Addiction: A Statement of the Problem.
“The hottest places in hell are reserved for those, who in a period of moral crisis, maintain their neutrality.” —John F. Kennedy
The psychiatric community has replaced the terms addict and addiction with Substance Use Disorder (SUD). This reduces any stigma attached to those who become dependent on opioid medications following medical procedures for pain management. I question the distinction; not all who are treated with opiates become addicted following medical procedures.
What is the secondary gain? This is more of the “hijacked-brain” model.
The Challenge: Existing Paradigm
The drug-usurpation hypothesis concluded that once addicted, the brain had been unalterably changed structurally and functionally. In other words, “Once an addict, always and forever an addict.“ There was contradictory evidence as early as 1940.7 In this study, Spragg demonstrated that chimpanzees preferred a piece of fruit to morphine except when they were in acute withdrawal. In 1991, Nader demonstrated that by increasing the amount and availability of the nondrug reinforcement, it was preferred over cocaine.6
I am proposing that it is time to critically evaluate our “existing paradigm” regarding addiction etiology and treatment that is over eighty years old. In order to create more effective treatment protocols, it is the purpose of this book to offer a multifaceted alternative explanation to the genetic-disorder hypothesis of the disease model. The data does not support the claim that we know enough about addiction to refuse to exam (let alone collaborate about) the real causes of addiction.
The crux of the problem has relied on the misperception and lack of understanding of the explanatory utility of self-destructive behavior to the person exhibiting it.