Talk:Issues in Interdisciplinarity 2019-20/Evidence in Addiction

Group contribution
Introduction: written together by Anna and Rita

Neuroscience: written by Adèle

Economics: written together by Charlotte and Rita

Psychology: written by Anna

Combining Evidence in Government Intervention: written together by Adèle and Charlotte

Overall editing: done throughout all members of the group

drafts
Anna and Rita

Addiction is a complex topic which has created a lot of controversy over its meaning, effects and treatment methods. The topic of addiction has yielded a lot of research from several different disciplines: Neuroscience, Psychology and Economics. Due to the different methodologies, sources, intent and data used by the disciplines, the issue of evidence has created tensions between the disciplines. However, when brought together, they can facilitate a more holistic understanding of the cause, nature and effect of addiction and therefore make useful contributions to government decisions on interventions to decrease the harm caused by it. Just as addiction has various effects on individuals and their surroundings, addiction is studied across several disciplines. Neuroscience, Psychology and Economics are three examples of disciplines with particular interest in the study of addiction. Through their different models and methodologies, they produce different evidence describing different aspects of addiction and its effects. Brought together, it can facilitate a more holistic understanding of the cause, nature and effect of addiction and therefore make useful contributions to government decisions on interventions to decrease the harm caused by it.

possible paragraph: looking at the difference/ tensions between real world (historical and stat) evidence vs hypothetical/ social experiment/ model evidence. hypothetical psychological models which show pattern of behaviour can sometimes not work in real life. e.g. number of deaths due to overdose could be in those with addictions but also many first time users who have limited education and take drugs of high potency/ impurities etc. genetics - contribute to higher dopamine levels naturally which doesn't directly cause addiction however it can cause more high risk behaviour leading to the possibility of drug use ( psychological argument but the wider context has to be considered.)

Conflict between qualitative (ex psychology) and quantitative (ex neuroscience) evidence. - language: what is the definition of addiction

physical effect on brain e.g. release of dopamine can equal addiction however from a psychological perspective can look at the meaning of addiction e.g effect on relationships, spending, quality of life. These view points can be created using either quantitative evidence or qualitative evidence. methodologies.

essential to combine evidence to have different uses: clinical use (drugs against addiction) but also psycho therapies - is the evidence representative and does it have meaning (e.g. for clinical use). Combining evidence from different disciplines enables a more efficient treatment against addiction.

Quantitative evidence can sometimes be more easily obtained for alcohol and opiate addictions because, as depressant drugs, they are the only ones which will exhibit physical withdrawal symptoms. How can we measure e.g. a gambling addiction. addiction has a relationship with environment. All physical symptoms of addiction can disappear after withdrawal however what is causing the addiction will still be there - must look from a wider context (a psychological approach).

behavioural economics - war on drugs - shipments of drugs obviously can contribute to addiction however due to the economic situation, complete control of drugs is near impossible. estimated worth of the UK drug market is £5 billion however in reality it is much more (the illegality means the economic evidence can never be truly valid and therefore cannot always reflect the relationship between economic trends and addiction.

Psychological methods for obtaining evidence: negative and positive reinforcement models suggest that people become addicted to substances to gain the positive reward and to avoid the negative withdrawal effects. this model has limitations as drugs such as psycho-stimulants do not produce any withdrawal symptoms. this shows how in psychology models are constantly edited (process of elimination).

Limitations of quantitative methods used in neuroscience (brain imaging): can’t measure emotions, perception (interpretativist) - can you extrapolate results from primate testing to apply to humans, with more complex society and interactions?

Possible Structure:

Introduction: Each of the disciplines uses specific methodologies and different types of evidence to support theories (with some overlaps) - focus more on positivist/interpretivist approaches using qualitative/quantitative evidence (usually a combination of both) Understanding real world complex problems - need a combination of evidence and methodology

1. Neuroscience evidence >already have a good start by Adele

2. Economic evidence >Lotti and Rita

3. Psychology (as a possible overlap with both) >Adele and Anna

4. Government decision making in the real world - what types of evidence should be used to inform decisions > come together to draw together research

Conclusion: To respond to rising levels of addiction, the disciplinary methods and evidence need to be combined to give governments the best understanding ...

Difference between drug addiction and dependence is defined by DrugRehab.com as “compulsively seeking the medication despite obvious harms” But this is a source with a specific aim (curing drug addiction)... worth considering if the definition of ‘addiction’ varies depending on the organisation/research aims.

Economics

Evidence for addiction in Economics usually focuses on addiction in the case of drugs, including illegal substances as well as alcohol and tobacco - does psychology and neuroscience take a more varied base of evidence for addiction, not just to substances but to social media, excercise, sex etc...??

Economic article which has a section on government policy-making - can use it later: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2896982/pdf/nihms188513.pdf

Economic models and research methodologies can bring about:

-	Quantitative evidence of quantities consumed of addictive substances (simple demand/supply models)

-	Quantitative evidence of consumers’ behavior in response to price change of the addictive substances (price elasticity of demand)

-	Quantitative evidence of the effectiveness of government legislation on quantity demanded (and therefore consumed) over time (simple supply/demand) ex: cigarette pricing in Australia >> https://www.tobaccoinaustralia.org.au/chapter-13-taxation/13-5-impact-of-price-increases-on-tobacco-consumpt

-  Quantitative evidence of the cost of consumption of addictive substances (to economy?); direct costs include medical costs but also costs of social services and informal care while indirect costs include "premature mortality, short-term absence, early retirement, crime-related costs" >> https://link-springer-com.libproxy.ucl.ac.uk/content/pdf/10.1007%2Fs10198-005-0282-5.pdf

However, purely quantitative economic evidence has weaknesses:

-	Fails to distinguish between misuse/dependence/addiction of consumers to the studied product, as it doesn’t consider individuals’ life circumstances

-	Lack of data for illegal substances makes it difficult to make precise estimates

Possibly helpful paper: https://books.google.co.uk/books?hl=de&lr=&id=5hZY4e0L_OcC&oi=fnd&pg=PR9&dq=economics+addiction&ots=m16zNpDA3T&sig=CTBjt6Xda0__D_nm3ruz3Pt4ztk&redir_esc=y#v=onepage&q=economics%20addiction&f=false

Several economic models and methodologies are used in producing evidence contributing to studies of addiction. Cost-of-illness methodologies give rise to quantitative evidence of the costs to a nation generated by consumption of addictive substances. These encompass both direct costs, such as those of health-care and social services, as well as indirect costs such as premature mortality, early retirement and costs relating to crime (CITE). Limitations in the cost-of-illness methodology include difficulties in making precise estimations, especially for the indirect costs (CITE). Additionally, these indirect costs do not contain all negative effects of addiction, for instance on family members of the one affected. Simple demand/supply models can show hypothetical information but also real world quantitative evidence of quantities of addictive substances consumed and consumer’s behavior to price changes of these substances. Price elasticity models can then more specifically compare the ratio of change in quantity consumed to change in price, giving a more precise idea of the behavior of consumers of addictive substances (CITE).

Ideas for Part on Government Intervention:

Economics study a whole market rather than individuals, and economic evidence is therefore very valuable to consider when making policies that will affect a whole society (Caulkin). >> Should compliment not dominate study of addiction. Combined with psychological evidence focusing on individuals gives more complete idea of the problem.

Moreover, economic models can not only consider real-world case studies but also the hypothetical, which should be useful in foreseeing the possible impact of certain policies (Caulkin). It is difficult, however, to make precise estimations, especially for the consumption of illegal substances.