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Neuroscientific technologies have begun to change the ways in which we understand, respond to, and treat drug addiction. According to addiction researchers, neuroscience marks a new era because of its potential to locate the causes of addiction within the brain and to treat addiction through altering neurochemistry. However, little is known about how addiction neuroscience and new neurochemical treatments shape individuals' experience of addiction and constitute new arrangements of knowledge and power that shape subjectivity and governance. This chapter addresses these domains by drawing on an analysis of scientific literature about addiction neuroscience and qualitative interviews with people being treated for addiction with buprenorphine, a pharmaceutical treatment for opioid dependence. The chapter charts four major themes in the addiction neuroscience literature (pleasure and the limbic system, rationality and the role of the prefrontal cortex, theories of plasticity, and the role of volition) and explores how each of these is incorporated, adapted, or rejected by individuals being treated for addiction with a pharmaceutical. This analysis demonstrates how neuroscientific ideas are mediated by the lived experiences of those being treated under a neuroscientific model. It also suggests that while neuroscientific interventions, like pharmaceuticals, shape the experience of those being treated for addiction, so too do many other forces, including social circumstances, moral frameworks, the drive for autonomy, and the quest to be “normal.”

Neuroscientific research on addictions has prompted a paradigm shift from a moral to a medical understanding – with substantial implications for legal professionals’ interactions with and decision-making surrounding individuals with addiction. This study complements prior work on US defense attorney’s understandings of addiction by investigating two further perspectives: the potential “next generation” of legal professionals in the USA (criminal justice undergraduates) and legal professionals from another system (Germany). This paper aims to assess their views on the brain disease model of addiction, dominance and relevance of this model, the responsibility of affected persons and preferred sources of information.

Views of 74 US criminal justice undergraduate students and 74 German legal professionals were assessed using Likert scales and open-ended questions in an online survey.

Neuroscientific research findings on addictions and views that addiction is a brain disease were rated as significantly more relevant by American students to their potential future work than by German legal professionals. However, a majority of both samples agreed that addiction is a brain disease and that those affected are responsible for their condition and actions. Sources of information most frequently used by both groups were publications in legal academic journals.

In the USA, information for legal professionals needs to be expanded and integrated into the education of its “next generation,” while in Germany it needs to be developed and promoted. Legal academic journals appear to play a primary role in the transfer of research on addiction into legal practice.

This study complements prior work on US defense attorney’s understandings of addiction by investigating two further perspectives.

Purpose – This chapter critically examines efforts to destigmatize addiction through the creation of a diagnostic category and medicalization. It further critiques “realist” accounts of neuro-scientific knowledge, proposing instead a “biocultural” framework that enables a more multifaceted understanding of drug problems that leads back to questions of biopolitics.

Methodology/approach – After showing that medicalization is not always associated with destigmatization, this chapter reviews evidence suggesting that the social class of drug users is central to questions of stigma. A literature review concerning social constructionist approaches to bodies is then offered, culminating in an exploration of “biocultural” frames and their implications for psychiatric knowledge.

Findings – The material world can only be grasped through a cultural frame, an understanding that challenges “realist” accounts of knowledge. While making reference to brain functioning, psychiatric “disorders” in fact identify violations of interpersonal or psychic norms. These violations cannot be linked in a linear way to patterns of brain activity, even at a theoretical level.

Social implications – This chapter points toward a way of analyzing psychiatric disorders that allows for and highlights their political effects. Without ruling out medical interventions, it suggests that clinical and social understandings are an essential component of psychiatric understanding.

Originality/value of chapter – While “biocultural” approaches have been proposed by other social theorists, this chapter applies the frame in new ways to the psychiatric endeavor. In the face of increasing medicalization within the field of psychiatry, this chapter makes a strong theoretical case concerning the value of clinical and social knowledge concerning psychiatric disorders.

Purpose – With reference to the long-term struggle to confirm cigarette smoking as a manifestation of nicotine addiction, this chapter explores the extent to which new understandings of addictions as ‘appetitive disorders’ rather than ‘dependence disorders’ derive from treatment technology development as well as advances in basic scientific research.

