Addiction Is Not A Disease – Quotes From Experts

What is addiction? The publicly acceptable opinion is that there is a brain disease called addiction that robs people of their free will and compels (i.e. forces) them to crave and take drugs. Many purveyors of this opinion like to pretend that it is settled science, and that anyone who thinks otherwise is painfully ignorant, and probably just a cruel monster who’d like to see drug users rot in jail. But the fact is that the science is not settled in favor of the disease model of addiction, and there are plenty of classically authoritative sources who will attest to this fact. This is probably why the pro-disease camp pivots so quickly to – and indeed often begins by – attacking the morality and motives of those of us who believe we “addicts” retain the power of choice.

This page will be a permanent repository for anti-disease model quotes from various sources such as PhD’s of all kinds, doctors, philosophers, researchers, addiction experts, former heavy substance users, et cetera. I will add to it over time, and since I get many requests for info from students, I hope this page can serve as a great reference source for those looking for credible opinions on the non-disease side of the great debate about the nature of addiction. If you have any quotes you’d like to add, please paste them in the comments section below. I also encourage those of you who have been diagnosed with addiction/alcoholism/Substance Use Disorders, but who reject the disease model of addiction to join these experts and let your opinion be known in the comments section at the bottom of the page.

Addiction Is Not A Disease Quotes

“There are no published studies that establish a causal link between drug-induced neural adaptations and compulsive drug use or even a correlation between drug-induced neural changes and an increase in preference for an addictive drug.”

Gene Heyman (2013). Addiction and Choice: Theory and New Data. Frontiers in Psychiatry, 4.

“Many addiction researchers begin with the assumption that this condition is a brain disease. Yet there are virtually no data in humans indicating that addiction is a brain disease in the way that, for instance, Huntington’s or Parkinson’s are brain diseases. The present evidence indicates that this assumption should be reevaluated to formulate a more accurate view of drug addiction. An evidence-informed view would be more inclusive, would emphasize a prominent role for psychosocial and environmental factors, and would focus on offering alternative reinforcers—nondrug alternatives that decrease problematic drug-taking. From a practical or clinical perspective, this approach means it is unacceptable to tell substance-use disorder patients that they suffer from a diseased brain.“

Carl Hart (Columbia University Neuroscientist) & Marc Grifell, “Is Drug Addiction a Brain Disease?” American Scientist magazine (2018).

“I believe that, whatever disease is, it is not mere statistical difference: the idea of pathology requires a state or mechanism to be dysfunctional, not just atypical. Yet much (although not all) of the evidence adduced to support the brain disease model establishes only atypicality, not dysfunction.”

Hannah Pickard, Hastings Center Report (2020)

“as a general rule, where a disease interferes with behaviour it replaces something purposive and coordinated with something chaotic (for example, Parkinsons disease, Huntingdon’s chorea, peripheral neuritis). Commonsense suggests that the disease definition should indeed normally make reference to something which disrupts or is inimical to integrated and purposive behaviour patterns. It does not make sense as a category description for the replacement of one behaviour with a new, equally integrated, coordinated and purposive pattern. If we postulate a disease which has the direct capacity to force people to steal, to lift up glasses, or to stick needles in their arms when they are actually trying not to, and furthermore to execute long strings of appetitive goal-directed behaviour as precursors to these actions, we have to accept the possibility that any integrated chain of goal directed behaviour in any realm might be nothing more than a disease symptom.”

John Booth Davies (1997). Myth of Addiction: Second Edition. 

“people are active agents in–not passive victims of–their addictions.”

Stanton Peele (1999). Diseasing of America: How We Allowed Recovery Zealots and the Treatment Industry to Convince Us We Are Out of Control

“Although the brain disease model of addiction is perceived by many as received knowledge it is not supported by research or logic. In contrast, well established, quantitative choice principles predict both the possibility and the details of addiction.”

Gene Heyman. (2013). Addiction and Choice: Theory and New Data. Frontiers in Psychiatry, 4.

“Pathology, as revolutionized by Rudolf Virchow (1821-1902), requires an identifiable alteration in bodily tissue, a change in the cells of the body, for disease classification. No such identifiable pathology has been found in the bodies of heavy drinkers and drug users. This alone justifies the view that addiction is not a physical disease (Szasz 1991; 1994).”

Jeffrey Schaler PhD, Addiction Is A Choice, 1999.

