When you hear or see the word “addiction,” what is your first thought? If you are like me your brain went right to drugs and alcohol. This is totally understandable as drugs and alcohol garner the most attention. I mean, how often do you hear about Clutterers Anonymous, Debtors Anonymous, or Online Gamers Anonymous? Again, if you’re like me you had no idea these groups existed. Wikipedia lists 34 types of recovery groups based on a 12-step program, and I’m sure there are many more not listed. The reason so many groups have sprung up could perhaps be attributed to the American Society of Addiction Medicine’s (ASAM) release of a new definition of addiction. Over 80 experts from the ASAM spent four years developing the new parameters and identifying addiction as a chronic brain disease. They concluded it develops from physical abnormalities in the reward circuitry of the brain, particularly in atypical differences in the way areas of the brain communicate regarding memory, emotional response and pleasure. Dr. Michael Miller, a former ASAM president who oversaw the four-year study, felt that addiction, at its core, is not just a social problem or a moral problem or a criminal problem, it is a brain problem whose behaviors manifest in all these other areas. The disease is about brains, not drugs. It is about underlying neurology, not outward actions.
Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.
Addiction is characterized by inability to consistently abstain, impairment in behavioral
control, craving, diminished recognition of significant problems with one’s behaviors and
interpersonal relationships, and a dysfunctional emotional response. Like other chronic
diseases, addiction often involves cycles of relapse and remission. Without treatment or
engagement in recovery activities, addiction is progressive and can result in disability or
American Society of Addiction Medicine “Public Policy Statement: Definition of Addiction” 8-15-2011
The main features, in layman’s terms, of this new vision as cited on the Addiction.com website are:
All addictions are simply addiction. In other words, addiction to food and gambling is the same as drug addiction. This new way of thinking would change how doctors diagnose this category of disorders. In the Diagnostic and Statistical Manual of Mental Disorders (DSM), each kind of addiction is considered a separate behaviorally based disease, i.e., substance abuse is not the same as alcohol abuse or obsessive shopping.
Imbalances in the brain’s reward system cause the disease. This means addictions do not cause brain differences, although addictions reinforce them.
Addiction is a primary disease and
not caused by other mental disorders. Depression, bipolar disorder, and other mental illnesses do not cause people to “self-medicate” and then progress into addiction to food, drugs, and other substances and activities. Addiction is a primary or first disease with its own root causes in the brain.
Addictive behaviors are symptoms of the underlying disease. An addict’s neglect of social relationships, his or her seeking out the substance or activity involved, and other compulsive behaviors are not the addiction but rather symptoms of an underlying brain disorder that is addiction.
The disease is chronic and lifelong, like diabetes, arthritis and other illnesses that currently have no cures but can be managed through drugs, therapy, and behavior-based treatments such as losing weight, monitoring blood sugar, etc.
Like other chronic, lifelong diseases, addiction can cause disabilities and premature death if left untreated.
Addiction is a progressive disease. It will get worse without treatment. Gamblers will escalate to higher stakes and drug addicts will increase the amounts they use if they don’t receive treatment.
Addiction.com Staff on August 19, 2011 in Addiction Research, Causes
“Redefining Addiction: Controversy Among Doctors”
In my opinion, the most common misconception of addiction is that it is almost always accompanied by a mental health issue and/or an individual begins using because they have a mental health diagnosis and are self-medicating with drugs and alcohol. Addiction and mental health issues can co-exist, but one does not cause the other
If an individual with significant anxiety discovers that drinking relieves their symptoms they may drink to the point that they have crossed the threshold to full-blown alcoholism. Treating only the anxiety does not magically make someone put the plug in the jug. Both maladies must be treated separately.
Dr. Miller also felt that it was time to stop moralizing, blaming, controlling, or smirking at the person with the disease of addiction. Society listened, and since the release of this new definition the public understanding and acceptance of addiction as a chronic brain disease and the possibility of remission and recovery has increased. There has also been a growing acknowledgment surrounding the roles of prevention and harm reduction in the spectrum of addiction and recovery. I’ve personally experienced this new acceptance. In 2002 I was so full of shame as I headed to treatment. I didn’t dare say the word “alcoholic” out loud because then it would be true, and I didn’t want it to be true. Today I introduce myself as the token alcoholic of Frederick Place feeling zero shame. I say it with pride. My battle with alcoholism made me who I am today, and I like who I am. In 2002 nobody, including yours truly, understood why I couldn’t just quit drinking and vocalized their frustration to the point I became a hermit just so I didn’t have to deal with the lectures. Today I have an amazing support system comprised of people who often tell me how proud they are of me. My sobriety birthday has come to mean more to those who love me than my bellybutton birthday.
I grew up with an alcoholic father, and I did not understand alcoholism or why my dad couldn’t quit drinking. I grew up thinking my dad was just a jerk and alcohol intensified his character flaws. Today I understand his behavior. He had a disease. He passed away in 2009 and there is nothing I can do to “fix” what was broken long ago. I share that on the chance one of you is at the end of your rope with a loved one’s addiction. You may feel the addict in your life doesn’t care about or love you enough to quit whatever they are addicted to no matter how many times you voice your concerns and feelings. If you feel you are somehow to blame for another’s addiction, please know you are not. They have the disease of addiction and it is a selfish disease. The good news is that addiction can be treated and put into remission. However, it takes work on the addict’s part, and they will not succeed if they are not ready and willing to do whatever it takes to be rid of the substance or behavior destroying their life.
In the meantime, follow the 3 C’s……….