This outlook is directly related to the implementation of expensive and unsuccessful drug policies as it focuses solely on neural mechanisms as opposed to behavioral and psychosocial factors.

Sociocultural limitations of drug addiction as a brain disease

- Sociocultural
- Dosing regimens are not representative 
- Effects of long-term administration of drug use are not conclusive                                     
- Positron Emission Tomography (PET)  is not enough evidence
- Experimental designs are limited to establishing cause and effect 
- Physiological evidence overlaps and is not necessarily clinically significant
- Imaging techniques and clinical assessment are not representative
 

Limitations of drug abuse as a brain disease 

In a drug addiction context, brain disease suggests there is a significant brain dysfunction that is detectable and explained by discrepancies in drug use between addicts and non-addicts. 

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The brain disease model of addiction (BDMA) purports that addiction is, fundamentally, a chronic and relapsing brain disease. The main argument is that drug use alters the brain's reward system and circuitry.

Brain Disease Model of Addiction (BDMA)

Grifell , M., &amp; Hart, C. L. (2018). Is Drug Addiction a Brain Disease? https://doi.org/file:///C:/Users//OneDrive/Desktop/Research%20proposal/Drug%20addiction%20is%20not%20brain%20disease.pdf 

Is Drug addiction a Brain Disease? 

- The main supporting evidence is derived from animal models which have identified specific neural circuitry that addictive drugs act on including the mesolimbic brain reward system
- Neuroimaging studies on human brains of addicted individuals have also supported these animal models and the changes in reward circuitry and dopamine activation
- genetic research and twin studies have also found correlations between specific genetic markers addiction risk


Evidence for the BDMA

- One main critique is that the BDMA labels addiction as a chronic and relapsing brain disease, but many people with addiction recover without treatment
- Another critique is the presence of evidence that those addicted to recreational drugs can respond to small personal changes such as finances or mandatory drug tests

Critiques of the BDMA

Understanding and researching addiction through the brain disease model of addiction has provided numerous benefits including:

- Helping researchers understand specific neurobiological processes involved in loss of control, compulsive drug use, rigid behavior, and negative emotional states
- Revealing molecules and circuits of addiction has resulted in multiple effective medications (naloxone, buprenorphinenaloxone, and varenicline)
- The knowledge provided by the BDMA has also become. thebasis for using stimulation techniques to strengthen brain circuits with promising results
- The knowledge provided by the BDMA has also given clinicians a framework for specific and targeted interventions that strengthen the impaired brain circuits
- There have been positive effects on public policy surrounding addiction including the 2008 passing of the parity law, which requires insurance to cover costs associated with addiction treatment (the first time ever in the US)
- It also provides benefits for treatment because the model helps reduce the stigma attached to addiction as being a moral failing

Benefits of the BDMA

Brain disease model of addiction in Health Psychology

- Falls under the umbrella of substance use disorder. The word "addiction" is not formally recognized in the DSM-5.
- Strong, uncontrollable compulsion to administer a drug of abuse to yourself due to dependence.
- Acts on reward circuitry in the brain (dopamine) and changes the chemical composition of your brain over time.
- According to the DSM 5, only gambling addiction has been listed as a diagnosable disorder, the rest of the behavioral addictions are yet to find themselves a place on the DSM manual.

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