Substance use disorders represent one of the most complex, persistent, and misunderstood challenges confronting contemporary mental health systems. Despite decades of scientific advancement, clinical innovation, and public health investment, addiction continues to impose profound individual, familial, and societal costs. Its chronic, relapsing nature, high comorbidity with psychiatric disorders, and deep entanglement with social, cultural, and developmental factors make it fundamentally different from many other medical or psychological conditions. Yet, treatment systems across much of the world still rely on fragmented, reductionist, and often outdated models that fail to capture the full psychological reality of addiction.Historically, addiction has been conceptualized through shifting paradigms: first as a moral failing, later as a behavioral problem, and more recently as a chronic brain disease. Each of these perspectives has contributed valuable insights, yet none alone has proven sufficient to guide comprehensive and sustainable treatment.
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