“Is addiction a disease of the brain? That’s a bit like saying that eating is a phenomenon of the stomach. The stomach is an important part of the story. But don’t forget the mouth, the intestines, the blood, and don’t forget the hunger, and also the whole socially-sustained practice of producing, shopping for and cooking food.

And so with addiction. The neural events in VTA clearly belong to the underlying mechanisms of addiction. They are necessary, but not sufficient; they are only part of the story.”

Alva Noë. Addiction Is Not A Disease Of The Brain.

“While I do believe that a host of human habits and compulsions can be understood as addiction, I think the disease version of addiction does at least as much harm as good. An addiction does not mean that God in heaven decided which people are alcoholics and addicts. There is no biological urge to form addictions, one that we will someday find under a microscope and that will finally make sense of all these different cravings and idiocies (such as exercising to the point of injury or having sex with people who are bad for you). No medical treatment will ever be created to excise addictions from people’s lives, and support groups that convince people that they are helpless and will forever be incapable of controlling an activity are better examples of self-fulfilling prophecies than of therapy.”

Stanton Peele (1999). Diseasing of America: How We Allowed Recovery Zealots and the Treatment Industry to Convince Us We Are Out of Control

“Q: What do you think about the idea that addiction is a progressive incurable brain disease?

A: Ask the person who says that, ‘can you please show me the data to show that?‘ There is absolutely no data to support that fallacious sort of claim. It’s a nice sexy claim and you can show brain imaging pictures and you pretend that you’re telling the person who’s listening something that’s remarkable when in fact you’re not. I wrote a paper back in 2012 that systematically reviewed the brain findings in people who use methamphetamines for extended periods of time. They met the criteria for addiction and all of these things, and could not find this sort of pathological brain structure or measures that people had been talking about, and it was a review of all of that literature.

It’s one of the biggest frauds that’s been perpetrated on the public – this notion of a chronic progressive brain illness.”

Carl Hart PhD, neuroscientist, addiction researcher, interviewed by Michelle Dunbar on Saint Jude Retreats Blogtalkradio Show February 2015

Also see High Price: A Neuroscientist’s Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society by Carl Hart

“Physical changes in the brain are its only way to learn, to remember, and to develop. But we wouldn’t want to call learning a disease.So how well does the disease model fit the phenomenon of addiction? How do we know which urges, attractions, and desires are to be labeled “disease” and which are to be considered aspects of normal brain functioning? There would have to be a line in the sand somewhere. Not just the amount of dopamine released, not just the degree of specificity in what you find rewarding: these are continuous variables. They don’t lend themselves to two (qualitatively) different states: disease and non-disease.

In my view, addiction (whether to drugs, food, gambling, or whatever) doesn’t fit a specific physiological category. Rather, I see addiction as an extreme form of normality, if one can say such a thing. Perhaps more precisely: an extreme form of learning. No doubt addiction is a frightening, often horrible, state to endure, whether in oneself or in one’s loved ones. But that doesn’t make it a disease.”

Marc Lewis PhD, Neuroscientist, “Why Addiction Is Not a Brain Disease” PLOS Blog, Nov 12 2012.

“…the human behavior summarized as ‘addiction’ is not studied by neurologists… the cultural notions of addiction are taken as wholly self evident and then ‘confirmed’ in neurological description of the same. The notions of addiction transformed into the language of neurology as performed by authors like Volkov, Berridge, Gessa or De Vries are completely tautological.”

Peter Cohen (2009). The Naked Empress. Modern neuro-science and the concept of addiction. Presentation at the 12th Platform for Drug Treatment, Mondsee Austria, 21-22 March 2009. Cedro.

“It surely is irresponsible to claim that ‘addiction’ is a brain disease based on the present state of neurological knowledge and underlying theories and techniques. It is more probable that addiction is a normal human bonding to an object, in spite of the negative social and cultural evaluations it is subjected to.”

Peter Cohen. (2009). The Naked Empress. Modern neuro-science and the concept of addiction. Presentation at the 12th Platform for Drug Treatment, Mondsee Austria, 21-22 March 2009. Cedro.

