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Moral weakness
Disease
Psychodynamic symptom
Social Issue
Psychological problem
Genetic predisposition
Public health issue
A product of our brain functioning
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• The most common community model
• Gambling- an “idiot tax”
• People choose to gamble- (and almost all addictive
behaviours)
– No one does it for you
– People do it despite expressing a desire not to
• Judged as a “character flaw”
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• Developed from12 step approaches
– AA, GA, NA, AlAnon
• Need to have a diagnosis to be eligible for treatment
• Altered metabolism of drugs
– Drugs/addictive agents regarded as allergens
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• Addiction is a symptom of something else
• Associated with early life stress
• Treat the psychological issues causing the symptom
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• Learned from family and friends:
– Its what the family talk about when we get together
• Women needing a safe place to socialise
• A social activity:
– Sports and social groups
• Casino bus trips
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• Rats in Skinner boxes share many features of
humans on slot machines:
– Variable Response Schedules
• Pavlovian - classical conditioning:
– triggers associated with the reward take on
rewarding functions
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• Alcoholic rats:
– Breeding from thirsty and alcohol using rats
– 12 generations to produce an alcoholic population
• Bariatric surgery:
– some people who have this surgery rapidly establish other
addictions
– D2 has a reward dampening function
– D3 limbic area- associated with impulsivity
• Complicated by epigenetic inheritance:
– Transcription factors/environmental factors
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• If addictive products are available some people will get addicted to
them
• Focus on the agent rather than the person
• Strategies to limit:
– Exposure
– Advertising
– Availability
– Price
– Access
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• Behavioural addictions mimic behaviours related to survival
– A hunter gather species
• Substance addictions highjack the reward pathways
– Activate reward pathways in the brain
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