Life-process model of addiction

The life-process model of addiction is the view that addiction is not a disease but rather a habitual response and a source of gratification and security that can be understood only in the context of social relationships and experiences. This model of addiction is in opposition to the disease model of addiction. It was originated and advocated by Stanton Peele in his book The Truth About Addiction and Recovery (with Archie Brodsky and Mary Arnold, 1991).

Proponents of the life-process model argue that unitary biological mechanisms cannot account for addictive behavior and thus do not support using the term disease. They instead emphasize the individual's ability to overcome addiction by augmenting life options and coping mechanics, pursuing values and purpose, repairing relationships, and expressing personal agency — all of which occur through normal human development. Indeed, the disease model impedes these natural life processes. The biological mechanisms typically claimed to underlie all forms of addiction (CREB and ΔFosB) — while psychosocial factors are considered as only tangential issues leading to lesser or greater use and exposure — were reviewed by Eric J. Nestler in 2013.^[1] The range of data opposing these assertions and disputing the chronic relapsing disease nature of addiction were reviewed by Gene M. Heyman in 2013a^[2] and 2013b,^[3] and by Stanton Peele in 2016.^[4] Peele particularly cites US and international epidemiological data indicating worsening mental health and drug use outcomes dating from the 1990s, when American investment in neuropsychiatric approaches and brain research rose to billions of dollars annually.^[5]

References

^ Nestler EJ (December 2013). "Cellular basis of memory for addiction". Dialogues Clin Neurosci. 15 (4): 431–43. doi:10.31887/DCNS.2013.15.4/enestler. PMC 3898681. PMID 24459410. DESPITE THE IMPORTANCE OF NUMEROUS PSYCHOSOCIAL FACTORS, AT ITS CORE, DRUG ADDICTION INVOLVES A BIOLOGICAL PROCESS: the ability of repeated exposure to a drug of abuse to induce changes in a vulnerable brain that drive the compulsive seeking and taking of drugs, and loss of control over drug use, that define a state of addiction. Here, we review the types of molecular and cellular adaptations that occur in specific brain regions to mediate addiction-associated behavioral abnormalities. These include alterations in gene expression achieved in part via epigenetic mechanisms, plasticity in the neurophysiological functioning of neurons and synapses, and associated plasticity in neuronal and synaptic morphology mediated in part by altered neurotrophic factor signaling. [emphasis in original]
^ Heyman GM (March 2013). "Quitting drugs: quantitative and qualitative features". Annu Rev Clin Psychol. 9: 29–59. doi:10.1146/annurev-clinpsy-032511-143041. PMID 23330937. ACCORDING TO THE IDEA THAT ADDICTION IS A CHRONIC RELAPSING DISEASE, REMISSION IS AT MOST A TEMPORARY STATE. Either addicts never stop using drugs, or if they do stop, remission is short lived. However, research on remission reveals a more complex picture. In national epidemiological surveys that recruited representative drug users ... EACH YEAR A CONSTANT PROPORTION OF THOSE STILL ADDICTED REMITTED, independent of the number of years since the onset of dependence. [emphases added]
^ Heyman GM (May 2013). "Addiction and choice: theory and new data". Front. Psychiatry. 4: 31. doi:10.3389/fpsyt.2013.00031. PMC 3644798. PMID 23653607. Addiction's biological basis has been the focus of much research. The findings have persuaded experts and the public that drug use in addicts is compulsive. BUT THE WORD "COMPULSIVE" IDENTITIES PATTERNS OF BEHAVIOR, AND ALL BEHAVIOR HAS A BIOLOGICAL BASIS, INCLUDING VOLUNTARY ACTIONS. Thus, the question is not whether addiction has a biology, which it must, but whether it is sensible to say that addicts use drugs compulsively. The relevant research shows most of those who meet the American Psychiatric Association's criteria for ADDICTION QUIT USING ILLEGAL DRUGS BY ABOUT AGE 30, THAT THEY USUALLY QUIT WITHOUT PROFESSIONAL HELP, and that the correlates of quitting include legal concerns, economic pressures, and the DESIRE FOR RESPECT, PARTICULARLY FROM FAMILY MEMBERS. [emphases added]
^ Peele S (December 2016). "People control their addictions: no matter how much the "chronic" brain disease model of addiction indicates otherwise, we know that people can quit addictions - with special reference to harm reduction and mindfulness". Addictive Behaviors Reports. 4: 97–101. doi:10.1016/j.abrep.2016.05.003. PMC 5836519. PMID 29511729.
^ Stanton Peele (June 14, 2022). "How American Psychiatry Misled the World & Ruined Mental Health". lifeprocessprogram.com.

