When the Brain Leaves the Scanner and Enters the Clinic

Abstract

Addiction neuroscience promises to uncover the neural basis of addiction by mapping changes in the "diseased brains" of people with "drug addictions." It hopes to offer revolutionary treatments for addiction and reduce the stigma experienced by those seeking treatment for a medical, rather than moral, condition. While the promises of addiction neuroscience have received considerable attention, relatively few studies have examined how neuroscientific discourses and promises play out in drug treatment settings. Instead of asking how neuroscience might measure or treat a preexisting addiction "problem," we draw on poststructuralist ideas to trace how neuroscientific discourses produce addiction as a certain type of "problem" and the effects of these particular problematizations. Based on interviews with a range of different types of treatment providers working in Victoria, Australia, we discuss three themes that reveal neuroscientific discourses at work: (1) constituting pathological subjects, (2) neuroplasticity and "recovery," and (3) the alleviation of guilt and shame via references to the "diseased brain." On the basis of our analysis, we argue that dominant neuroscientific discourses produce patients as pathologized subjects, requiring medical treatment. We also contend that the intersection of neuroscientific and recovery discourses enacts "recovery" in terms of brain "recovery" through references to neuroplasticity. Further, when

“An exercise in careful diplomacy”: talking about alcohol, drugs and family violence

“…The AOD sector has employed a more "medical" approach (Humphreys et al 2005), focused on the individual (rather than broader societal factors), and seeking to reduce the stigma of addiction by framing it as a disease or disorder. One study examining the discourse of Victorian AOD treatment providers found that they tended to alleviate the guilt and shame of substance abusers by referring to the "diseased" or "hijacked" brain (Barnett et al 2018). This "medical" model of addiction as disease or disorder can be seen as allowing men to shift responsibility for violence.…”