The NIDA Brain Disease Paradigm: History, Resistance and Spinoffs

This article examines ‘the NIDA paradigm’, the theory that addiction is a chronic, relapsing brain disease characterized by loss of control over drug taking. I critically review the official history of the National Institute on Drug Abuse (NIDA) paradigm and analyze the sources of resistance to it. I argue that, even though the theory remains contested, it has yielded important insights in other fields, including my own discipline of history.