Progressing from Simple to Multidimensional Models Towards a Biopsychosocial Framework of Addiction

Neuroscientific models of addiction have progressed from simple dopamine-based explanations to more complex frameworks involving multiple brain circuits and systems. Recent evidence shows that addiction alters large-scale brain networks and that social, psychological, and developmental factors play a more central role than previously recognized. New treatments, such as psychedelic-assisted therapies, highlight the need for changes across biological, cognitive, and emotional levels. The authors argue that viewing addiction as a multilevel, interactive biopsychosocial process better accounts for differences in how addiction develops and resolves, and can guide more precise and effective interventions.

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Abstract

Purpose of Review: Neuroscientific models of addiction have evolved over the past four decades from single-circuit dopamine frameworks to dual-process, tripartite, and multidimensional accounts. Despite these advances, existing models incompletely account for the lived experience of addiction and for developmental, social, and mental-health factors that contribute to heterogeneity in risk and outcome. This review synthesizes this progression and evaluates the need for more integrative frameworks. Recent Findings: Recent work highlights addiction-related alterations in large-scale brain networks and demonstrates that psychosocial and contextual factors play a more central mechanistic role than previously acknowledged. Emerging interventions, including psychedelic-assisted therapies, further underscore the relevance of multilevel change across neurobiological, cognitive, and affective domains. Summary: Framing addiction as a multilevel, interactive process within a biopsychosocial framework provides a unifying perspective that accommodates heterogeneity in pathways and outcomes. Integrative models may better inform mechanistic research and guide the development of more precise, clinically meaningful interventions.