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Views of Addiction Neuroscientists and Clinicians on the Clinical Impact of a ‘Brain Disease Model of Addiction’

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Abstract

Addiction is increasingly described as a “chronic and relapsing brain disease”. The potential impact of the brain disease model on the treatment of addiction or addicted individuals’ treatment behaviour remains uncertain. We conducted a qualitative study to examine: (i) the extent to which leading Australian addiction neuroscientists and clinicians accept the brain disease view of addiction; and (ii) their views on the likely impacts of this view on addicted individuals’ beliefs and behaviour. Thirty-one Australian addiction neuroscientists and clinicians (10 females and 21 males; 16 with clinical experience and 15 with no clinical experience) took part in 1 h semi-structured interviews. Most addiction neuroscientists and clinicians did not uncritically support the use of brain disease model of addiction. Most were cautious about the potential for adverse impacts on individuals’ recovery and motivation to enter treatment. While some recognised the possibility that the brain disease model of addiction may provide a rationale for addicted persons to seek treatment and motivate behaviour change, Australian addiction neuroscientist and clinicians do not assume that messages about “diseased brains” will always lead to increased treatment-seeking and reduced drug use. Research is needed on how neuroscience research could be used in ways that optimise positive outcomes for addicted persons.

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References

  1. Illich, I. 1976. Medical nemesis: the expropriation of health. New York: Random House.

    Google Scholar 

  2. Clarke, A.E., J.K. Shim, L. Mamo, J.R. Fosket, and J.R. Fishman. 2003. Biomedicalization: Technoscientific transformations of health, illness, and U.S. biomedicine. American Sociological Review 68: 161–194.

    Article  Google Scholar 

  3. Conrad, P. 1992. Medicalization and social control. Annual Review of Sociology 18: 209–232.

    Article  Google Scholar 

  4. Parr, J., and N. Rasmussen. 2012. Making addicts of the fat: obesity, psychiatry and the ‘fatties anonymous’ model of self-help weight loss in the post-war United States. Critical perspectives on addiction (series volume 14), 181–200. Bingley: Emerald Group Publishing Limited.

    Google Scholar 

  5. Midanik, L. 2006. Biomedicalization of alcohol studies: Methodological shifts and institutional challenges. New Brunswick: Transaction Publishers.

    Google Scholar 

  6. Netherland, J. 2011. “We haven’t sliced open anyone’s brain yet”: Neuroscience, embodiment and the governance of addiction. In Sociological reflections on the neurosciences (advances in medical sociology, volume 13), ed. M. Pickersgill and I. Van Keulen, 153–177. Bingley: Emerald Group Publishing Limited.

    Chapter  Google Scholar 

  7. Leshner, A.I. 1997. Addiction is a brain disease, and it matters. Science 278: 45–47.

    Article  Google Scholar 

  8. Volkow, N.D., and J.S. Fowler. 2000. Addiction, a disease of compulsion and drive: involvement of the orbitofrontal cortex. Cerebral Cortex 10: 318–325.

    Article  Google Scholar 

  9. McLellan, A.T., D.C. Lewis, C.P. O’Brien, and H.D. Kleber. 2000. Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation. Journal of the American Medical Association 284: 1689–1695.

    Article  Google Scholar 

  10. Volkow, N.D., and T.K. Li. 2004. Drug addiction: the neurobiology of behaviour gone awry. Nature Reviews Neuroscience 5: 963–970.

    Article  Google Scholar 

  11. ASAM. 2011. Public policy statement: definition of addiction (long Version). Chevy Chase, MD: American Society of Addiction Medicine; Contract No.: Document Number|.

  12. Cunningham, J.A., and J. McCambridge. 2012. Is alcohol dependence best viewed as a chronic relapsing disorder? Addiction 107: 6–12.

    Article  Google Scholar 

  13. Vrecko, S. 2010. Birth of a brain disease: science, the state and addiction neuropolitics. History of the Human Sciences 23: 52–67.

    Article  Google Scholar 

  14. Vrecko, S. 2010. “Civilizing technologies” and the control of deviance. BioSocieties 5: 36–51.

    Article  Google Scholar 

  15. Dackis, C., and C. O'Brien. 2005. Neurobiology of addiction: treatment and public policy ramifications. Nature Neuroscience 8: 1431–1436.

    Article  Google Scholar 

  16. Cunningham, J.A., L.C. Sobell, and V.M. Chow. 1993. What’s in a label? The effects of substance types and labels on treatment considerations and stigma. Journal of Studies on Alcohol 54: 693–699.

