Addiction: a new paradigm

Abstract

The older view of addiction was that people became addicted because they were ignorant of the risks of addiction, they were unhappy, or they lacked healthy opportunities. Once addicted, they were hooked by physical dependence, causing them to continue use despite wanting to quit. The new paradigm of addiction focuses on reward and the powerful experience of falling in love with the feeling that addictive behaviors produce. Potential addicts seek brain reward and are heedless of the risks, of which they are seldom ignorant. Withdrawal is largely irrelevant. The problem of addiction is the power of brain reward. The new view of addiction has important implications for prevention, treatment, public policy, and medical treatment with controlled substances.