The future of addiction psychiatry

Addiction remains one of the most complex challenges in psychiatry, marked by conceptual ambiguity and persistent treatment gaps. Advances in neuroscience, genetics, neuroimaging and artificial intelligence have deepened understanding of reward circuitry, vulnerability and relapse trajectories, yet controversies endure regarding whether addiction is best conceived as disease, disordered choice or socially constructed phenomenon. This article aims to synthesize current debates and outline future perspectives in addiction psychiatry through an integrative framework that bridges biological, technological, systemic and humanistic approaches. Findings highlight the promise and limitations of precision psychiatry, pharmacogenetics and neurocircuit-guided interventions, as well as the ethical and equity challenges of AI-based tools and biomarker-driven approaches. Novel consumption forms (dual vaping, synthetic cannabinoids) demand adaptive clinical and regulatory responses. Values-based practice and phenomenological psychiatry emerge as essential for truly person-centered care. The future of addiction psychiatry lies in integrating science, technology, humanism and values to deliver ethically grounded, patient-centered and socially responsive care.