Addiction, treatment, and evidence-based medicine

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Wilcox, Sean
University of Lethbridge. Faculty of Arts and Science
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Lethbridge, Alta : University of Lethbridge, Dept. of Philosophy
How addiction is conceived has important practical implications for how addicts are to be treated. This paper argues that we have a horrible concept of addiction and that has led to horrible treatment results. Examining this concept’s history will show that its main components (especially the brain disease view and the loss of control hypotheses) were invented or assumed by social reformers about 200 years ago, and that they do not map onto the physical world in a rich and systematic fashion. Science has been used to promote these assumptions instead of ever substantively establishing them. There are treatment methods that have been shown to be effective, but these are rarely employed in standard practice. Instead, addicts are provided with interventions that have been shown to be ineffective. Continuing to offer addicts treatment modalities that do not work when there are interventions with proven efficacy, is medical malpractice.
addiction medicine , addicts , co-morbid disorders , evidence based treatment , mutual support organizations