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Tuesday, April 17, 2012

What are the public policy implications of a neurobiological view of addiction?

Neuroscience research has provided a greater understanding of the neurochemical mechanisms underpinning drug use and addiction. Alteration of gene regulation and functioning appears to explain many of the persistent changes in brain structure and function that are observed after chronic substance use. These neurobiological changes may explain why relapse is common, even after years of abstinence [1]. This research also indicates that there are molecular, cellular and other system-level mechanisms common to both drug addiction and other compulsive behaviours, such as gambling, hypersexuality and compulsive over-eating [2–4].

How should these findings affect the way in which we deal with addiction to illicit drugs, tobacco smoking, alcohol consumption and ‘behavioural addictions’? Should we view addiction primarily as a disease, like other physical ailments, and treat it medically? This view, often described as the ‘brain disease’ model of addiction, is promoted strongly by prominent public health researchers, neuroscientists and addiction physicians [5,6]. Advocates believe that it will produce a range of clinical and social benefits that include: reduced stigma towards addicted individuals, increased treatment-seeking and compliance with medical treatment regimens, less reliance on imprisonment and other punitive responses to addictive drug use and greater investment in addiction treatment and research [5,6]. > > > > Read More