Emerging Neurobiological Treatments of Addiction: Ethical and Public Policy Considerations

This chapter examines prospective neurobiological interventions on the horizon and discusses some of the ethical and social challenges that may arise from their future use. The use of neurobiological treatments for addiction can often serve competing goals. The usual aim of medical treatment is to alleviate or cure an affected person’s condition. Neurobiological treatments targeted at the individual may come at the expense of broader social approaches to reduce drug use such as taxation, education, and welfare initiatives or a failure to address the social problems that promote drug use and poor treatment outcomes. The most commonly used pharmacological approaches to treat addiction have involved either drug substitution or relapse prevention. In drug substitution, a patient is prescribed a drug that has similar but less harmful effects than the drug that is abused. Anti-craving drugs aim to reduce relapse by preventing or reducing the intensity of cravings. Drugs for which there is some evidence of anti-craving effects, from either animal studies or human clinical trials, include acamprosate, bupropion, disulfiram, ondansetron, and naltrexone.