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[Nestler-1] Nestler EJ (December 2013). "Cellular basis of memory for addiction". Dialogues Clin Neurosci. 15 (4): 431–43. doi:10.31887/DCNS.2013.15.4/enestler. PMC 3898681. PMID 24459410. DESPITE THE IMPORTANCE OF NUMEROUS PSYCHOSOCIAL FACTORS, AT ITS CORE, DRUG ADDICTION INVOLVES A BIOLOGICAL PROCESS: the ability of repeated exposure to a drug of abuse to induce changes in a vulnerable brain that drive the compulsive seeking and taking of drugs, and loss of control over drug use, that define a state of addiction. Here, we review the types of molecular and cellular adaptations that occur in specific brain regions to mediate addiction-associated behavioral abnormalities. These include alterations in gene expression achieved in part via epigenetic mechanisms, plasticity in the neurophysiological functioning of neurons and synapses, and associated plasticity in neuronal and synaptic morphology mediated in part by altered neurotrophic factor signaling. [emphasis in original]

[2] Heyman GM (March 2013). "Quitting drugs: quantitative and qualitative features". Annu Rev Clin Psychol. 9: 29–59. doi:10.1146/annurev-clinpsy-032511-143041. PMID 23330937. ACCORDING TO THE IDEA THAT ADDICTION IS A CHRONIC RELAPSING DISEASE, REMISSION IS AT MOST A TEMPORARY STATE. Either addicts never stop using drugs, or if they do stop, remission is short lived. However, research on remission reveals a more complex picture. In national epidemiological surveys that recruited representative drug users ... EACH YEAR A CONSTANT PROPORTION OF THOSE STILL ADDICTED REMITTED, independent of the number of years since the onset of dependence. [emphases added]

[Heyman_b-3] Heyman GM (May 2013). "Addiction and choice: theory and new data". Front. Psychiatry. 4: 31. doi:10.3389/fpsyt.2013.00031. PMC 3644798. PMID 23653607. Addiction's biological basis has been the focus of much research. The findings have persuaded experts and the public that drug use in addicts is compulsive. BUT THE WORD "COMPULSIVE" IDENTITIES PATTERNS OF BEHAVIOR, AND ALL BEHAVIOR HAS A BIOLOGICAL BASIS, INCLUDING VOLUNTARY ACTIONS. Thus, the question is not whether addiction has a biology, which it must, but whether it is sensible to say that addicts use drugs compulsively. The relevant research shows most of those who meet the American Psychiatric Association's criteria for ADDICTION QUIT USING ILLEGAL DRUGS BY ABOUT AGE 30, THAT THEY USUALLY QUIT WITHOUT PROFESSIONAL HELP, and that the correlates of quitting include legal concerns, economic pressures, and the DESIRE FOR RESPECT, PARTICULARLY FROM FAMILY MEMBERS. [emphases added]

[Peele-4] Peele S (December 2016). "People control their addictions: no matter how much the "chronic" brain disease model of addiction indicates otherwise, we know that people can quit addictions - with special reference to harm reduction and mindfulness". Addictive Behaviors Reports. 4: 97–101. doi:10.1016/j.abrep.2016.05.003. PMC 5836519. PMID 29511729.

[5] Stanton Peele (June 14, 2022). "How American Psychiatry Misled the World & Ruined Mental Health". lifeprocessprogram.com.

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See also

References