Accurate yet problematic: the divided sentiments regarding brain-based addiction by professionals in the Finnish service system

AbstractBackground There is an ongoing debate regarding the value and applicability of brain-based understandings of addiction. This study examines how professionals in the Finnish addiction service system view this matter.Methods The study participants (n = 997) were recruited at different levels of policy-making, treatment, prevention work, education, administration and research. We created an online questionnaire containing both multiple-choice and open-ended questions. Quantitative and qualitative analyses were performed.Results There was a broad agreement among survey participants regarding the relevance and importance of brain-based understandings, per se. The support seemed to have increased a great deal in the past decades. On a closer view, a dichotomous attitude prevailed among the respondents: They expressed robust support for etiologies and ontologies of brain-based addiction, but simultaneously acknowledged some greater risks with neurocentrism and with wider implementations of neuroscientifically based interventions. New divisions of responsibility and the weakening of rights among concerned parties were presented as risk scenarios. The respondents feared that a medicalization of addiction would sideline social approaches.Conclusion The Finnish addiction service professionals were not prepared to let brain-based ideas of addiction guide the country’s addiction services but saw them as a useful supplementary hermeneutic and pedagogic tool.Keywords: Brain-based addiction paradigmaddiction service systemexpert viewsexpert perceptionssubstance use addictionaddiction Disclosure statementNo potential conflict of interest was reported by the author(s).Additional informationFundingThe research was funded through the ERA-NET NEURON ELSA-call [No. 01GP1823]. The consortium’s Finnish part was funded by the Academy of Finland. Two of the authors were also partly funded by a cooperation contract with the Finnish Institute for Welfare and Health (THL), based on Section 52 in the Lotteries act. The Signe and Ane Gyllenberg Foundation has co-funded the work of Hellman and Koivula.