“…regardless of whether disease explanations fit the facts or not, there are reasons supporting the use of these concepts which derive directly from societal values which are second nature, and which are rigorously defended. A crucial facet of ‘addiction’ which influences treatment offered, outcome success, and all aspects of the substance-abuse system, as well as the nature of the individual cognitions of sufferers, is that it involves behaviour which in terms of conventional societal values needs to be explained as malfunction. It would therefore involve the notion of guilt, for which punishment rather than treatment is generally felt to be appropriate; or worse imply that using drugs was a reasonable adaptation to the world in which we live, should an explanation be offered in terms of personal responsibility or voluntary action.

Addiction is thus driven by a moral, rather than a scientific, consensus. In the absence of such a moral consensus a particular kind of behaviour could not have attributed to it the features that are said to characterise, and that we require from, our addictions. And though people would still encounter the same problems deriving from what Orford (1985 op cit) terms their ‘excessive appetites’, there would be no such thing as ‘addiction’ per se.”

Peter Cohen. (2009). The Naked Empress. Modern neuro-science and the concept of addiction. Presentation at the 12th Platform for Drug Treatment, Mondsee Austria, 21-22 March 2009. Cedro.

“Despite the fact that there is no general agreement about the definition of alcoholism, hundreds of hypotheses have been proposed about what causes it. In 1980 a monograph published by the National Institute on Drug Abuse discussed a selection of specially interesting theories-forty-three of them. The temptation to doubt that the theories could all be wrong must be balanced by the thought that, however plausible they may seem, at least most of them must be wrong. After all, how many true explanations can there be?”

Herbert Fingarette (1989). Heavy Drinking: The Myth of Alcoholism as a Disease.

“Research to date has shown that no one causal formula explains plains why people become heavy drinkers. Indeed, the attempt tempt to find a single catchall “cause” of a single “disease” has repeatedly led researchers astray. On the basis of all the available evidence, many scientists are challenging any theory that assumes “[a] sharp distinction between the determinants of ordinary drinking and harmful drinking.”

There are, in short, many kinds of heavy drinking that arise from many different causes and produce many different patterns of associated problems. This recognition, after all these years of research, is not evidence of failure. It is an important and productive discovery, for we now know that we can give up the search for an explanation of a disease that does not exist. We can then look at the realities of alcohol abuse in our society and begin to think constructively about the variety of people and problems associated with alcohol abuse.”

Herbert Fingarette (1989). Heavy Drinking: The Myth of Alcoholism as a Disease.

“addiction is not a chemical side effect of a drug. Rather, addiction is a direct result of the psychoactive effects of a substance–of the way it changes our sensations. The experience itself is what the person becomes addicted to. In other words, when narcotics relieve pain, or when cocaine produces a feeling of exhilaration, or when alcohol or gambling creates a sense of power, or when shopping or eating indicates to people that they are being cared for, it is the feeling to which the person becomes addicted. No other explanation–about supposed chemical bondings or inbred biological deficiencies–is required.”

Stanton Peele (1999). Diseasing of America: How We Allowed Recovery Zealots and the Treatment Industry to Convince Us We Are Out of Control

“after reviewing the available research from both sides of the debate, the belief in the disease of alcoholism (addiction), causes the disease. Organizations and institutions that promote the disease theory are, in many cases, doing irreparable harm to the individual and performing a disservice to the population as a whole. Geneticists are aware that a predisposition does not dictate subsequent behavior, and treatment professionals are aware that the programs they offer, fail. It is an outright injustice when faced with the facts. Stripping human beings of their ability to choose is damaging, whereas giving them back the power of their own volition is essential for recovery. Alcoholism is a choice, not a disease.”

Alcoholism Is Not A Disease, Baldwin Research Institute

During the 1990s – known as the “decade of the brain” – advancements in neuroscience and brain imaging meant “technology caught up with the terminology,” Ritter says. “There seemed to be a shift from the term ‘disease’ as a rhetorical device to something that Americans believed literally. This simplifies dependence down to brain chemistry. In reality it is a complex cultural, social, psychological and biological phenomenon.”

Ritter predicts fatigue with the brain disease model. “It has not produced any new technologies for treatment nor necessarily decreased stigma or improved the lot of people who experience dependence problems,” she says. “So in a sense, there is this available space to ask: ‘What has it been good for, if anything?'”

Professor Alison Ritter​, director of the Drug Policy Modeling Program at the University of New South Wales

Quoted in “Why addiction isn’t a disease but instead the result of ‘deep learning'” by Jenny Valentish

“We disagree with your one-dimensional view that addiction is a disease, and with your claim that this view is not particularly controversial among scientists… Neuroscience has been widely documented as just one of many important influences in drug addiction.

