Wellcome Lecture in Neuroethics

Genetic and neuroscience research on addiction has been interpreted by leading figures in the USA as demonstrating that addiction is a chronic relapsing brain disease that reflects enduring changes in brain function that are produced by sustained heavy drug use and explain the inability of addicted persons to refrain from using drugs, despite their professed intentions to do so. The brain disease model contrasts starkly with the commonsense view that drug use is a free choice for which individual drug users are responsible. This paper: assesses the evidence and arguments offered in favour of the brain disease model of addiction; assesses the arguments advanced by critics of the model; considers the social and ethical implications of these views in dealing with addicted persons and in formulating public health policies that we should adopt to prevent the harmful use of and addiction to alcohol, tobacco and illicit drugs.