From reidl@rpi.eduTue Sep 9 17:02:57 1997 Date: Tue, 9 Sep 97 16:37:16 +0200 From: Larry Reid To: Selmer Bringsjord Subject: Re: neuro project needed. Dear Selmer: I found a disk with a slightly more complete paper than the one I sent to you. Somewhere, someplace, totally unknown to me, there is a more complete paper. This is the best I can do currently to provide the beginnings of a paper of models of addiction. I am more than happy to have you do anything you wish with this material. Perhaps, in retirement, I might have decided to work on this paper, but I do not see me working on the paper anytime this year. So, if Jim, Mike or anyone else wants to polish the paper for consideration as a publication or as a focus of discussion that is surely O.K. Here it is: A REVOLUTION IN THE SCIENCE OF ADDICTIONS Larry D. Reid Rensselaer Polytechnic Institute This brief note sketches the recent historical development of our theories of addiction, particularly addictions to drugs such as morphine, cocaine, ethanol, and nicotine. The case is made that, across the recent decades, such developments constitute a sufficiently radical shift in thinking to qualify for status as a scientific revolution in pharmacology. The shift in thinking, in fact, has been sufficiently revolutionary to make the study of addictions more than a subspeciality of pharmacology and place such study into a broader framework nutured by disciplines such as neuroscience and psychopharmacology with healthy contributions by social sciences. The idea of scientific revolutions, as a way of describing scientific progress, was popularized by Thomas S. Kuhn in his influential book The Structure of Scientific Revolutions (ref). The essence of this way of characterizing scientific progress is that science progresses by stages. First, there is a baseline level of what Kuhn terms normal science in which there is a dominant paradigm guiding the work of individual scientists. Then, there is a period during which anomalies (observations and results of experiments) accrue that do not fit within the dominant paradigm. There is, then, sufficient accumulation of anomalous findings to form a crisis which, in turn, weakens the extant dogma (extant paradigm). Then, there is revolution. One indexes that a revolution has occurred by the establishment of a new paradigm (a paradigmatic shift) with the proponents of the new paradigm gaining control over the social structures of normal science (in our day, control over granting agencies, editorships of journals, and being touted as experts). The new theory replaces the old theory as the explanation of the phenomena in question in standard textbooks. Progress in science qualifies as being revolutionary if it overthrows an entrenched orthodoxy, engenders resistence, and, results in a obvious break with the past. The participants in the revolution, if it is a revolution, must have a sense that revolutionary change has occurred and not consider that the resulting progress is part of the normal day-to-day progress of a scientific enterprise. Usually, talk of scientfic revolutions involves rather grand schematic changes such as the Copernican Revolution or the Behaviorist Revolution within psychology. Here, we apply the concept of revolutionary change to a much smaller domain of science, the science associated with understanding addictions. The Prerevolutionary View Given that the problems associated with addictions to drugs have been extant since the time of recorded history, almost all ideas about their nature (including our most modern ideas) has ancient historical roots. A consideration of the complete history of these ideas is not germane to this discussion. Our history begins with a consideration of the scientific view of addictions as represented by the dominant science of addictions as expressed by the scientific, medical community working on the problems following World War II, i.e., during the decades of the '40s, '50s, and '60s. The beginnings of what I am purporting to be a revolution began in the '60s, and was nutured during the '70s and '80s. I see that the revolution is virtually complete by the early '90s. The Appearance of Anomaly and Crisis The Emergence of Alternative Concepts The Postrevolutionary View Before we describe the new paradigm of the science of addictions, it is necessary to say something about whether or not a revolution has, indeed, occurred in terms that historians of science take as evidence. Are, for example, the social structures associated with the science of addictions dominated by advocates of the new way of thinking? I will leave to the socologists of science to completely document this aspect of our considerations. Here, I will mention only a few of the most obvious signs that a revolution has occurred in terms of the social structure. Professor Charles Schuster was appointed the Director of the National Institute on Drug Abuse in 19xx. Professor Schuster, prior to his appointment, was a professor of psychology and psychiatry at