Chapter 27 Balancing the ethical and methodological pros and cons of the BDMA


As scientific research is always to some extent value laden, addiction research carries (ethical) implications for science, society and the individual. The brain disease model of addiction (BDMA) narrows down the kinds of questions formulated, the kinds of data produced and utilized, and the types of explanations considered satisfactory. Our chapter provides an overview of the ethical and methodological pros and cons of the brain disease model of addiction.

Although there are good reasons to link many facets of addictive behavior to functional and physiological changes in the brain, overly reductive conceptualization of these behaviors is liable to miss crucial environmental and social determinants of addiction. Perhaps more importantly, if taken as the sole explanatory model and the basis for the design of interventions, BDMA may lead to self-defeating therapeutic and regulative practices by downplaying the person-level agency of the individual and the importance of social scaffolding in recovery.

We suggest new ways in which the conceptual and communicative tensions arising from BDMA can be better addressed.


Susanne Uusitalo - ORCiD:

Jaakko Kuorikoski - ORCiD:


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