Brain disease or biopsychosocial model in addiction?Remembering the Vietnam Veteran Study

  1. Elisardo Becoña 1
  1. 1 Universidade de Santiago de Compostela
    info

    Universidade de Santiago de Compostela

    Santiago de Compostela, España

    ROR https://ror.org/030eybx10

Journal:
Psicothema

ISSN: 0214-9915

Year of publication: 2018

Volume: 30

Issue: 3

Pages: 270-275

Type: Article

DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Psicothema

Abstract

Background: In recent years, we have repeatedly been told that addictions are a brain disease, leaving aside their classic biopsychosocial explanation. Objective: To describe both models and discusses the weakness and reductionism of the brain disease model following the consumption of heroin by North American soldiers in the Vietnam war in the 1970s. Method: A literature review of the Vietnam Veteran Study in relation to drug consumption. Results: The soldiers greatly increased their consumption of heroin in Vietnam, but almost all of them ceased using it upon returning home. The analysis of the environmental factors related to this self-healing is a critique of the brain disease model of addictions because it cannot explain this or other studies. Conclusion: The biopsychosocial model is still the best model to guide the fi eld of addiction due to its utility, coherence, and effi cacy in treatment.

Bibliographic References

  • Ahmed, S. H. (2012). The science of making drug-addicted animals. Neuroscience, 211, 107-125. doi: 10.1016/j.neuroscience.2011.08.014
  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
  • Becoña, E. (2002). Bases científicas de la prevención del consumo de drogas [Scientific bases of drug consumption prevention]. Madrid: Delegación del Gobierno para el Plan Nacional sobre Drogas.
  • Becoña, E. (2016a). Addiction is not a brain disease. Papeles del Psicólogo, 37, 118-125.
  • Becoña, E. (2016b). Trastornos adictivos [Addictive disorders]. Madrid: Síntesis.
  • Blonigen, D. M., Finney, J. W., Wilbourne, P. L., & Moos, R. H. (2015). Psychosocial treatments for substance use disorders. In P.E. Nathan & J. M. Gorman (Eds.), A guide to treatments that work (4th ed., pp. 731761). New York, NY: Oxford University Press.
  • Bogdanovica, I., McNeil, A., Murray, R., & Britton, J. (2011). What factors influence smoking prevalence and smoke free policy enactment across the European Union Member States. Plos One, 6, e23889. doi: 10.1371/ journal.pone.0023889
  • Cabanis, D, K,, Moga, D. E., & Oquendo, M. A. (2015). Rethinking the biopsychosocial formulation. Lancet Psychiatry, 2, 1-2. doi: 10.1016/ S2215-0366(15)00180-7
  • Chien-Chang, W. (2011). Governing drug use through neurobiological subject construction: The sad loss of the sociocultural. Behavioral and Brain Sciences, 34, 327-328. doi: 10.1017/S0140525X11000835
  • Courtwright, D. T. (2010). The NIDA brain disease paradigm: History, resistance and spinoffs. BioSocieties, 5, 137-147. doi:10.1057/ biosoc.2009.3
  • de León, J. (2015). Is psychiatry only neurology? Or only abnormal psychology? Déjâ vu after 100 years. Acta Neuropsychiatrica, 27, 6981. doi: 10.1017/neu.2014.34
  • Edwards, G. (2010). The trouble with drink: Why ideas matter. Addiction, 105, 797-804. doi: 10.1111/j.1360-0443.2009.02773.x
  • Engel, G. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196, 129-136. doi: 10.1126/science.847460
  • Engel, G. (1980). The clinical application of the biopsychosocial model. American Journal of Psychiatry, 137, 535-544. doi: 10.1176/ajp.137.5.535
  • Flanagan,. D. (2013). The shame of addiction. Frontiers in Psychiatry, 4, article 120.
