What does it mean when we call addiction a brain disorder?
March 23, 2018
As a young scientist in the 1980s, I used then-new imaging technologies to look at the brains of people with drug addictions and, for comparison, people without drug problems. As we began to track and document these unique pictures of the brain, my colleagues and I realized that these images provided the first evidence in humans that there were changes in the brains of addicted individuals that could explain the compulsive nature of their drug taking. The changes were so stark that in some cases it was even possible to identify which people suffered from addiction just from looking at their brain images.
Alan Leshner, who was the Director of the National Institute on Drug Abuse at the time, immediately understood the implications of those findings, and it helped solidify the concept of addiction as a brain disease. Over the past three decades, a scientific consensus has emerged that addiction is a chronic but treatable medical condition involving changes to circuits involved in reward, stress, and self-control; this has helped researchers identify neurobiological abnormalities that can be targeted with therapeutic intervention. It is also leading to the creation of improved ways of delivering addiction treatments in the healthcare system, and it has reduced stigma.
Informed Americans no longer view addiction as a moral failing, and more and more policymakers are recognizing that punishment is an ineffective and inappropriate tool for addressing a person’s drug problems. Treatment is what is needed.