Substance addiction is commonly described as a “chronic, relapsing brain disease,” both in scientific and public discourse, and has been compared to other chronic diseases such as hypertension or diabetes. However, conceptualizing addiction as a “disease” has faced growing criticism due to weak empirical support and its focus on individual, rather than psychosocial, contributors to addiction.
A new article in Lancet Psychiatry takes aim at the brain disease model of addiction (BDMA), arguing that its scientific foundation is weak and that it has distracted public health efforts from more promising, systemic solutions. The article, led by Chrysanthi Blithikioti of the University of Padova, and co-authored by Eiko Fried, Edoardo Albanese, Matt Field, and Ioana A. Cristea, calls for a major rethinking of how addiction is understood and treated. They write:
“By framing addiction primarily as an individual problem, the BDMA has contributed to obscuring the broader societal and systemic factors at play. Beyond finding cutting-edge cures for addiction that often result in a small advantage for a limited subgroup of patients, the real challenge lies in confronting and dismantling the systemic barriers that prevent us from effectively leveraging existing knowledge to address patients’ living situations, including material conditions, families, social networks, and all other factors that give meaning to people’s lives.”
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This is a classic case of a proper criticism of existing theory and practice with no real idea of what would be better.
People from all walks of life get addicted to all sorts of substances. While it would be great to improved social support systems for all who are suffering, these people need an effective way to end their addictions. The best way I am aware of is delivered by Narconon, but of course this is not mentioned. This method requires live-in patients and months for them to get through the full program. Thus, only financially able people can afford it.
The big challenge generally speaking is to bring effective treatments to those who currently cannot afford them.
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