  • Frances, A. (2014). ¿Somos todos enfermos mentales? [Saving normal. An insider’s look at the epidemic of mental illness.] Madrid: Ariel.
  • Ghaemi, S. N. (2011). The biopsychosocial model in psychiatry: A critique. Existenz, 6, 1-8. doi: 10.3389/fpsyt.2013.00120
  • Goodwin, D. W., Davis, D. H., & Robins, L. N. (1975). Drinking amid abundant illicit drugs. The Vietnam case. Archives of General Psychiatry, 32, 230-233. doi:10.1001/archpsyc.1975.01760200094009
  • Hall, W., Carter, A., & Forlini, C. (2015). The brain disease model of addictions: Is it supported by the evidence and has it delivered on its promises? Lancet Psychiatry, 2, 105-110. doi: 10.1016/S22150366(14)00126-6
  • Hall, W. & Weier, M. (2017). Lee Robin’s studies of heroin use among US Vietnam veterans. Addiction, 112, 176-180. doi:10.1111/add.13584
  • Hammer, R., Dingel, M., Ostergren, J., Partridge, B., McCormick, J., & Koening, B. A. (2013). Addiction: Current criticism of the brain disease paradigm. AJOB Neuroscience, 4, 27-32. doi: 10.1080/21507740.2013.796328
  • Heim, D. (2014). Addiction: Not just brain malfunction. Nature, 507, 40. doi: 10.1038/507040e
  • Helzer, J. E. (2010). Significance of the Robins et al Vietnam veterans study. American Journal of Addiction, 19, 218-221. doi:10.1111/j.15210391.2010.00044.x
  • Heyman, G. M. (2013). Quitting drugs: Quantitative and qualitative features. Annual Review of Psychology, 9, 29-59. doi: 10.1146/ annurev-clinpsy-032511-143041
  • Holden, T. (2012). Addiction is not a disease. Canadian Medican Asociation Journal, 184, 679. doi: 10.1503/cmaj.112-2033
  • Insel, T. R., & Cuthbert, B. N. (2015). Brain disorders? Precisely. Precision medicine comes to psychiatry. Science, 348, 499-500. doi: 10.1126/ science.aab2358
  • Jaffe, J. H. (2010). A follow-up of Vietnam drug users: Origins and context of Lee Robins’s classic study. American Journal of Addictions, 19, 212-214. doi:10.1111/j.1521-0391.2010.00043.x
  • Le Moal, M., & Swendsen, J. (2015). Sciences of the brain: The long road to scientific maturity and to present-day reductionism. Comptes Rendus Biologies, 228, 593-601. doi: 10.1016/j.crvi.2015.06.014
  • Lenoir, M., Cantin, L., Vanhille, N., Serre, F., & Ahmed, S. H. (2013). Extended heroin access increases heroin choices over a potent nondrug alternative. Neuropsychopharmacology, 38, 1209-1220. doi: 10.1038/ npp.2013.17
  • Leshner, A. I. (1997). Addiction is a brain disease, and it matters. Science, 278, 45-47. doi: 10.1126/science.278.5335.45
  • Levy, N. (2013). Addiction is not a brain disease (and it matters). Frontiers in Psychiatry, 4, article 24. doi: 10.3389/fpsyt.2013.00024
  • López-Quintero, C., Hasin, D. S., de los Cobos, J. P., Pines, A., Wang, S., Grant, B. F., … Blanco, C. (2011). Probability and predictors of remission from life-time nicotine, alcohol, cannabis or cocaine dependence: Results from the National epidemiologic survey on alcohol and related conditions. Addiction, 106, 657-669. doi: 10.1111/ j.1360-0443.2010.03194.x
  • Matto, H. C., Hadjiyane, M. C., Kost, M., Marshall, J., Wiley, L., StrolinGoltzman, J.,... VanMeter, J. W. (2014). Functional magnetic resonance imaging clinical trial of a dual-processing treatment protocol for substance-dependent adults. Research on Social Work Practice, 24, 659-669. doi: 10.1177/1049731513515056
  • Maze, I., & Nestler, E. J. (2011). The epigenetic landscape of addiction. Annals of the New York Academy of Sciences, 1216, 99-113. doi: 10.1111/j.1749-6632.2010.05893.x
