Looking to the future: Clinical and policy implications of the brain disease model of addiction

The increasing recognition of addiction as a brain disease promises to significantly improve clinical treatment, reduce the stigma and discrimination aimed at people with an addiction, increase treatment funding and access, and discourage the use of punitive responses. This chapter argues that the brain disease model of addiction is not supported by the evidence sought in laboratories worldwide, and has failed to provide the clinical, social, and public policy benefits espoused by its proponents. Treating addiction solely as a brain disease may in fact reduce treatment-seeking, increase stigma, and focus attention on the medical treatment of addiction at the expense of more broadly effective public health policies that reduce the harms of drug use. The neuroscience research of addiction needs to be framed in a way that both accurately reflects the impact of drug use on the brain and communicated in a way that realizes the clinical and social benefits while eschewing avoidable harms.