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[Perspectives] Addiction treatment in the USA: signs of change

In 1997, Alan Leshner, the then Director of the US National Institute on Drug Abuse (NIDA), argued that addiction should be understood as a chronic, relapsing, brain disease. Drug use was initially voluntary, he argued, but chronic drug use flicked a neurochemical switch in the brain that made it difficult to stop using drugs. These unspecified changes in brain function were said to comprise a disease that explained why addiction was a chronic, relapsing disorder. The brain disease model of addiction, Leshner argued, would lead to more effective drug treatments.