Theory 19/Life, Medicine & Mind /Addiction science
Addiction Is a Competition
Addiction is modelled as a drug-driven process. It may be a comparison that drugs win.
Compulsive use emerges when the value of the drug exceeds the value of alternatives by a threshold, so interventions that raise alternative value should reduce use more than interventions that lower drug value.
01The evidence
Drug use falls when alternatives are enriched in animal models and in human contingency management, which is a competition effect.
02The tension
Models emphasise drug reinforcement and cue reactivity. Those predict use from the drug's own value and treat alternatives as context.
03The mechanism
Choice is comparative. A drug is chosen when its expected value exceeds the best available alternative, so the threshold for compulsion depends on what else is available.
That makes alternative value the lever, and predicts that enrichment should reduce use even when drug value is unchanged.
04What this is not
Those models focus on the drug. This focuses on the comparison, which explains contingency management.
05Predictions
- P1Use should fall as alternatives rise.
- P2Enrichment should beat drug-value reduction.
- P3The threshold should shift with alternative quality.
06Refutation
Use independent of alternative value would favour reinforcement models.
07What it changes
It would shift treatment toward contingency and enrichment.