    Google Scholar 

  17. Moyers, T.B., and W.R. Miller. 1993. Therapists’ conceptualizations of alcoholism: measurement and implications for treatment decisions. Psychology of Addictive Behaviors 7: 238.

    Article  Google Scholar 

  18. Varney, S.M., D.J. Rohsenow, A.N. Dey, M.G. Myers, W.R. Zwick, and P.M. Monti. 1995. Factors associated with help seeking and perceived dependence among cocaine users. The American Journal of Drug and Alcohol Abuse 21: 81–91.

    Article  Google Scholar 

  19. Pescosolido, B.A., J.K. Martin, J.S. Long, T.R. Medina, J. Phelan, and B. Link. 2010. “A disease like any other?”: a decade of change in public reactions to schizophrenia, depression, and alcohol dependence. The American Journal of Psychiatry 167: 1321–1330.

    Article  Google Scholar 

  20. Kuppin, S., and R.M. Carpiano. 2006. Public conceptions of serious mental illness and substance abuse, their causes and treatments: findings from the 1996 general social survey. American Journal of Public Health 96: 1766–1771.

    Article  Google Scholar 

  21. Cunningham, J.A., J. Blomqvist, and J. Cordingley. 2007. Beliefs about drinking problems: results from a general population telephone survey. Addictive Behaviors 32: 166–169.

    Article  Google Scholar 

  22. Satel, S. 1999. The fallacies of no-fault addiction. Public Interest: Winter: 52–67.

  23. Satel, S. 2006. For addicts, firm hand can be the best medicine. New York Times. 15 August: http://query.nytimes.com/gst/fullpage.html?res=9D07E4DB173EF936A2575BC0A9609C8B63&scp=1&sq=For%20addicts,%20firm%20hand%20can%20be%20the%20best%20medicine&st=cse. Accesed 16 May, 2011. Archived at http://www.webcitation.org/62jXgGGxv on 27 October, 2011.

  24. Satel, S., and S. Lilenfeld. 2007. Medical misnomer: addiction isn’t a brain disease, Congress. Slate. 2 August: http://www.slate.com/articles/health_and_science/medical_examiner/2007/07/medical_misnomer.html. Accesed 2 August 2007. Archived at http://www.webcitation.org/62jYPAQv1 on 27 October, 2011.

  25. Satel, S.L. 2001. Is drug addiction a brain disease? In Drug addiction and drug policy: the struggle to control dependence, ed. P. Heymann and W. Brownsberger, 118–143. New York: Harvard University Press.

    Google Scholar 

  26. Davies, J.B. 1998. Pharmacology versus social process: competing or complementary views on the nature of addiction? Pharmacology & Therapeutics 80: 265–275.

    Article  Google Scholar 

  27. Herrman, H. 2001. The need for mental health promotion. The Australian and New Zealand Journal of Psychiatry 35: 709–715.

    Article  Google Scholar 

  28. Phelan, J.C. 2002. Genetic bases of mental illness—a cure for stigma? Trends in Neurosciences 25: 430–431.

    Article  Google Scholar 

  29. Kessler, R.C., C.B. Nelson, K.A. McGonagle, M.J. Edlund, R.G. Frank, and P.J. Leaf. 1996. The epidemiology of co-occurring addictive and mental disorders: implications for Prevention and Service Utilization. The American Journal of Orthopsychiatry 66: 17–31.

    Article  Google Scholar 

  30. Lam, D.C.K., P.M. Salkovskis, and H.M.C. Warwick. 2005. An experimental investigation of the impact of biological versus psychological explanations of the cause of “mental illness”. Journal of Mental Health 14: 453–464.

    Article  Google Scholar 

  31. Chapman, S., and R. MacKenzie. 2010. The global research neglect of unassisted smoking cessation: causes and consequences. PLoS Medicine 7: e1000216.

    Article  Google Scholar 

  32. Walker, M.J. 2010. Addiction and self deception: a method for self control? Journal of Applied Philosophy 27: 305–319.

    Article  Google Scholar 

  33. Carter, A., B. Capps, and W. Hall. 2009. Addiction neurobiology: ethical and social implications. Lisbon: European Monitoring Centre for Drugs and Drug Addiction.

    Google Scholar 

  34. Carter, A., and W. Hall. 2012. Addiction neuroethics: the promises and perils of neuroscience research on addiction. London: Cambridge University Press.

