Against the Drug Cure Model: Addiction, Identity, Pharmaceuticals (original) (raw)

Recent advances in brain imaging methods as well as increased sophistication in neuroscientific modeling of the brain’s reward systems have facilitated the study of neural mechanisms associated with addiction such as processes associated with motivation, decision making, pleasure seeking, and inhibitory control. These scientific activities have increased optimism that the neurological underpinnings of addiction will be delineated, and that pharmaceuticals that target and change these mechanisms will by themselves facilitate early intervention and even full recovery. In this paper, we argue that it is misguided to construe addiction as just or primarily a brain-chemistry problem, which can be adequately treated by pharmaceutical interventions alone. Addiction affects the person as an embodied agent in the world, not just as a brain on a body’s shoulders. Addictive behaviour patterns involve not only brain chemistry, but an addict’s interpersonal relationships, social and physical environment, and personal identity, all of which contribute to habits that cause or perpetuate addiction. No doubt, drugs may be useful in treating some features of addiction. But unfettered optimism about pharmaceuticals in the treatment of addiction is scientifically unwarranted and therapeutically imprudent.

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