This article by psychiatrist and psychologist Sally Satel and Scott Lilienfeld in Slate magazine offers compelling arguments against the current trend to see addictions as brain diseases (hat tip: Mind Hacks). Much of the rhetoric about addictions as a disease has been motivated by the Director of the National Institute of Drug Abuse, Dr. Nora D. Volkow. Since addictions are currently not considered diseases in the traditional sense, health insurers often refuse or limit their coverage for substance abuse treatment. The effort by Dr. Volkow is a noble one in a certain sense since the cost of addictions literally and figuratively is enormous. Indeed, HBO recently aired a gripping documentary pretty much espousing the additions as a brain disease model. What is troubling, however, is that brain scans have been heavily implemented by the addictions-as-disease model proponents in an effort to convince the public that addictions are indeed caused by brain abnormalities indicative of disease pathology. But, of course, brain scans cannot tell us anything about causation and as the Satel and Lilienfeld article notes, there's much skepticism surrounding their use in addictions. This article by law professor Stephen Morse, also notes the difficulties in conceptualizing addictions as brain diseases. But this is hardly new, see also: Herbert Fingarette, Addiction and Criminal Responsibility, 84 YALE L. J. 413, 414-415 (1975) (sorry, no link).