Efectos del enriquecimiento ambiental en la recuperación de la adicción: ni enfermedad, ni crónica ni recidivante

  1. José María Ruiz Sánchez de León
Revista:
Revista española de drogodependencias

ISSN: 0213-7615

Año de publicación: 2022

Título del ejemplar: Monográfico: Hacia un nuevo paradigma en adicciones

Número: 47

Páginas: 144-165

Tipo: Artículo

Otras publicaciones en: Revista española de drogodependencias

Resumen

En el presente trabajo se analizan de manera crítica los axiomas sobre los que se apoya el modelo de enfermedad cerebral de la adicción: i) es una enfermedad, ii) está determinada genéticamente, iii) se desarrolla irremediablemente por las drogas, iv) se explica por el valor que se otorga a la recompensa, y v) se mantiene por evitación de la abstinencia. Se sostiene que, a la luz de los hallazgos científicos y bajo el prisma del sentido común, cada uno de sus axiomas resulta falsable. Se discute sobre la idea -habitualmente sostenida- de que autoadministrarse droga, comer un exceso de comidas palatables o jugar persistentemente a videojuegos produce una enfermedad incurable en las personas porque sus cerebros sufren cambios irreversibles tras la ejecución repetida del hábito. Posteriormente, se deconstruye la definición clásica de la adicción como enfermedad crónica y recidivante analizando los datos epidemiológicos sobre la supuesta cronicidad y recidiva, aportando evidencias de la recuperación como, de hecho, el curso espontáneo más probable. Finalmente, y como hilo conductor de todo el trabajo, se propone el enriquecimiento ambiental como enfoque terapeútico y precursor del cambio de paradigma. Se concluye aportando ideas sobre la necesidad de construir un mejor modelo biopsicosocial que optimice sustancialmente la respuesta asistencial que se ofrece a las personas que han desarrollado una adicción.

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