  • McKay, J. R., Kranzler, H. R., Kampman, K. M., Ashare, R. L., & Schnoll, R. A. (2015). Psychopharmacological treatments for substance use disorders. In P.E. Nathan, & J. M. Gorman (Eds.), A guide to treatments that work (4th ed., pp. 763-785). New York, NY: Oxford University Press.
  • Melchert, T. P. (2015). Biopsychosocial practice. A science-based framework for behavioral health care. Washington, D. C.: American Psychological Association.
  • NIDA (2007). Drugs, brain and behavior: The science of addiction. Rockville, MD: Author.
  • O’Brien, C. P., & McLellan, A. T. (1996). Myths about the treatment of addiction. Lancet, 347, 237-240. doi:10.1016/S0140-6736(96)90409-2
  • Pedrero, E. J. (2015). Salud mental y adicción [Mental health and addiction]. Madrid: Fundación Atenea.
  • Pérez, A. (2013). “Adicciones” y otros asuntos humanos [“Addictions” and other human affairs]. Bogotá, Colombia: Corporación Nuevos Rumbos.
  • Pickard, H., Ahmed, S. H., & Foddy, B. (2015). Alternative models of addiction. Frontiers in Psychiatry, 6, article 20. doi: 10.3389/ fpsyt.2015.00020
  • Prestwich, A., Kellar, I., Conner, M., Lawton, R., Gardner, P., & Turgut, L. (2016). Does changing social influence engender changes in alcohol intake? A meta-analysis. Journal of Consulting and Clinical Psychology, 84, 845-860. doi: 10.1037/ccp0000112
  • Robins, L. N. (1993). Vietnam veterans’rapid recovery from heroin addiction: A fluke or normal expectation? Addiction, 88, 1041-1054. doi: 10.1111/j.1360-0443.1993.tb02123.x
  • Robins, L. N., Helzer, J. E., & Davis, D. H. (1975). Narcotic use in southeast Asia and afterward. An interview study of 898 Vietnam returnees. Archives of General Psychiatry, 32, 955-961. doi:10.1001/ archpsyc.1975.01760260019001.
  • Robins, L., Helzer, J., Hesselbrock, M., & Wish, E. (2010). Vietnam veterans three years after Vietnam: How our study changed our view of heroin. American Journal of Addiction, 19, 203-211. doi:10.1111/j.1521-0391.2010.00046.x
  • Satel, S., & Lilienfeld, S. O. (2014). Addiction and the brain-disease fallacy. Frontiers in Psychiatry, 4, article 141. doi: 0.3389/fpsyt.2013.00141
  • Schwartz, S. J., Lilienfeld, S. O., Meca, A., & Sauvigné, K. (2016). The role of neuroscience within psychology: A call for inclusiveness over exclusiveness. American Psychologist, 71, 52-70. doi: 10.1037/ a0039678.
  • Skewes, M. C., & Gonzalez, V. M. (2013). The biopsychosocial model of addiction. In P. M. Miller (Ed.), Principles of addiction. Vol. 1. Comprehensive addictive behaviors and disorders (pp. 61-70). San Diego, CA: Academic Press.
  • Stanton, M. D. (1976). Drugs, Vietnam, and the Vietnam Veteran: An overview. American Journal of Drug and Alcohol Abuse, 3, 557-570. doi: 10.3109/00952997609014295
  • Swenson, J., & Le Moal, M. (2011). Individual vulnerability to addiction. Annals of the New York Academy of Science, 1216, 73-85. doi: 10.1111/ j.1749-6632.2010.05894.x.
  • Tsuang, M. T., Bar, I. L., Harley, R. M., & Lyons, M. J. (2001). The Harvard Twin Study of substance abuse: What we have learned. Harvard Review of Psychiatry, 9, 267-279.
  • Vrecko, S. (2010). Birth of a brain disease: Science, the state and addiction neuropolitics. History of the Human Sciences, 23, 52-67. doi: 10.1177/0952695110371598
  • Volkow, N. D., & Morales, M. (2015). The brain on drugs: From reward to addiction. Cell, 162, 712-725. doi: 10.1016/j.cell.2015.07.046
  • Volkow, N. D., Koob, F. F., & McLellan, T. (2016). Neurobiologic advances from the brain disease model of addiction. New England Journal of Medicine, 374, 363-371. doi: 10.1056/NEJMra1511480.
  • West, R., & Brown, J. (2013). Theory of addiction (2nd ed.). London: Wiley-Blackwell.
Data source: Dialnet