    Google Scholar 

  35. Rhodes, T., and R. Coomber. 2010. Qualitative methods and theory in addictions research. Addiction research methods, 59–78. Oxford: Wiley Blackwell.

    Book  Google Scholar 

  36. Dingel, M.J., K. Karkazis, and B.A. Koenig. 2011. Framing nicotine addiction as a “disease of the brain”: social and ethical consequences. Social Science Quarterly 92: 1363–1388.

    Google Scholar 

  37. Bammer, G., W. Hall, M. Hamilton, and R. Ali. 2002. Harm minimization in a prohibition context—Australia. Annals of the American Academy of Political and Social Sciences 58: 80–93.

    Google Scholar 

  38. Ritter, A., and J. Cameron. 2007. Australian clinician attitudes towards contingency management: comparing down under with America. Drug and Alcohol Dependence 87: 312–315.

    Article  Google Scholar 

  39. Meurk, C., A. Carter, W. Hall, and J. Lucke. 2012. Public understandings of addiction: the impact of addiction neuroscience research. Neuroethics under review.

  40. Morphett, K., J. Lucke, C. Gartner, A. Carter, C. Meurk, and W. Hall. 2012. Public attitudes towards the treatment of nicotine addiction. Nicotine and Tobacco Research under review.

  41. Pinto, R.M., G. Yu, A.Y. Spector, P. Gorroochurn, and D. McCarty. 2010. Substance abuse treatment providers’ involvement in research is associated with willingness to use findings in practice. Journal of Substance Abuse Treatment 39: 188–194.

    Article  Google Scholar 

  42. Sartorius, N. 2010. Short-lived campaigns are not enough. Nature 468: 163–165.

    Article  Google Scholar 

  43. Racine, E., S. Waldman, N. Palmour, D. Risse, and J. Illes. 2007. “Currents of hope”: neurostimulation techniques in U.S. and U.K. print media. Cambridge Quarterly of Healthcare Ethics 16: 312–316.

    Google Scholar 

  44. Singh, J., J. Hallmayer, and J. Illes. 2007. Interacting and paradoxical forces in neuroscience and society. Nature Reviews Neuroscience 8: 153–160.

    Article  Google Scholar 

  45. Racine, E., S. Waldman, J. Rosenberg, and J. Illes. 2010. Contemporary neuroscience in the media. Social Science and Medicine 71: 725–733.

    Article  Google Scholar 

  46. Weisberg, D.S., F.C. Keil, J. Goodstein, E. Rawson, and J.R. Gray. 2008. The seductive allure of neuroscience explanations. Journal of Cognitive Neuroscience 20: 470–477.

    Article  Google Scholar 

  47. McCabe, D.P., and A.D. Castel. 2008. Seeing is believing: the effect of brain images on judgments of scientific reasoning. Cognition 107: 343–352.

    Article  Google Scholar 

  48. Greene, J.D., R.B. Sommerville, L.E. Nystrom, J.M. Darley, and J.D. Cohen. 2001. An fMRI investigation of emotional engagement in moral judgment. Science 293: 2105–2108.

    Article  Google Scholar 

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Acknowledgments

The research presented in this paper was funded by Fellowships awarded to Dr Carter and Professor Hall by the National Health and Medical Research Council of Australia (Grant IDs 628935 and 569738 respectively). We would like to thank Anke Snoek, Carla Meurk and Daniel Buchman for comments on an earlier draft of this paper.

Declaration of Conflicting Interests

The Authors declare that there is no conflict of interest.

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Authors and Affiliations

  1. University of Queensland Centre for Clinical Research, The University of Queensland, QLD, 4029, Brisbane, Australia

    Stephanie Bell, Adrian Carter, Rebecca Mathews, Coral Gartner, Jayne Lucke & Wayne Hall

  2. Queensland Brain Institute, The University of Queensland, QLD, 4029, Brisbane, Australia

    Wayne Hall

  3. University of Queensland Centre for Clinical Research, Royal Brisbane and Women’s Hospital Campus, The University of Queensland, Herston Road, Herston, Brisbane, Queensland, 4029, Australia

    Adrian Carter

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  1. Stephanie Bell
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Correspondence to Adrian Carter.

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Bell, S., Carter, A., Mathews, R. et al. Views of Addiction Neuroscientists and Clinicians on the Clinical Impact of a ‘Brain Disease Model of Addiction’. Neuroethics 7, 19–27 (2014). https://doi.org/10.1007/s12152-013-9177-9

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  • DOI: https://doi.org/10.1007/s12152-013-9177-9

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