Approach – Through historical analysis it is discussed how cigarette smoking only became widely accepted as a real drug problem in the 1980s after it had been shown to be amenable to treatment as such through the use of novel nicotine replacement therapies.

Findings – These replacement therapies succeeded in showing that the same drug that drew users into addiction could be redeployed to help draw up them out of it. Nicorette® could serve as at least the partial antidote to nico-wrong (cigarettes). However, as relapse to smoking has remained the most likely outcome of any smoking cessation attempt, so medicinal nicotine has also served to demonstrate that nicotine addiction is ultimately a problem of an uncontrollable appetite for cigarettes in excess of drug dependence.

Implications – Pharmaceutical incursion on cigarette smoking commencing in the late 1970s pointed to the need for a new mental disease model of drug-related problems while also providing valuable new tools and insights for ensuing brain research.

Biological understandings of mental illness are promoted by both anti-stigma campaigners and increasingly by activists protesting against social security cuts. The purpose of this paper is to analyse the pitfalls of the “illness” conceptualisation for reducing discrimination, comments on divisions between those arguing for a right to work and those who seek a right not to work, and proposes bridge building and more effective messages, drawing on the UN Convention on the Rights of Persons with Disabilities.

Review of relevant evidence on the effectiveness or lack of it of the “mental illness is an illness like any other” message in anti-stigma work, and discussion of grey literature from campaigners and bloggers.

There is a growing body of evidence that the “illness like any other” message entrenches rather than reduces stigma and discrimination: this message should not be used in anti-discrimination work. At the same time some social security bloggers and campaigners have argued they are “sick” in order to resist efforts to compel them to seek work or face sanctions; whilst older disability rights campaigners have argued for the right to work. The paper argues for new bridge building and use of evidence based messages in campaigning.

This paper is based on review of evidence on the impact of using the “illness” message to reduce stigma and discrimination; and on discussion of campaigns and blogs. It is not based on a systematic review of campaigns.

There is a need for campaigns that support rights holistically – the right to a decent standard of living and the right to work. This requires bridge building between activists, which could usefully be rooted in the UN Convention on the Rights of Persons with Disabilities. The “illness” conceptualisation is harmful to the effort to reduce stigma and discrimination. Mental health staff can act as allies to those they serve in securing all these rights.

This is the only recent paper to analyse the evidence that the “illness like any other” message is harmful in anti-stigma work, together with its implications for the recent phenomenon of mental health campaigners moving from opposition to the medical model, to a new argument that they are “too sick” to work. This paper suggests ways forward for everyone with an interest in combatting stigma and discrimination.

So much has been written about addiction, one can reasonably ask why we need another volume on the subject now. The pieces gathered here take up a number of current trends that make this exactly the right time to take a fresh look at addiction. These include: debates over the nosology of addiction as part of the revision to the Diagnostic and Statistical Manual of Mental Disorders (DSM); the expansion of addiction's meaning and spheres of control beyond alcohol and illicit substances; the rise of neuroscience; the increasing ‘pharmaceuticalization’ of everyday life and new pharmaceutical treatments for addiction; growing awareness about the intersection of the drug war and the mass incarceration of people of color; and new theoretical frameworks for understanding the role of addiction as a fundamental technique of social control. These trends are reshaping addiction in both new and not-so-new ways that warrant the interrogation this volume provides.

Purpose – This chapter explores how discourses of obesity as addiction are taken up by weight loss surgery patients and medical and scientific professionals.

Methodology/approach – Based on 14 semistructured interviews, I discuss the ways in which bariatric patients partially account for their presurgical bodies and contemporary struggles with weight loss and regain by referencing food addiction. This work is part of a larger project involving 35 interviews and participant-observation work and therefore these results should thus be considered preliminary.

Findings – I argue that bariatric patients and bariatric professionals portray weight loss surgery as an extraordinary tool that allows the “out of control” to become controllable. However, bariatric patients also emphasize the hard work that is entailed in both losing weight and maintaining a weight loss even after surgery.

