Crisis, what crisis? Addiction neuroscience and the challenges of translation

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In this article we interrogate the claim that there is an opioid crisis: a
dramatic rise in drug overdose fatalities in the United States over the
past two decades that is also spreading to other countries. The usual
argument is that this crisis is largely explained by errant prescription
practices leading to an oversupply of opioids, leading to addiction,
premature mortality and drug overdose deaths, both among those
prescribed opioids for pain relief, and those obtaining them on the
illegal market. We argue, that this view is highly problematic and that
it is likely to entrench deeper problems with how substance addiction
has been perceived and known. In this article, we develop an
alternative picture of the addiction crisis based on four years of
research and collaboration with addiction neuroscientists. Drug
overdose deaths, we claim, are symptoms of what we term the
‘structural distribution of social despair.’ We argue that this is
compounded by a translation crisis at the heart of addiction
neuroscience. For all its dominance, the ‘dopamine hypothesis’ of
addiction that shaped understandings for some three decades, has
still not produced a single effective treatment. However, this
translation crisis also represents an opportunity for ‘the memory turn’
in addiction neuroscience as it seeks to translate its emerging
conception of addiction as a problem of memory into effective forms
of treatment. We conclude by arguing that, for the ‘memory turn’ to
underpin effective interventions into ‘the opioid crisis’, a new relation
between neuroscientists and social scientists of addiction is needed,
one that proceeds from the lived experience of human beings.
Original languageEnglish
Pages (from-to)1-20
Number of pages20
JournalWellcome Open Research
Issue number215
Early online date14 Sept 2020
Publication statusPublished - 14 Sept 2020


  • Drug addiction
  • opiod crisis
  • translation
  • addiction neuroscience
  • the memory turn
  • dopamine theory
  • critical friendship


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