Decision-making is a complex activity for which emotions and affects are essential. Maladaptive choices depend on negative affects. Vulnerabilities to drug or non-drug objects depend on previous psychopathological comorbidities. Premorbid individual characteristics allow us to understand why some individuals enter into the addiction cycle. Moreover, plasticity of reward neurocircuitry is, at least in past, responsible for these vulnerabilities leading to compulsive drug use.

Structure entails arrangements and interrelations of parts that organize the whole (i.e., personality). It involves stability of traits over time. Extraversion varies along a continuum towards introversion. Multiple behavioral and biological variables in several systems vary and are regulated homeostatically within the normal range. If there is a fixed point for an individual, what inhibits variation in the biological parameter?

The adaptive use of drugs, or is presented as a reality that the scientific literature has largely ignored. In this commentary, we demonstrate why this concept has limited value from the standpoint of nosology, why it should not be viewed as and why it has dangerous implications for policy and public health efforts.