Q & A: The Brain Disease Model of Addiction

A Q&A with a research scientist on the Research Update

Advances in neuroscience and imaging technology have rapidly evolved our understanding of addiction and demonstrated a great deal of support for what is often referred to as the brain disease model of addiction. This model considers genetic and environmental factors that cause physical changes to the brain and is the basis for many existing and emerging concepts.

In this Q&A, Bethany Ranes, PhD, research scientist with the Hazelden Betty Ford Foundation's Butler Center for Research, comments on the Research Update, The Brain Disease Model of Addiction.

Q: What do you hope professionals glean from this Research Update?

A: I was particularly excited about this update. Over the past 10 years, neuroscience and psychology have really started to meld together. This is particularly true for studies surrounding the nature of addiction. For decades, so many people have written addiction off as some kind of character flaw, but science shows us that there is a very real, physiological component to addiction. Despite this, there is still a lot of controversy surrounding the disease model of addiction, even among treatment professionals.

It was my primary intention that professionals would have the opportunity to use this Research Update as a brief digest for all the disease model research that has occurred in the past decade. I was also excited to present some recent literature that demonstrates that behavioral addictions (e.g., food addictions, video game addictions, etc.) share many similar physiological components to chemical addictions. This suggests that perhaps there are universal patterns across all addictions.

Q: What implications do these findings have for treatment?

A: There are several implications for treatment. The brain disease model of addiction is the foundation for modern pharmacotherapies, most prominently for medication-assisted treatment related to opioid addiction. In fact, research on the physiological nature of addiction and the benefits of using carefully-monitored non- or less-addictive medication to control opioid cravings was the foundation for the Hazelden Betty Ford Foundation’s Comprehensive Opioid Response with the Twelve Steps (COR-12™) program.

Results of studies that administered naltrexone or buprenorphine to patients showed that individuals with opioid dependence were more successful in treatment when they used these medications to treat the chemical-related effects in the brain that cause opioid cravings.

Research on the neurological basis of addiction also has allowed scientists and clinicians to begin understanding how some people may have physical traits that make them more prone to addiction while others have traits that make them ideal candidates for behavioral interventions. By understanding what parts of the brain are involved in addiction and what functions they perform among healthy individuals, scientists can develop more effective treatment interventions with or without medication assistance.

Q: Where can professionals learn more about this issue?

A: The National Institute on Drug Abuse (NIDA) continues to focus research funding on improving the brain disease model of addiction. Professionals can find many articles and summaries at drugabuse.gov. I also recommend the BCR’s Research Update titled, Drug Abuse, Dopamine, and the Brain’s Reward System, for those who would like to get a little more information on how dopamine is involved in healthy brain function and addiction.

For those who have access to peer-reviewed journals, The Lancet Psychiatry, Trends in Cognitive Sciences, and other neuroscience-focused journals also have published many great articles on this topic. Dr. Nora Volkow, Director of NIDA, is a prominent author in this area and has released a TED Talk on the brain disease model of addiction called “Why Do Our Brains Get Addicted?

Q: What does the future hold for treatment in light of these findings?

A: With the continued innovation in brain imaging and our ongoing understanding of how our brains function, the future is bright for addiction treatment. While initial disease model findings have resulted in the rise of new pharmacological interventions, such as naltrexone and buprenorphine, there is a lot of potential for behavioral interventions as well. As we understand how chemical and structural components of the brain are impacted by addiction, scientists can use this information for more effective and efficient treatment strategies, either through non-pharmacological therapeutic techniques or with the use of future medication-assisted therapy options.

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