What does ‘acceptance’ mean? Public reflections on the idea that addiction is a brain disease

Abstract

Public responses to the dissemination of neuroscientific explanations of addiction and other mental disorders are an interesting sociocultural phenomenon. We investigated how 55 members of the Australian public deliberated on the idea that 'addiction is a brain disease'. Our findings point to the diverse ways in which the public understands and utilises this proposition. Interviewees readily accepted that drugs affect brain functioning but were ambivalent about whether to label addiction as a 'disease'. Contrary to the prediction of neuroscientific advocates and social science critics, acceptance of a neurobiological conception of addiction did not necessarily affect beliefs about addicted persons' responsibility for their addiction. We discuss the theoretical and applied implications of these findings. Theoretically, we examine the complexity surrounding how people adopt new knowledge and its role in reshaping ethical beliefs. We also discuss the implications of these findings for the ethics of communication of neuroscientific information to reduce stigma and enhance social support for the treatment of addicted individuals.

Scepticism and hope in a complex predicament: People with addictions deliberate about neuroscience

“…We do not ascribe to the brain disease label because it is too simplistic to describe addiction and is not consistent with the views of ourselves or our participants (see also Meurk, Fraser, et al, 2015). We note that many Australians agree with this sentiment, associating disease concepts with a condition having a biological basis, whilst rejecting biological reductionism with respect to addiction (Meurk, Partridge, et al, 2014;Meurk, C., Hall, W. D., Morphett, K., Carter, A., & Lucke, J, 2013).…”

“…Critics argue that the BDMA reduces drug dependent persons' feelings of control, undermines their selfefficacy, promotes fatalism and leads policy-makers to neglect the role of social factors in the development and treatment of addiction (Dingel, Karkazis, & Koenig, 2011;Kalant, 2009;Levy, 2013;Midanik, 2004). M a n u s c r i p t 3 A growing literature has begun to examine the extent to which neuroscientific explanations of addiction have influenced the views of addiction held by the general public, addiction clinicians and neuroscientists, and addicted persons Dingel, et al, 2011;Hammer, Dingel, Ostergren, Nowakowski, & Koenig, 2012;Hammer, et al, 2013;Meurk, Hall, Morphett, Carter, & Lucke, 2013;Meurk, Partridge, et al, 2014;Netherland, 2011). Although there are some who express concerns about the negative consequences of the BDMA (Hammer, et al, 2013), others suggest that the predicted positive and negative social impacts of the BDMA have been overstated (Courtwright, 2010).…”

“…Although there are some who express concerns about the negative consequences of the BDMA (Hammer, et al, 2013), others suggest that the predicted positive and negative social impacts of the BDMA have been overstated (Courtwright, 2010). Although some aspects of brain-based explanations of addiction are accepted by most people (Meurk, Hall, Morphett, Carter, & Lucke, 2013), these ideas tend to be incorporated into older ideas about addiction, often in idiosyncratic ways. This means that the social effects of any new concepts of addiction are likely to be more subtle and difficult to identify and measure than proponents of the model have hoped or its critics have feared.…”

“…We have approached this task by focussing on the patterns in participants' verbalised deliberations (Meurk, Hall, Morphett, Carter, & Lucke, 2013). As part of this analysis we wanted to explore the implications of the BDMA that are unique to addicted persons, specifically, how these might influence, and be influenced by, addicted persons' self-understanding and identity.…”

The biomedicalisation of smoking cessation: a mixed methods study of lay perspectives on nicotine addiction

“…This data was collected via 55 semi-structured interviews with members of the Australian public on their understandings of addiction to heroin, alcohol and nicotine, and their beliefs about the role of the brain in addiction. The primary analysis of this data is reported elsewhere (Meurk, Hall, Morphett, Carter, & Lucke, 2013). Based on debates about the medicalisation of smoking as outlined in Chapter 1, I explored the extent to which members of the Australian public perceive medical treatment as suitable and effective for smoking cessation.…”