Social implications – I suggest that this portrayal, in addition to being an accurate assessment of the potential for regain following weight loss surgery, is a technology of stigma management.

Originality/value – This work contributes to the sociology of the body and medical sociology literatures by illustrating that, within a neoliberal and anti-fat social context, highlighting the hard work involved in weight loss and weight maintenance allows bariatric patients to demonstrate proper subjectivity and thereby reclaim “proper selves” as they work toward a “proper bodies.”

The purpose of this study is twofold. First, the study shall evaluate the extent of usage of grey literature and its different types of addiction research. The second purpose of the research is to analyze the extent of usage of reports such as research reports, survey reports, data reports, etc. As the reports are produced in general by various organizations and can be accessed by not only academicians but also the general public, they play an important role in the dissemination of research to the people. Therefore, the study endeavored to identify the major organizations that are involved in the publishing of research reports in the field of addiction.

Scopus database was used for the purpose of collecting the data. References in the reference lists of the articles published in 2018 in the journal Psychology of Addictive Behaviors of the American Psychological Association were collected. Scopus indexes the references of the papers in two different categories, namely, indexed in scopus/scopus references and reference lists. They were then categorized as grey literature and non-grey literature. Further, reports were searched manually so that their producers/authors can be found and categorized according to the organizations.

The study found that grey literature comprises a very small proportion of citations in addiction research (just approximately 5 per cent). This suggests that the improper indexing and bibliographic control of grey literature may be one of the reasons behind the low numbers. Reports comprised the largest proportion of the grey literature cited in addiction research, followed by software documentation, unpublished manuscripts, guidebooks, handbooks, manuals, websites, government publications, etc. The reports of the US Department of Health and Human Services comprised the maximum citations in the reports category because of the reports produced by organizations like Substance Abuse and Mental Health Services Administration (SAMHSA) which comprised 17.59 per cent of the total reports. National Institute of Health (USA) and Centers for Disease Control and Prevention and others. Other than the reports of the organizations of the USA, the reports published by the organizations of Canada, Australia, UK, New Zealand and one European Body were also cited by the articles of the journal.

The research focuses on the use of grey literature in addiction research. The findings of the study indicate very low citations to grey literature in addiction research. This reinforces the need for a separate worldwide information retrieval system for grey literature for researchers to conduct systematic reviews.

Very few studies have been conducted on the use of grey literature and hardly any research focuses on the use of grey literature in addiction research. The study goes one step further and identifies major organizations that are involved in the production of research reports in the field so that their reports can be properly indexed.

The Therapeutic Communities (TCs) movement tends to become from a revolutionary answer to the problem of addiction to another mainstream therapeutic proposal. The author considers that the crisis in 1968 in the seminal TC of Daytop was a pivotal event of this transition. This study aims to evaluate the impact of this historical crisis on the course of the TCs movement, assuming that, to enter into a constructive dialogue that can lead to the overcoming of today’s deadlocks of the movement, an awareness of the history is needed.

The present paper is a perspective/opinion paper and starts with a brief review of the origins of the first TCs for addicts. Emphasis is placed on their inevitable, according to the author, confrontation with the political and scientific status quo of that time. Then, it focuses on the period of the crisis in Daytop TC. The author interprets the events under a whole new scope, based on conversations he personally had with pioneers of that time, on his longstanding experience on the field, and the available literature.

The author attempts a historical and sociological analysis of the course of TCs and the Daytop TC. He concludes with a dispute of the prevailing idea that the Daytop crisis was a product of the confrontation between personal ambitions. He maintains that the collision that took place in Daytop TC was a confrontation between two antipodal perspectives over the notion of therapy. In any case, the subsequent estrangement of the movement from the groundbreaking attributes of the first TCs did not prove to be in the best interests of addicts; it was rather dictated by the need of the leaders of TCs to rescue their professional career.

The present paper attempts to offer a different view from the conventional reading of TCs’ history and their present situation for today’s predicaments of this proposal to be understood and possibly overcome.