the University of Chicago where he had done considerable research on drug self-administration. Professor Roy Wise gave a seminal address at the 1990 meeting of the Society for Neuroscience documenting the new paradigm. The Social Context of the Scientfic Revolution Some Thoughts for Historians of Science As we traced this small putative case for a scientific revolution, a number of features emerged that are usually not considered by those inspecting the nature of scientific progress. A consideration of these features, it seems to me, add considerably to the overall consideration of the nature of scientific progress. One of those considerations is discussed above, i.e., the social context of this particular revolution. As mentioned, the impetus for a reconsideration of the ideas of addictions was the health and social problems engendered by the epidemic rise in use of illegal drugs in the United States during the '60s. There was also, relatedly, a growing recognition that a number of problems of public health were directly related to the widespread use of addictive agents. There was, for example, the recognition that the effects of using tobacco products contributed substantially to the incidence of lung cancer. There was, for another example, a marshalling of evidence that extensive use of alcoholic beverages contributed substantially to mortality associated with automobile accidents. The convergence of evidence indicating that the addictions and their consequences were the Nation's most serious health and social problems (and the recogition that available treatments were not efficacious) provided the impetus for a considerably expanded flow of money directed toward resolving the issues. This money, in turn, encouraged other scientists, from disciplines usually not considering the issues, to consider the problem. This, in turn, provided new perspectives which were vital to the revolutionary change in ideas. I suspect that as historians of science begin the inspection of scientific progress on a less grand scale than they have in the past, they will see a greater connection among the emergence of health and social problems (and the concommitant response of devoting new resources to resolve those problems) and scientific progress. If practical problems are the mother of invention, I suspect that practicle problems are also going to be the mother of scientic revolutions. I also suspect that the equivalent of mother's milk for nuturing offsping will be the money that flows for nuturing research. It is no revolutionary idea that science is part and parcel of the greater social structure. The consideration of scientific revolutions, however, has been sort of disembodied. The consideration has focused on great ideas as if they occurred without the press of trying to understand and resolve real problems. I suspect that scientific revolutions flow from common responses to real problems and represent merely one aspect of the adaptive response of people as they face new dangers. Another aspect of consideration of this scientific progress, that seems to be a feature worth considering from a history of science perspective, is that this progress involved one discipline (psychology) considering another discipline's (pharmacology's) problem. I supect that this interdisciplinary feature will become more characteristic in the future. Usually, however, the case seems to be made that a more molucular view infuses strength to a more molar view as when molucular biology infuses new strength to such topics as evolution. The converse can also be the case, a more molar view can infuse new strength to a system using more reductionistic procedures. Another aspect worth considering is that this scientific revolution really did not take hold with the mere accumulation of anomalies. It seemed that new theory, including some ideas of mechanisms involved (in this case, ideas about the reward mechanisms of brain), had to be extant before the intellectual crisis was recognized. I suspect that until an alternative way of viewing the issues begins to emerge that the extent of the problems with the old way of viewing the problem just do not emerge as salient. Scientific progress, if this case study is applicable, is more apt to appear, upon closer inspection, to be more continuous than is characterized by those who enjoy the drama of thinking about revolutions. I suspect that it is not as glamorous to think of scientific progress as just being the accumulation of a lot of hard work and good thinking as it is to fashion progress in terms of revolutions (Leahey, 1992). Nevertheless, it seems that, given a bent for discussing progress in terms of revolutions, a scientific revolution has occurred in the science of addictions. REFERENCES Kuhn, T.S. (1970). The structure of scientific revolutions (Rev. ed.). Chicago: University of Chicago Press. (Orginal work published 1962). Leahey, T.H. (1992). The mythical revolutions of American psychology. American Psychologist, 47 (No. 2), 308-318.