Substance abuse… is not simply a consequence of brain malfunction. Such a myopic perspective undermines the enormous impact people’s circumstances and choices have on addictive behaviour. It trivializes the thoughts, emotions and behaviours of current and former addicts.”

Derek Heim of Edge Hill University, Ormskirk, UK, on behalf of 94 signatories in the addiction field – working in academia; policy; neuroscience, sociological, behavioral, and psychological research; and in professional practice helping people with substance use problems. From a letter to the editors of the Journal Nature, in response to an article stating the typical brain disease view of addiction.

Signatories to the letter:

Ravindra Agrawal Manipal Hospital, Goa, India
Allaman Allamani Firenze, Italy
Philippe Arvers Université de Grenoble, Grenoble, France
Franca Beccaria Eclectica, Institute for Training and Research, Torino, Italy
Virginia Berridge London School of Hygiene and Tropical Medicine, UK
Jan Blomqvist Stockholm University, Sweden
Sadie Boniface University College London, UK
Raimondo Bruno University of Tasmania, Australia
Julian Buchanan Victoria University of Wellington, New Zealand
Gerhard Bühringer Technische Universität Dresden, Germany
Doug Cameron University of Leicester (Emeritus), Market Bosworth, Nuneaton, UK
Tanya Chikritzhs Curtin University, Australia
Ross Coomber Plymouth University, UK
Stephanie Covington Center for Gender and Justice, La Jolla, California, USA
Phil Dalgarno Glasgow Caledonian University, UK
John B. Davies University of Strathclyde (Emeritus), Glasgow, UK
Tom Decorte Ghent University, Belgium
Vagner Dos Santos University of Brasilia, Brasilia-DF, Brazil
Cameron Duff Monash University, Victoria, Australia
Johan Edman Stockholm University, Sweden
Francisco Eiroa Orosa University of East London, UK
Niamh Fitzgerald University of Stirling, UK
Alasdair Forsyth Glasgow Caledonian University, UK
Vibeke Asmussen Frank Aarhus University, Denmark
Suzanne Fraser Curtin University, Victoria, Australia
Lars Fynbo Social Policy and Welfare Services, Copenhagen, Denmark
Wayne Hall The University of Queensland, Herston, Australia
Jan Halldin Karolinska Institutet, Solna, Sweden
Richard Hammersley University of Hull, UK
Lana Harrison University of Delaware, Newark, USA
Carl Hart Columbia University, New York, USA
Nick Heather Northumbria University (Emeritus), Newcastle upon Tyne, UK
Derek Heim Edge Hill University, Ormskirk, UK
Matilda Hellman University of Helsinki, Finland
Ray Hodgson Alcohol Research UK, London, UK
John Holmes University of Sheffield, UK
Geoffrey Hunt Institute for Scientific Analysis, Alameda, California, USA
Jerome H. Jaffe University of Maryland School of Medicine, Baltimore, Maryland, USA
Margaretha Järvinen University of Copenhagen, Denmark
Chris-Ellyn Johanson Chicago, Illinois, USA
Harold Kalant University of Toronto (Emeritus), Ontario, Canada
Katherine J. Karriker-Jaffe San Mateo, California, USA
Srinivasa Vittal Katikireddi MRC/CSO Social and Public Health
Sciences Unit, University of Glasgow, UK
Florence Kellner Carleton University (Emeritus), Ottawa, Canada
Axel Klein University of Kent, UK
Dirk J. Korf Universiteit van Amsterdam, Netherlands
Anja Koski-Jännes University of Tampere (Emeritus), Finland
Kypros Kypri University of Newcastle, Australia
Paul Lemmens University of Maastricht, Netherlands
Neil Levy University of Melbourne, Australia
Scott O. Lilienfeld Emory University, Georgia, Atlanta, USA
Anne Lingford-Hughes Imperial College London, UK
Susanne MacGregor London School of Hygiene and Tropical Medicine, UK
Claire Mawditt University College London, UK
Jim McCambridge London School of Hygiene & Tropical Medicine, UK
Neil McKeganey Centre for Drug Misuse Research, Glasgow, UK
Petra S. Meier University of Sheffield, UK
Rebecca Monk Edge Hill University, Ormskirk, UK
David Moore Curtin University, Victoria, Australia
Philip Murphy Edge Hill University, Ormskirk, UK
Ethan Nadelmann Drug Policy Alliance, New York City, New York, USA
Abhijit Nadkarni London School of Hygiene and Tropical Medicine, UK
James Nicholls Alcohol Research UK, London, UK
Kerry O’Brien Monash University, Australia
Pat O’Hare Prevessin, France
Stephen Parkin University of Huddersfield, UK
Andy Parrott Swansea University, UK
Stanton Peele New York City, New York, USA
Andrew Percy Queen’s University Belfast, UK
Hanna Pickard University of Oxford, UK
Melissa Raven Flinders University, Australia
Amanda Reiman University of California, Berkeley, USA
Craig Reinarman University of California, Santa Cruz, USA
Tim Rhodes London School of Hygiene and Tropical Medicine, UK
Ron Roizen Wallace, Idaho, USA
Stephen Rollnick Cardiff University, UK
Anders Romelsjö Karolinska Institutet (Emeritus), Sweden
Robin Room University of Melbourne, Australia
Fred Rotgers Manasquan, New Jersey, USA
Alastair Roy University of Central Lancashire, UK
Sally Satel Yale University, USA
Toby Seddon University of Manchester, UK
Gillian W. Shorter University of Ulster, UK
Roland Simon European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal
Martine Stead University of Stirling, UK
Gerry Stimson Imperial College London (Emeritus); London School of Hygiene and Tropical Medicine, UK
Tim Stockwell University of Victoria, Canada
Jessica Storbjörk Stockholm University, Sweden
Stuart Taylor Liverpool John Moores University, UK
Andy Towers Massey University, New Zealand
Richard Velleman University of Bath (Emeritus), UK
Darin Weinberg University of Cambridge, UK
Reinout W. Wiers Universiteit van Amsterdam, Netherlands
Sharon C. Wilsnack University of North Dakota, USA

