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Running Head: Models and the Assessment Process 2
Article one description; The BDMA (brain disease model of addiction)
postulates that addiction is a brain disease caused and made worse by substance
use and abuse. The substances taken by the individual damages brain activity and
systems involved in reward and pleasure-seeking. According to Volkow, MD, ‘the
evidence supports that BDMA “helped deliver more effective treatment and impact
public policy’ (Volkow, N.D., & Koob, G., 2015). Preclinical and clinical studies
produce evidence that ‘repeated drug use causes specific molecular and functional
neuroplastic changes at the synaptic and circuitry level’ (Volkow, N.D., & Koob, G.,
2015). Preclinical and clinical studies using BDMA have also developed medications
such as naloxone, acamprosate, buprenorphine-naloxone, and Varenicline. Naloxone
and Acamprosate effectively treat alcoholism, Buprenorphine-Naloxone effectively
treats opioid addiction, and Varenicline effectively treats tobacco addiction. BDMA
effect on public policy is substantial; for instance, in 2008, the parity law (the Paul
Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act), driven
by the BDMA model that requires medical insurance for the first time in the USA to
cover the costs associated with addiction treatment (Volkow, N.D., & Koob, G., 2015).
Article two description; According to Nordqvist, ‘addiction is a chronic brain
disorder, not merely a behavioral problem or simply the result of taking the wrong
choices’ (Norqvist, 2011). In the past, addiction as a behavior problem was commonly
accepted. Thanks to the American Society of Addiction Medicine (ASAM), addictive
behaviors involving drugs, sex, gambling, and alcohol point to brain damage.
According to the new definition of addiction, compulsive and harmful behaviors ‘are
really manifestations of a disease involving several areas of the brain’ (Norqvist,
2011). Dr. Michael Miller, former president of ASAM, explains the rationale behind
Running Head: Models and the Assessment Process 3
the new definition of addiction. ‘At its core, addiction isn’t just a social problem or a
moral problem or a criminal problem. It’s a brain problem whose behaviors manifest
in all these other areas. Many behaviors driven by addiction are real problems and
sometimes criminal acts. But the disease is about brains, not drugs. It’s about
underlying neurology, not outward actions’ (Norqvist, 2011). It is essential to know
that addiction as a primary disease is long-term and (chronic). Thus addiction
treatment and monitoring must continue throughout the patient’s lifespan. Long-term
care is needed to treat damaged brain circuitry, impacting impulse control and
judgment altered by drug use. It is essential to know that the person suffering from
addiction does choose to seek treatment. According to Dr. Raju Hadela, former
president of the Canadian Society of Addiction, Medicine stated, ‘choice still plays an
important role in getting help. While the neurobiology of choice may not be fully
understood, a person with addiction must make choices for a healthier life in order to
enter treatment and recovery. Because no pill alone can cure addiction, choosing
recovery over unhealthy behaviors is necessary’ (Norqvist, 2011).
An explanation of the model is reflected in Miller’s statement, ‘“At its core,
addiction is not just a social problem or a moral problem or a criminal problem. It is a
brain problem whose behaviors manifest in all these others areas…The disease is
about brains, not drugs. It is about underlying neurology, not outward actions’
(Nordqvist, 2011) illustrates the BDMA (brain disease model of addiction). BDMA
focuses on the damage caused to the brain by addictive substances. The specific
area of the brain damaged by addictive substances is the nucleus accumbens and
the prefrontal cortex. When the nerve cells in the nucleus accumbens and the
prefrontal cortex are damaged, planning and executing task behavior are affected in
Running Head: Models and the Assessment Process 4
the individual. Thus the individual develops aggressive behavior patterns of seeking
out the addictive substance. With this information, the clinician must understand
brain-damaged to be a cause of behavior when conducting the assessment. As
mentioned previously, ‘In the past, addiction as a behavior problem was commonly
accepted’ (Norfleet, 2020). Thanks to the American Society of Addiction Medicine
(ASAM), addictive behaviors involving drugs, sex, gambling, and alcohol point to
brain damage. Therefore, knowing this scientific fact no, controversy should exist
between addiction models regarding assessment. It is now clear that clinicians must
consider brain damage during the assessment process.
Running Head: Models and the Assessment Process 5
References:
Volkow, N. D., & Koob, G. (2015). Brain disease model of addiction: why is it so
controversial?. The Lancet Psychiatry, 2(8), 677-679.
Norqvist, C. (2011, August 16). Addiction has a new definition – it’s a disease, not just
bad choices or behaviors. Medical News Today. Retrieved from
https://www.medicalnewstoday.com/articles/232841.php#1
American Society of Addiction Medicine. (2011, August 15). New definition of
addiction: Addiction is a chronic brain disease, not just bad behavior or bad
choices. ScienceDaily. Retrieved October 26, 2020, from
www.sciencedaily.com/releases/2011/08/110815095013.htm