Disease Model of Addiction Lacks Empirical Support, New Study Finds

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.”