Centre for the Study of Professions, Oslo and Akershus University College of Applied Sciences , Oslo , Norway.
Front Psychiatry. 2013 Aug 7;4:77. doi: 10.3389/fpsyt.2013.00077. eCollection 2013.
Normative thinking about addiction has traditionally been divided between, on the one hand, a medical model which sees addiction as a disease characterized by compulsive and relapsing drug use over which the addict has little or no control and, on the other, a moral model which sees addiction as a choice characterized by voluntary behavior under the control of the addict. Proponents of the former appeal to evidence showing that regular consumption of drugs causes persistent changes in the brain structures and functions known to be involved in the motivation of behavior. On this evidence, it is often concluded that becoming addicted involves a transition from voluntary, chosen drug use to non-voluntary compulsive drug use. Against this view, proponents of the moral model provide ample evidence that addictive drug use involves voluntary chosen behavior. In this article we argue that although they are right about something, both views are mistaken. We present a third model that neither rules out the view of addictive drug use as compulsive, nor that it involves voluntary chosen behavior.
关于成瘾的规范性思维传统上分为两种，一方面是医学模型，它将成瘾视为一种疾病，其特征是强迫性和复发性药物滥用，而成瘾者对此几乎或完全无法控制；另一方面是道德模型，它将成瘾视为一种选择，其特征是在成瘾者的控制下进行自愿行为。前者的支持者援引证据表明，经常使用毒品会导致已知参与行为动机的大脑结构和功能发生持久变化。根据这一证据，人们常常得出这样的结论，即成瘾涉及从自愿选择的药物使用过渡到非自愿强迫性药物使用。针对这种观点，道德模型的支持者提供了大量证据表明，成瘾性药物使用涉及自愿选择的行为。在本文中，我们认为，尽管这两种观点都有一定的道理，但它们都是错误的。我们提出了第三种模型，既不排除成瘾性药物使用是强制性的观点，也不排除它涉及自愿选择的行为。
