TY - JOUR
T1 - Physicians’ and Attorneys’ Beliefs and Attitudes Related to the Brain Disease Model of Addiction
AU - Avery, Joseph J.
AU - Avery, Jonathan D.
AU - Mouallem, Joseph
AU - Demner, Adam R.
AU - Cooper, Joel
N1 - Funding Information:
The brain disease model of addiction holds that substance use disorders (SUDs) are chronic, relapsing brain diseases. Relapses are symptoms, and a part of the expected course, of the disease. As with other diseases, SUDs are caused by multiple factors, including behavioral, environmental, and biological ones. The general disease conception of addiction, which includes the brain disease model, is supported by all major psychiatric authorities, including the National Institute on Drug Abuse (NIDA), the Diagnostic and Statistical Manual of Mental Disorders, and the American Academy of Addiction Psychiatry. It is also not a recent trend in thinking. As early as 1784 in the United States, Benjamin Rush discussed addiction in terms that anticipated the disease model. In 1956, the American Medical Association (AMA) affirmed that alcoholism qualified as an illness, and in 1960, Jellinek published his influential book, . By the 1970s and 1980s, NIDA was funding neuroscience research that resulted in pronouncements that addiction was specifically a disease ; by 1987, the AMA had officially affirmed the brain disease model of addiction. 1 2 3 4 5 The Disease Concept of Alcoholism 6 brain 7 8
Funding Information:
This research was partially supported by grants to the first author from the Horowitz Foundation for Social Policy. The first author also was supported by the Department of Defense (DoD) through the National Defense Science & Engineering Graduate Fellowship (NDSEG) Program.
Publisher Copyright:
© 2020 American Academy of Addiction Psychiatry
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Background and Objectives: Addiction is increasingly considered a chronic, relapsing brain disease; however, many scholars still disagree with the brain disease model of addiction. We set out to provide evidence of attorneys’ and physicians’ beliefs regarding the model. First, we asked the following question: do attorneys and physicians affirm the full brain disease model, or its modified form, or do they believe that addiction is driven by deficits in self-control or moral weakness? Second, we evaluated the extent to which such beliefs correspond to attitudes toward individuals with substance use disorders (SUDs). Methods: A questionnaire was sent to resident physicians (N = 301) and criminal defense attorneys (N = 483) practicing in the United States. It was comprised of (i) an attitudes measure, (ii) a measure regarding conceptions of addiction, and (iii) demographic questions. Results: Attorneys were more likely to believe that individuals with SUDs had “practically no choice” about whether to seek and use, whereas physicians were more likely to believe that such individuals had “genuine choice.” For both groups of participants, the rejection of the full brain disease model of addiction was associated with more negative attitudes toward individuals with SUDs. Conclusion and Scientific Significance: These results represent an important advance, as past research has neglected attorneys’ attitudes and is inconclusive regarding the manner in which beliefs about the brain disease model of addiction are related to attitudes toward individuals with SUDs. Educating practitioners regarding this relationship would raise awareness regarding when and to what extent stigma is likely to be present, which may in turn provide a foundation from which to address stigma. (Am J Addict 2020;00:00–00).
AB - Background and Objectives: Addiction is increasingly considered a chronic, relapsing brain disease; however, many scholars still disagree with the brain disease model of addiction. We set out to provide evidence of attorneys’ and physicians’ beliefs regarding the model. First, we asked the following question: do attorneys and physicians affirm the full brain disease model, or its modified form, or do they believe that addiction is driven by deficits in self-control or moral weakness? Second, we evaluated the extent to which such beliefs correspond to attitudes toward individuals with substance use disorders (SUDs). Methods: A questionnaire was sent to resident physicians (N = 301) and criminal defense attorneys (N = 483) practicing in the United States. It was comprised of (i) an attitudes measure, (ii) a measure regarding conceptions of addiction, and (iii) demographic questions. Results: Attorneys were more likely to believe that individuals with SUDs had “practically no choice” about whether to seek and use, whereas physicians were more likely to believe that such individuals had “genuine choice.” For both groups of participants, the rejection of the full brain disease model of addiction was associated with more negative attitudes toward individuals with SUDs. Conclusion and Scientific Significance: These results represent an important advance, as past research has neglected attorneys’ attitudes and is inconclusive regarding the manner in which beliefs about the brain disease model of addiction are related to attitudes toward individuals with SUDs. Educating practitioners regarding this relationship would raise awareness regarding when and to what extent stigma is likely to be present, which may in turn provide a foundation from which to address stigma. (Am J Addict 2020;00:00–00).
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U2 - 10.1111/ajad.13023
DO - 10.1111/ajad.13023
M3 - Article
C2 - 32187771
AN - SCOPUS:85081748914
SN - 1055-0496
VL - 29
SP - 305
EP - 312
JO - American Journal on Addictions
JF - American Journal on Addictions
IS - 4
ER -