Is addiction a brain disease

Abstract Over the past two decades the brain disease model has become the prevailing scientific narrative for explaining substance addictions. This model, buoyed by brain imaging data, posits that addictions are rooted in brain dysfunctions, and are chronic, relapsing conditions that largely eradicate individuals’ capacity to control substance use. We argue that the assertion that addictions are rooted in brain dysfunction is essentially unfalsifiable and devoid of scientific content. Further, there is overwhelming scientific evidence that other key presuppositions of the brain disease model are false. Finally, this model has been of questionable utility; there is minimal evidence that it leads to effective intervention, reduces stigma, or accounts for recent large-scale societal changes in the prevalence of addictions. It is high time to abandon this model and to adopt a pluralistic approach to addiction that acknowledges the value of neuroimaging evidence in conjunction with other lenses of analysis.