The brain disease model of addiction and epistemic injustice

IF 4.4 2区 医学 Q1 SUBSTANCE ABUSE
Shane O’Mahony
{"title":"The brain disease model of addiction and epistemic injustice","authors":"Shane O’Mahony","doi":"10.1016/j.drugpo.2025.105015","DOIUrl":null,"url":null,"abstract":"<div><div>The brain disease model of addiction (BDMA) is a dominant, if highly contested, model of drug addiction globally. Over many decades, researchers have marshalled evidence from animal studies, neuroimaging scans, and genome wide association studies to argue that addiction is a brain disease. However, critics have argued that the model de-emphasises social and economic contexts, downplays the phenomenon of spontaneous or natural recovery, and over-interprets neuroscientific findings. Building on this critical tradition, the current paper asks a related question: Has the claim that addiction is a brain disease helped or harmed those experiencing drug-related harm epistemically? While no definitive answer to this question is offered, the current paper argues that overall, the claim that addiction is a brain disease advanced by proponents of the BDMA has harmed substance users already experiencing multiple disadvantages epistemically.</div><div>Drawing on the concept of epistemic injustice, the current paper argues that the category ‘drugs’ creates an artificial and harmful dichotomy between those who use licit medicines and experience harm and those who use illicit substances and experience harm. Furthermore, this artificial dichotomy is compounded by racist and colonial discourses central to the war on drugs, and a rigid biological reductionism that de-emphasises social, economic, and cultural harm. The paper concludes by sketching an alternative approach rooted in epistemic justice, and a discussion of the implications of this concept for research and theory.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"145 ","pages":"Article 105015"},"PeriodicalIF":4.4000,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Drug Policy","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0955395925003111","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SUBSTANCE ABUSE","Score":null,"Total":0}
引用次数: 0

Abstract

The brain disease model of addiction (BDMA) is a dominant, if highly contested, model of drug addiction globally. Over many decades, researchers have marshalled evidence from animal studies, neuroimaging scans, and genome wide association studies to argue that addiction is a brain disease. However, critics have argued that the model de-emphasises social and economic contexts, downplays the phenomenon of spontaneous or natural recovery, and over-interprets neuroscientific findings. Building on this critical tradition, the current paper asks a related question: Has the claim that addiction is a brain disease helped or harmed those experiencing drug-related harm epistemically? While no definitive answer to this question is offered, the current paper argues that overall, the claim that addiction is a brain disease advanced by proponents of the BDMA has harmed substance users already experiencing multiple disadvantages epistemically.
Drawing on the concept of epistemic injustice, the current paper argues that the category ‘drugs’ creates an artificial and harmful dichotomy between those who use licit medicines and experience harm and those who use illicit substances and experience harm. Furthermore, this artificial dichotomy is compounded by racist and colonial discourses central to the war on drugs, and a rigid biological reductionism that de-emphasises social, economic, and cultural harm. The paper concludes by sketching an alternative approach rooted in epistemic justice, and a discussion of the implications of this concept for research and theory.
成瘾和认知不公正的脑疾病模型
脑疾病成瘾模型(BDMA)是一个占主导地位的,如果高度争议,全球药物成瘾模型。几十年来,研究人员从动物研究、神经成像扫描和全基因组关联研究中收集证据,证明成瘾是一种脑部疾病。然而,批评人士认为,该模型淡化了社会和经济背景,淡化了自发或自然恢复的现象,并过度解释了神经科学的发现。基于这一批判传统,当前的论文提出了一个相关的问题:成瘾是一种脑部疾病的说法在认知上是帮助还是伤害了那些经历毒品相关伤害的人?虽然这个问题没有明确的答案,但目前的论文认为,总的来说,BDMA的支持者提出的成瘾是一种脑部疾病的说法,已经在认知上伤害了已经经历了多重不利的物质使用者。根据认知不公正的概念,本文认为,“药物”这一类别在使用合法药物并遭受伤害的人和使用非法药物并遭受伤害的人之间制造了一种人为的有害二分法。此外,这种人为的二分法还与以毒品战争为中心的种族主义和殖民主义话语以及不强调社会、经济和文化危害的严格的生物还原论相结合。本文最后概述了一种基于认知正义的替代方法,并讨论了这一概念对研究和理论的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
7.80
自引率
11.40%
发文量
307
审稿时长
62 days
期刊介绍: The International Journal of Drug Policy provides a forum for the dissemination of current research, reviews, debate, and critical analysis on drug use and drug policy in a global context. It seeks to publish material on the social, political, legal, and health contexts of psychoactive substance use, both licit and illicit. The journal is particularly concerned to explore the effects of drug policy and practice on drug-using behaviour and its health and social consequences. It is the policy of the journal to represent a wide range of material on drug-related matters from around the world.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信