Are addicted individuals responsible for their behaviour?

Abstract

For two centuries, clinicians have argued that chronically addicted individuals suffer from a disease that is produced by the effects that chronic alcohol or drug use has on their brains. Neuroscience research has provided support for this view by describing the brain mechanisms that are believed to underlie chronic addiction. Research on animals has revealed the neurochemical circuitry on which psychoactive drugs of dependence act and produced animal models of human addiction that reproduce features of human addiction, such as drug tolerance and withdrawal symptoms, and rapid reinstatement of drug use after periods of abstinence. Human neuroimaging studies suggest that similar neurobiological processes operate in the brains of addicted humans. Leading proponents of neurobiological research on addiction have argued that it shows that addiction is a chronic brain disease. In this paper we critically examine the research used to support this claim and discuss its implications for ascribing responsibility to addicted persons for criminal acts that they commit to enable their drug use. We also assess whether the evidence for a brain disease model of addiction justifies the compulsory treatment of severely addicted persons for paternalistic reasons, that is, for their own good.