Too often anecdote alone and misinterpretation of data drive the unrealistic and inaccurate drug stories presented to the public. For example, despite the fact that there are practically no data indicating that recreational drug use causes a brain disease, many people, including some drug scientists, believe otherwise. But beliefs alone are insufficient to guide drug-education efforts and evidence-based health policies.

Carl Hart (2021). Drug Use for Grown-Ups.
See more of Carl’s work at drcarlhart.com

---

Loss Of Control of Drug and Alcohol Use

“Up to the early 1960’s the evidence on which formulations of loss of control and craving had been based were the clinical observations of psychiatrists and other professional helpers and the historical reports of their experiences given by recovered alcoholics themselves. Thus the ultimate source of this evidence was, in both cases, the retrospective accounts of past or present alcoholics made when sober. However well-intentioned and devoted to accuracy, such accounts are obviously suspect for scientific purposes, owing, for example, to alcohol-induced amnesias, to the general fallibility of human memory, the possibility of conscious or unconscious anticipation of the interviewer’s expectations and the influence of theoretical constructions of alcoholism to which the alcoholic individual or the interviewer may have subscribed. The main point is that no systematic observations of alcoholics’ drinking behavior had been made under controlled conditions and subject to elementary objective criteria for the collection of scientific data.”

Nick Heather & Ian Robertson, Controlled drinking, 1981

“Case-control studies do not show whether addiction is a cause or a consequence of differences in brain structure and function or some combination of the two. Patterns of brain activity on MRI in people with addiction differ from people without addiction and do not show the use of drugs is a compulsion. The fact that decreased activity in frontal brain regions is modestly correlated with self- reported drug craving does not show that drug use is driven by irresistible impulses.”

Hall, W., Carter, A., & Forlini, C. (2015). The brain disease model of addiction: is it supported by the evidence and has it delivered on its promises? The Lancet Psychiatry, 2(1), 105–110.

“Is being addicted really something else as not wanting to change behavior? Resisting change in spite of negative consequences is such a basic element of everyday life, that when googling “resistance to change” 532.000 results appear, from scientific to popular literature. ‘Resistance to change’ is not often read as loss of control, but in the case of addiction it is. The key is in words like ‘uncontrollable’ and ‘compulsive’ but as said, we may have a very selective eye for where we assume the existence of control, and where not.”

Peter Cohen (2009). The Naked Empress. Modern neuro-science and the concept of addiction. Presentation at the 12th Platform for Drug Treatment, Mondsee Austria, 21-22 March 2009. Cedro.

---