming an addict.

All over the world researchers have tried to ask the right questions in the study to find answers and help us understand addiction better. In the end we can all agree that some of the things that happen deep inside the addict’s mind will remain a mystery.

The debate about the predisposition to become an addict is changing all the time because of new findings and studies.

In the first part of this essay, the disease model of addiction was presented to support the view that the addiction is based on the biological theory of addiction which states that humans become addicts because of the genetic, biological, and environmental predispositions. We can agree with it because of many years of research which proves that in some addicts, the genetic and biological factors stand out.

The first and most important difference between these two theories – Disease Model and Choice Theory – is, that in the ‘Disease Model’ addicts do not have control over their choice. As we have discussed in the beginning of this essay, the “loss of control” is so strong that the addicted person cannot keep any promises or agreement. The next and maybe the most important difference between the ‘Choice Theory’ and ‘Disease Model’ is that, the addict experiences the “urge” where in the Choice Model the addicted person does not experience any urge. The choice model believes that they have the opportunity to choose what they want to do with their addictive behaviour. In reality the craving is so strong that all choice points in direction to get the “next fix” to feel better.

The last difference is that the Disease Model claims that the addicted person believes that he or she has control over self- cure. This distinction can be determined by the time in which they engage in the addictive behaviour.

In addition to the theory of choice the “rational choice” has control over the addictive behaviour. The responsibility to be involved in addiction is in fact missing and an addict is not able to control the choice because the control is dominated by urge.

All of these findings point towards the idea that the force or urge to take drugs is determined not just by the choice, but by high biological and environmental factors.

This account clearly indicates that addiction can be explained in terms of brain dysfunction because even if the addict is able to make the choice to abstain from drugs for a period of time, some stronger force will take control over the motivation and those forces can be biological or genetical. These findings provide further explanation to the question of this essay. When we reflect on these theories, we can agree that all knowledge about addiction received from the different theories that have been discussed, have real potential to understand the causes of addiction and can be developed further in order to find the best possible strategies to cure the vulnerable people of the population who are suffering from the power of addiction.


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