- Researchers argue that the BDMA is still valid under the grounds that addiction is highly variable in severity, and those with less severe addictive disorders are more common and more likely to recover without treatment
- Researchers say chronic addictions occurs in a smaller number of people and these people fit the BDMA model

Counterarguments to the Critiques of 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

University of Michigan - Ann Arbor

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)

Hall, W., Carter, A., & Forlini, C. (2015). The brain disease model of addiction: Is it supported by the evidence and has it delivered on its promises? The Lancet Psychiatry, 2(1), 105-110. https://doi.org/10.1016/S2215-0366(14)00126-6

The brain disease model of addiction: Is it supported by the evidence and has it delivered on its promises?

- 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

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

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. 

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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