Hostname: page-component-8448b6f56d-sxzjt Total loading time: 0 Render date: 2024-04-20T12:03:19.652Z Has data issue: false hasContentIssue false

Indeed, not really a brain disorder: Implications for reductionist accounts of addiction

Published online by Cambridge University Press:  06 March 2019

Matt Field
Department of Psychology, University of Sheffield, Sheffield, S1 2LT, United
Nick Heather
Department of Psychology, Northumbria University, Gosforth, Newcastle-upon-Tyne, NE3 1LU, United
Reinout W. Wiers
Department of Psychology, University of Amsterdam, PB 15916, 1001 NK Amsterdam, The Netherlands. r.wiers@uva.nl


Borsboom et al.’s formulation provides an opportunity for a fundamental rethink about the “brain disease model” of addiction that dominates research, treatment, policy, and lay understanding of addiction. We also demonstrate how the American opioid crisis provides a contemporary example of how “brain disease” is not moderated by the environmental context but is instead crucially dependent upon it.

Open Peer Commentary
Copyright © Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


Berkman, E. T., Hutcherson, C. A., Livingston, J. L., Kahn, L. E. & Inzlicht, M. (2017) Self-control as value-based choice. Current Directions in Psychological Science 26(5):422Google Scholar
Case, A. & Deaton, A. (2015) Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. Proceedings of the National Academy of Sciences USA 112(49):15078Google Scholar
Davies, J. (2018) Addiction is not a brain disease. (Editorial). Addiction Research and Theory 26(1):12.Google Scholar
Dennett, D. C. (1995) Darwin's dangerous idea: Evolution and the meanings of life. Penguin.Google Scholar
Eiser, J. R. & Van der Pligt, J. (1986) “Sick” or “hooked”: Smokers’ perceptions of their addiction. Addictive Behaviors 11(1):1115.Google Scholar
Eiser, J. R., van der Pligt, J., Raw, M. & Sutton, S. R. (1985) Trying to stop smoking: Effects of perceived addiction, attributions for failure, and expectancy of success. Journal of Behavioral Medicine 8(4):321–41.Google Scholar
Hart, C. (2013) High price: Drugs, neuroscience and discovering myself. Penguin.Google Scholar
Heather, N. (2018) Rethinking addiction. The Psychologist 31(1):2428.Google Scholar
Heather, N., Best, D., Kawalek, A., Field, M., Lewis, M., Rotgers, F., Reinout, W. & Heim, D. (2018) Challenging the brain disease model of addiction: European launch of the addiction theory network. (Editorial). Addiction Research and Theory 26(4):249–55. doi:10.1080/16066359.2017.1399659.Google Scholar
Heyman, G. M. (1996) Resolving the contradictions of addiction. Behavioral and Brain Sciences 19(4):561610.Google Scholar
Heyman, G. M. (2013) Quitting drugs: Quantitative and qualitative features. Annual Review of Clinical Psychology 9:2959.Google Scholar
Hollingsworth, A., Ruhm, C. & Simon, K. (2017) Macroeconomic conditions and opioid abuse. NBER Working Paper No. 23192. NBER Working Paper Series. National Bureau of Economic Research. Available at: Scholar
Leshner, A. (1997) Addiction is a brain disease, and it matters. Science 278(5335):4547.Google Scholar
Levy, N. (2013) Addiction is not a brain disease (and it matters). Frontiers in Psychiatry 4: article 24. (Online publication). doi: 10.3389/fpsyt.2013.00024 Available at: Scholar
Lewis, M. (2017) Addiction and the brain: Development, not disease. Neuroethics 10:718.Google Scholar
Mattick, R. P., Breen, C., Kimber, J. & Davoli, M. (2009) Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence. Cochrane Database of Systematic Reviews 3:CD002209. doi: 10.1002/14651858.CD002209.pub2.Google Scholar
Miller, W. R., Westerberg, V. S., Harris, R. J. & Tonigan, J. S. (1996) What predicts relapse? Prospective testing of antecedent models. Addiction 91(Suppl.):S15572.Google Scholar
Quinones, S. (2016) Dreamland: The true tale of America's opiate epidemic. Bloomsbury Press.Google Scholar
Satel, S. & Lilienfeld, S. (2014) Addiction and the brain-disease fallacy. Frontiers in Psychiatry 4: article 141. (Online publication). doi: 10.3389/fpsyt.2013.00141. Available at: Scholar
Satel, S. & Lilienfeld, S. (2017) Calling it “brain disease” makes addiction harder to treat. Boston Globe, June 22, 2017. Available at: Scholar
Stead, L. F., Perera, R., Bullen, C., Mant, D., Hartmann-Boyce, J., Cahill, K. & Lancaster, T. (2012) Nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews 12:CD000146. doi: 10.1002/14651858.CD000146.pub4.Google Scholar
Volkow, N. D., Koob, G. F. & McLellan, A. T. (2016) Neurobiologic advances from the brain disease model of addiction. New England Journal of Medicine 374(4):363–71.Google Scholar
Zoorob, M. & Salemi, J. (2017) Bowling alone, dying together: The role of social capital in mitigating the drug overdose epidemic in the United States. Drug and Alcohol Dependence 173:19.Google Scholar