Disease or Developmental Disorder: Competing Perspectives on the Neuroscience of Addiction
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Lewis’ neurodevelopmental model provides a plausible alternative to the brain disease model of addiction (BDMA) that is a dominant perspective in the USA. We disagree with Lewis’ claim that the BDMA is unchallenged within the addiction field but we agree that it provides unduly pessimistic prospects of recovery. We question the strength of evidence for the BDMA provided by animal models and human neuroimaging studies. We endorse Lewis’ framing of addiction as a developmental process underpinned by reversible forms of neuroplasticity. His view is consistent with epidemiological evidence of addicted individuals ‘maturing out’ and recovering from addiction. We do however hold some reservations about Lewis’ model. We do not think that his analysis of the neurobiological evidence is clearly different from that of the BDMA or that his neurodevelopmental model provides a more rigorous interpretation of the evidence than the BDMA. We believe that our understanding of the neurobiology of drug use is too immature to warrant the major role given to it in the BDMA. Our social research finds very mixed support for the BDMA among addicted people and health professionals in Australia. Lewis’ account of addiction requires similar empirical evaluation of its real-world implications.
KeywordsAddiction Brain disease Neuroplasticity Neurodevelopment Learning
Adrian Carter received an Australian Research Council Discovery Early Career Researcher Award (No. DE140101097).
- 2.Keane, H. 2002. What’s wrong with addiction? Carlton: Melbourne University Press.Google Scholar
- 3.Heyman, G. 2009. Addiction: a disorder of choice. Cambridge: Harvard University Press.Google Scholar
- 5.Reinarman, C., and R. Granfield. 2014. Addiction is not just a brain disease. In Expanding addiction: critical essays, ed. C. Reinarman and R. Granfield, 1–24. New York: Routledge.Google Scholar
- 7.Satel, S., and S.O. Lilienfeld. 2013. Brainwashed: the seductive appeal of mindless neuroscience. New York: Perseus Books Group.Google Scholar
- 8.Lewis, M. 2015. The biology of desire: why addiction is not a disease. New York: Scribe Publications.Google Scholar
- 10.Peele, S. 2010. Addiction in society: blinded by biochemistry. Available from: https://www.psychologytoday.com/articles/201009/addiction-in-society-blinded-biochemistry. Accessed 13 August 2016 1 September.
- 23.Levy, N. 2013. Addiction is not a brain disease (and it matters). Frontiers in Psychiatry 4: 24.Google Scholar
- 24.Koob, G.F., and M. Le Moal. 2006. Neurobiology of addiction. New York: Academic Press.Google Scholar
- 30.Lewis, M. 2017. Addiction and the brain: development, not disease. Neuroethics. doi: 10.1007/s12152-016-9293-4
- 36.Bennett, M.R., and P.M.S. Hacker. 2003. Philosophical foundations of neuroscience. Malden: Blackwell.Google Scholar
- 37.Best, D., W. Dawson, G. De Leon, B. Kidd, T. McSweeney, M. Gilman, et al. 2010. Tackling addiction: pathways to recovery. London: Jessica Kingsley.Google Scholar
- 39.National Academies of Sciences Engineering and Medicine. 2016. Ending discrimination against people with mental and substance use disorders: the evidence for stigma change. Washington, DC: The National Academies Press.Google Scholar
- 41.Meurk, C., K. Morphett, A. Carter, M. Weier, J. Lucke, and W. Hall. 2016. Scepticism and hope in a complex predicament: people with addictions deliberate about neuroscience. International Journal of Drug Policy 32: 34–43.Google Scholar
- 42.Bell, S., A. Carter, R. Mathews, C. Gartner, J. Lucke, and W. Hall. 2014. Views of addiction neuroscientists and clinicians on the clinical impact of a brain disease model of addiction. Neuroethics 7(1): 19–27.Google Scholar
- 43.Barnett, A.I., and C.L. Fry. 2015. The clinical impact of the brain disease model of alcohol and drug addiction: exploring the attitudes of community-based AOD clinicians in Australia. Neuroethics 8(3): 271–282.Google Scholar