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Practical Recovery

The Continuing Debate About Addiction As a Disease

By Posted on April 3, 2026

By Tom Horvath, PhD

A recent scientific article entitled “Transcriptional regulation of ventral hippocampus-nucleus accumbens circuit excitability drives cocaine seeking” was summarized in a professional article at www.NeuroscienceNews.com (3/4/2026) under the title, “Cocaine Addiction is a Biological Rewiring, Not a Choice.” It was a large jump from the scientific article to the professional one. Let’s look at the problems with where they landed.

The study found brain changes from cocaine use and found that those changes make cocaine more desirable. As the professional article summarized:

The “Master Switch”: The protein DeltaFosB accumulates in the brain’s reward-memory circuit during chronic cocaine use, making it harder to quit and easier to relapse.

Rewiring the Hippocampus: Cocaine use doesn’t just change how you feel; it physically alters the hippocampus, the brain’s memory center, linking drug-seeking behavior to deep-seated survival instincts.

Continuing the Debate About Addiction

The counterargument I will make is more logical than scientific. If that “master switch” is so powerful, then presumably no one can quit using cocaine once they get to a sufficient accumulation of DeltaFosB, and the switch has been thrown. Once the switch is thrown, there should be a permanent state of using cocaine (as long as one can obtain it, and perhaps allowing for some time for recovering from cocaine binges).

However, most people who become heavily involved with cocaine or other substances end up getting over them (a topic to be covered in a future blog). Therefore, it must be possible to overcome that “master switch.” What is the point of calling it a master switch, if something else controls it?

I suggest this “master switch” label is misleading. I assume all have experienced something becoming more enjoyable in life. This scientific article helps us understand how the molecules moving around in our brains explain cocaine becoming more enjoyable, or at least more desired. What DeltaFosB does not explain is how we stop.

Yet stopping would seem to be more important to understand. We cannot rush scientific experimentation, and this impressive study appears to add significantly to our knowledge. Nevertheless, it is misleading, as the professional article does, to suggest that there is a master switch that changes cocaine use out of being a choice. What is plausible is that with enough DeltaFosB the choice is harder.  However, any cocaine user could tell you that if you keep using cocaine, it’s hard to stop. Until you do.

When it comes to the debate about addiction: We can move beyond addiction as a disease and acknowledge that we have choices about all our behavior. If I am not controlling my hands, feet, mouth, etc., who is? We can focus on how to make difficult choices easier, to better align our immediate behavior with our long-term values. We can recognize how choices that are easy for some are exceedingly difficult for others. We can recognize that probably all of us face difficult choices, just in different ways. Cocaine may be hard for you, ice cream for me. There can be radically different impacts from cocaine and ice cream, but we can unite in attempting to understand and face difficult choices. By confusing ourselves with non-sensical ideas that we have no choices about our behavior, we get distracted from the work we will be better off for doing.

Liked this article on Continuing the Debate About Addiction As a Disease? You might also be interested in: Is Addiction a Disease?

https://neurosciencenews.com/cocaine-brain-rewiring-deltafosb-30246/

https://www.science.org/doi/10.1126/sciadv.adv1236

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