Addiction treatment in the USA: signs of change

摘要

In 1997, Alan Leshner, the then Director of the US National Institute on Drug Abuse (NIDA), argued that addiction should be understood as a chronic, relapsing, brain disease. Drug use was initially voluntary, he argued, but chronic drug use fl icked a neurochemical switch in the brain that made it diffi cult to stop using drugs. These unspecifi ed changes in brain function were said to comprise a disease that explained why addiction was a chronic, relapsing disorder. The brain disease model of addiction, Leshner argued, would lead to more eff ective drug treatments. Its acceptance would also reduce stigma and increase treatment seeking by explaining that addicted individuals had a brain disease that was in need of science-based treatment.