Multiple Enactments of the Brain Disease Model: Which model, when, for whom, and at what cost?

Abstract

This chapter draws on the work of science and technology studies scholar John Law to engage with the neuroscience of addiction as a set of ongoing socio-material practices that bring phenomena such as brains, drugs, compulsion, and addiction itself, into being. Rather than positing the brain disease model of addiction as the object of analysis, the chapter discusses multiple enactments of addiction as brain disease, focusing on three discursive sites: 1) the public discourse of the National Institute on Drug Abuse; 2) the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders; and 3) the accounts of addiction generated in interviews with Australian and Canadian policymakers and service providers. The aim is to demonstrate the multiplicity of brain disease discourse and how different versions of the model are mobilized with different implications and effects. The chapter suggests the need to reframe the choice between being for or against the model to ask instead: ‘which brain disease model, when, for whom, and at what cost’?