These two models were the moral model and the disease model. In response to the widespread idea of sin addicts, the “disease of addiction” emerged that eliminated the burden of guilt on the substance user. For much of the 20th century, theories of addictive behavior and motivation polarized between two models. The first model saw addiction as a moral failure for which addicts are held responsible and judged accordingly.
The second model, on the other hand, considered addiction as a specific brain disease caused by neurobiological adaptations that occur in response to chronic drug or alcohol use, and over which addicts have no choice or control. As our ability to observe neurobiological phenomena improved, the second model became scientific orthodoxy, increasingly dominating addiction research and informing the public about addiction. The articles in this research topic aim to go beyond the polarization between competing models of moral addiction and disease. Satel and Lilienfeld (in “Addiction and the Brain-Disease Falacy”) directly challenge the disease model, drawing on historical and clinical data to argue that addicts respond to incentives and use drugs for reasons, so addictive behavior should be understood as an option.