Book Review February 25, 2015

Theory of Addiction, 2nd ed

Pedro Ruiz, MD

J Clin Psychiatry 2015;76(2):e235

Article Abstract

Because this piece does not have an abstract, we have provided for your benefit the first 3 sentences of the full text.

The first edition of Theory of Addiction, published in 2009, reviewed the major theoretical approaches that try to explain the range of phenomena we call addiction and synthesized them into an overarching theory that attempts to capture their core functions. Key topics such as conscious choice, powerful desires, and attempts to self-control were all well addressed in the first edition.

Revisions in the second edition focus on the following:

Theory of Addiction, 2nd ed

by Robert West and Jamie Brown. In book series: Addiction Press. Wiley Blackwell, New York, NY, 2013, 272 pages, $51.95 (paper).

The first edition of Theory of Addiction, published in 2009, reviewed the major theoretical approaches that try to explain the range of phenomena we call addiction and synthesized them into an overarching theory that attempts to capture their core functions. Key topics such as conscious choice, powerful desires, and attempts to self-control were all well addressed in the first edition.

Revisions in the second edition focus on the following:

  1. Updating the definition and conceptualization of addiction
  2. Updating the theoretical descriptions of the literature
  3. Offering new functional classification of new theories and models of addiction
  4. Offering a description of core concepts involved in these theories
  5. Updating the description and understanding of the synthetic theory of addiction (PRIME Theory) to offer clarity and to take accounts of new observations
  6. Understanding PRIME Theory in the light of new evidence
  7. Focusing on PRIME Theory motivation within the context of a more general theory of behavior that also incorporates capability and opportunity

This book takes you on a journey; that is, it starts with the simple understanding of the theory of addiction and continues into the understanding of how addiction develops, who becomes addicted, what they become addicted to, and how some of them are able to recover. The goal is to arrive at a theory that is comprehensive yet parsimonious, coherent, and useful. Clearly, additional aims of this volume are to encourage research efforts and to guide clinicians and policy makers toward better ways of tackling this global challenge. As new evidence emerges and better ways of explaining the evidence are brought to light, the theory will need updating.

In essence, Theory of Addiction creates a draft of a synthetic theory of addiction; it argues that the function of the brain has evolved to be inherently unstable, and it conveys a sense that this pattern of activity can be understood in terms of the concept of the “epigenic landscape”—that addiction develops in susceptible individuals from a failure to balance inputs leading the motivational system. This book also recognizes that a disorder of motivation, such as addiction, can arise from different causes. Further, this book proposes a change to the diagnoses of addiction and also suggests an approach to the development of population-level interventions to prevent or control addictive behavior that takes account of the whole of the motivational, including impulses, desires, evaluations, and plans.

I enjoyed reading this book and strongly recommend that it be read by all professionals working in the field of addiction.

Pedro Ruiz, MD

[email protected]

Author affiliations: Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida.

Potential conflicts of interest: None reported.