Pharmacological Research on Addictions: A Framework for Ethical and Policy Considerations (Report‪)‬

Although psychopharmacological research on drugs of abuse and addiction has been conducted for nearly 50 years, most of the ethical conflicts in the early years of study centered on such psychosocial dilemmas as confidentiality, privacy, and criminalization of the ingestion of certain mood-altering drugs (Buchanan et al. 2002). Recent scientific discoveries in genetics, neurochemistry, and brain imaging have demonstrated that there is an important biological contribution to the development of substance use disorders (SUD). Additionally, neuroscience has provided evidence for cuing, context-driven consumption, and other behavioral phenomena associated with addiction (Goldstein & Volkow 2002; Miller & Goldsmith 2001; Volkow, Fowler & Wang 2003) Gradually, a model of "addiction solely as a brain disease" has gained popularity, both supplementing and supplanting the traditional medical model and bringing with it expanded opportunities for research funding. According to Hall and colleagues, "Addiction as 'brain disease' has some of the appeal of the older 'disease models' of addiction with the added authority of the latest science. A 'disease' that can be 'seen' in the many-hued splendor of a PET scan carries more conviction that one justified by the possibly exculpatory self-reports of addicts who claim they are unable to control their drug use" (Hall, Carter & Morley 2003; Kleiman 2003; Wise 2000). The majority of researchers and opinion leaders in the field view SUD as having bases in not only neurobiology but also experience and environmental factors (Uhl 2003). Yet some contemporary interpretations of the brain disease model, such as the belief that biology determines addictive behavior to such an extent that individuals with SUDs are unable to make free choices (Charland 2002; Cohen 2002), could constrain the type of research that it is considered ethical to conduct.