Discussion with Sally Satel of AEI
If Addiction is a Disease, What Kind of Disease is It?
Please join the Marron Institute for a discussion led by Dr. Sally Satel titled "If Addiction is a Disease, What Kind of Disease is It?"
The National Institute on Drug Abuse defines "addiction" as "a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences." That definition was intended to eliminate stigma by characterizing people with drug problems as "sick" rather than "bad." It has been used to argue that people with addiction should not be held criminally liable for drug-related behavior, any more than schizophrenics should be held criminally liable for hearing voices or people with Parkinson's Disease for trembling, and that "will power" is irrelevant in the face of an overwhelming compulsion.
What is the scientific evidence behind the "brain disease" claim? There’s no question that the brain undergoes changes during addiction, but what do those changes mean? Is substance use disorder typically chronic and relapsing? Are people with addiction incapable of responding to incentives?
And what are the clinical, moral, and policy implications of characterizing habitual behavior as a "brain disease"? Looking behind the biology of the phenomenon to understand the deeper origins of addiction and its psychology helps us understand why some treatment approaches are more effective, and the ways in which recovery must transcend the clinical domain.
Dr. Sally Satel is a resident scholar at AEI and the staff psychiatrist at a local methadone clinic in D.C. Dr. Satel was an assistant professor of psychiatry at Yale University from 1988 to 1993 and remains a lecturer at Yale. From 1993 to 1994 she was a Robert Wood Johnson policy fellow with the Senate Labor and Human Resources Committee. She has written widely in academic journals on topics in psychiatry and medicine, and has published articles on cultural aspects of medicine and science in numerous magazines and journals. She has testified before Congress on veterans’ issues, mental health policy, drug courts,and health disparities. Dr. Satel is author of Drug Treatment: The Case for Coercion (AEI Press, 1999), and PC, M.D.: How Political Correctness Is Corrupting Medicine (Basic Books, 2001). She is coauthor of One Nation under Therapy (St. Martin’s Press, 2005), co-author of The Health Disparity Myth (AEI Press, 2006), and editor of When Altruism Isn’t Enough: The Case for Compensating Kidney Donors (AEI Press, 2009). Her recent book, co-authored with Emory psychologist Scott Lilienfeld is Brainwashed: The Seductive Appeal of Mindless Neuroscience (Basic, 2013).Brainwashed was a finalist for the 2013 Los Angeles TimesBook Prize in Science.
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