Overthink Addiction with Hanna Pickard
Feb 24, 2026
Hanna Pickard, philosopher and bioethicist at Johns Hopkins and author on addiction, offers a nuanced critique of the brain-disease and moral models. She explores how addiction is defined when drug use 'goes wrong.' Conversation covers the rise and limits of the broken-brain view, identity changes in long-term addiction, heterogeneity of causes, and using responsibility constructively in care.
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Pocket Contracts That Helped People Quit
- Hanna Pickard described using group 'quit' contracts with written commitments as a therapeutic tool for people with addiction.
- The contracts, simple pieces of paper kept in pockets and used to prompt support calls, helped many patients despite being non-medical interventions.
Brain Disease Model Replaced Moralism But Oversimplifies
- The brain disease model rose to counter moralizing views and to secure funding and reduce stigma, but it simplifies addiction into a single explanation.
- Hanna argues this forced binary (moralism vs brain disease) occludes more accurate plural explanations and ethical nuance.
Broken Brain Label Fuels Pessimism And Stigma
- Labeling addiction as a 'broken brain' produces mixed social effects: more funding but increased stigma and fatalism about recovery.
- The model can deter problem recognition and foster internalized shame, undermining individuals' agency in recovery.
