A paradigm shift for addiction science?

This article assumes that a radical transformation is currently occurring in addiction science and
asks whether this can usefully be seen as a Kuhnian ‘paradigm shift’. The puzzle of addiction is
that people labelled as addicts persist in behaving in ways they know cause harm to themselves
and others. In the currently dominant ‘normal science’, the answer to this puzzle is that addictive
behaviour represents a kind of compulsion caused by a disease of the brain. However, this
is contradicted by anomalous findings from several types of evidence that addictive behaviour
is not automatic and compelled but is voluntary and intentional. The emerging paradigm is
therefore based on the assumption that addictive behaviour is a disorder of choice. How the
puzzle addiction can be solved is the first task to be addressed under this new paradigm but
some possibilities are suggested. If it is believed that evidence from neuroimaging is sufficient
proof that addiction must be a brain disease, reasons are provided for why such a belief is
unfounded. Implications for the treatment and prevention of addiction arising from the new
paradigm are explored. The article concludes by pointing out that the existence of the Addiction
Theory Network shows that the author is not alone is believing that a paradigm shift in
addiction science is possible and by alerting the reader to a forthcoming multi-authored book
in which the validity of the brain disease model of addiction is comprehensively examined.