It’s Complicated – 

APRIL 28, 2020 – That drug use is a reaction to external stress may sound obvious, but the American response to drug use has rarely addressed environmental causes, instead treating it, at different points in time, as a moral failing or a chronic disease.

The currently prevailing view of drug use and addiction emphasizes biology over life events. According to the disease model of addiction, repetitive and prolonged drug use “hijacks” the brain’s reward system, leaving the person powerless over cravings. It is considered a chronic illness, often likened to such ailments as diabetes and hypertension.

While these analogies have helped gain support for medication-assisted treatment for opioid use or relatively less punitive drug policies, the disease model does not adequately account for the external context influencing a person’s drug use behavior—nor can it explain why people respond to drugs differently in different settings, or why most drug use never progresses to addiction.

All drugs, not just the ones people enjoy taking, can have adverse physical and neurological effects, but social and environmental factors are more relevant to understanding addiction and developing effective interventions.


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