The Clinical Impact of the Brain Disease Model of Alcohol and Drug Addiction: Exploring the Attitudes of Community-Based AOD Clinicians in Australia

Abstract

Despite recent increasing support for the brain disease model (BDM) of alcohol and drug addiction, the extent to which the model may clinically impact addiction treatment and client behaviour remains unclear. This qualitative study explored the views of community-based clinicians in Australia and examined: (i) whether Australian community-based clinicians support the BDM of addiction; (ii) their attitudes on the impact the model may have on clinical treatment; and (iii) their views on how framing addiction as a brain disease may impact addicted clients’ behaviour. Six Australian community-based clinicians participated in semi-structured in-depth interviews that were analysed using thematic analysis. Whilst the BDM was not fully supported by this purposive sample of Australian community-based clinicians, there was acceptance that addiction neuroscience formed a key part of a wider addiction framework. Participants believed the BDM ignored key social, psychological and environmental factors important for successful treatment. The BDM was seen as potentially irrelevant for certain client types (e.g., where housing or financial concerns were of high priority), however the model was believed to integrate with particular therapies (e.g., mindfulness or cognitive-behaviour therapy). Participants believed that for clients viewing their addiction in terms of a brain disease, there were potential positive (increased insight and decreased stigma) and negative (increased stigma and sense of helplessness, reduced personal responsibility) impacts on client behaviour. Implications for addiction treatment practice and public health policy are discussed.