This page contains links to the chapter abstracts in the Opposition section of the book: Evaluating the Brain Disease Model of Addiction.

  • Chapter 08, Introduction to Section II
    Abstract Section II of the book is devoted to criticisms that have been made of the BDMA. The 15 chapters in this section, some reprinted from previous literature but most original works, offer a collection of arguments that challenge the BDMA on four basic grounds: (i) the BDMA has not produced the benefits for the […]
  • Chapter 09 Giving the neurobiology of addiction no more than its due
    Abstract In 2015, we published an article in the Lancet Psychiatry critiquing the prevailing view in the USA that addiction was a chronic and relapsing brain disease. The brain disease model of addiction had been widely promoted by the US National Institute of Drug Addiction, resulting in significant changes in policy and professional position statements, […]
  • Chapter 14 Recovery is possible: Overcoming ‘addiction’ and its rescue hypotheses
    Abstract This chapter suggests that the core assumption underpinning the brain disease model, as well as other leading theories of addiction, is fundamentally flawed: addiction does not change the basis of human behavior for specific activities. It details how dominant approaches to addiction illogically assume that people can exercise volitional control over certain behaviors and […]
  • Chapter 15 Superpower rivalry, the American Grand Narrative, and the BDMA
    Abstract Both the scientific support and the therapeutic utility of the Brain Disease Model of Addiction (BDMA) have been fundamentally challenged by established scientists and scholars. Nonetheless, the BDMA continues to dominate mainstream governmental, professional, and public discourse on addiction within the United States and in much of Europe and Canada. But why? Unraveling this […]
  • Chapter 16 My brain disease made me do it: Bioethical implications of the brain disease model of addiction
    Abstract This chapter reviews basic ideas and principles of bioethics and examines the bioethical implications of the brain disease model of addiction (BDMA) based on the assumption that the BDMA is a valid and accurate representation of the causes of addiction. Utilizing the framework of Principlism developed by Beauchamp and Childress, the chapter raises questions […]
  • Chapter 17 Addiction is a human problem but brain disease models divert attention and resources away from human level solutions
    Abstract Neuroscience and other brain disease models of addiction are highly selective, seductive and visually alluring. Consequently, they lead to neglecting or ignoring the awkward complexities of the human level, which include irrationality, emotionality, spin, knowledge as power, politics, and the mutability of discourse. The human level is essential for understanding addiction. Examining opiate and […]
  • Chapter 18 Before “rock bottom”? Problem framing effects on stigma and change amongst harmful drinkers
    Abstract Under the disease model of alcoholism, “rock bottom” represents the point at which problem drinkers hit a low, after which denial is overcome and recovery begins. More specifically, the brain disease model of alcoholism implies those with the disease have a distinct pathology. However, a far broader population of drinkers experience harm without conforming […]
  • Chapter 19 Brain change in addiction: Disease or learning? Implications for science, policy and care
    Abstract The "brain-disease" model of addiction highlights changes in brain systems that mediate action, reward-acquisition, perception, and cognitive control. Despite its popularity in some sectors, many addiction researchers reject the disease definition and instead view addiction in terms of learning and environmental variables. "Non-disease" approaches typically omit the brain from any role in explaining addiction. […]
  • Chapter 20 Brains or persons? Is it coherent to ascribe psychological powers to brains?
    Abstract This chapter examines the brain disease model of addiction and its claim that the brain disease involves ‘hijacking’ decision-making, prioritizing, wanting, desiring, choosing, and calculating benefit. The literature speaks of these capacities as though they were predicates of the brain, or more usually parts of the brain. It is said that the pre-frontal cortex […]
  • Chapter 21 The persistence of addiction is better explained by socioeconomic deprivation related factors powerfully motivating goal-directed drug choice than by automaticity, habit or compulsion theories favored by the brain disease model
    Abstract Since its inception, the brain disease model of addiction (BDMA) has iteratively explained the puzzle of addiction (why drug use persists despite harms) by appealing to various automaticity accounts, including (but not limited to) automatic cue reactivity, habit and compulsion theories. The current chapter evaluates this claim of the BDMA by reviewing studies which […]
  • Chapter 22 Addiction and criminal responsibility: The law’s rejection of the disease model
    Abstract The chapter first provides a positive account of the law’s general concept of the person and responsibility doctrines. It then turns to the argument against the “no choice” claim that seemingly follows from the brain disease model. The next section considers the current legal response to addiction in the United States and, to a […]
  • Chapter 23 One cheer for the brain disease interpretation of addiction
    Abstract The brain disease interpretation of addiction has won the allegiance of national and international health organizations, the media, and clinicians, yet it remains controversial among addiction researchers. This chapter tests three brain-disease claims: (1) drug use is involuntary in those who meet the criteria for dependence, (2) drug and alcohol dependence are chronic disorders, […]
  • Webinar: Retiring the Brain Disease Model of Addiction. And Then What?
    ATN Webinar: Retiring the Brain Disease Model of Addiction. And Then What? Featuring:  Bruce K. Alexander When? 19/04/2022; 1600-1730 Edinburgh; 0800 Vancouver; 1100 New York; 1700 Paris Update: Full webinar video now available at ATN Webinar featuring Bruce Alexander Retiring the Brain Disease Model of Addiction BDMA And Then The free event will be held via […]