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Why the Disease Definition of Addiction Does Far More Harm Than Good

Summary and Analysis…

This is another in a set of articles published by Scientific American examining problems associated with the brain disease model of addiction (BDMA). This article, written by Marc Lewis, a neuroscientist and professor emeritus in developmental psychology at the University of Toronto, is an important summary of the limitations and issues associated with the BDMA. Lewis describes the direct and indirect problems it causes for researchers, treatment providers, families and those with addictions.

He also covers the financial and political motivating factors that keep the BDMA alive despite the science that belies its ability to explain or address the opioid crisis.

In addition to the high value of the article itself, it provides links to other studies and reports including the November 2017 announcement of the Addiction Theory Network, a leading group of more than ninety researchers and scientists “opposing the dominant influence of the BDMA and collaborating to develop alternative ways of understanding and responding to addiction.”

Lewis’ latest book is The Biology of Desire: Why Addiction is Not a Disease.

Excerpted from Scientific American

Over the past year and a half, Scientific American has published a number of fine articles arguing that addiction is not a disease, that drugs are not the cause of addiction, and that social and societal factors are fundamental contributors to opioid addiction in general and the overdose crisis in particular. The dominant view, that addiction is a disease resulting from drug use, is gradually being eroded by these and other incisive critiques. Yet the disease model and its corollaries still prevail in the domains of research, policy setting, knowledge dissemination and treatment delivery, more in the United States than in any other country in the developed world. You might wonder: what are we waiting for?

The disease model remains dominant in the U.S. because of its stakeholders. First, the rehab industry, worth an estimated $35 billion per year, uses the disease nomenclature in a vast majority of its ads and slogans. Despite consistently low success rates, that’s not likely to stop because it pulls in the cash. Second, as long as addiction is labeled a disease, medical insurance providers can be required to pay for it.

Of course they do so as cheaply as possible, to the detriment of service quality, but they at least save governments the true costs of dealing with addiction through education, social support, employment initiatives and anti-poverty mechanisms. Third, the National Institute on Drug Abuse (NIDA), a part of the National Institutes of Health (NIH) that funds roughly 90 percent of addiction research worldwide, is a medically oriented funder and policy setter, as are the American Society of Addiction Medicine and other similar bodies.

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