Addiction as a Disease and the Revolution in its Treatment.
At the ASAM (American Society of Addiction Medicine), meeting, and just a couple of months ago, at it’s July meeting, the board approved a new definition of addiction. I’m very excited about it. Here it is:
“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 the individual pursuing reward and/or relief by substance use and other behaviors.
Addiction is characterized by impairment in behavioral control, craving, inability to consistently abstain, and diminished recognition of significant problems with one’s behaviors and interpersonal relationships.
Like other chronic diseases, addiction involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.”
This definition has several new ideas in it. First, that the illness is primary. It doesn’t need a cause. Like diabetes, it can just happen to you.
Second, it’s an illness of the brain and is going to have symptoms caused by certain brain dysfunctions.
Third, that it is these dysfunctions that cause the seeking of drugs or compulsive behaviors to ameliorate symptoms as opposed to the symptoms and dysfunction being caused by the drug use.
Fourth, that the addict doesn’t have to be using drugs, but can have addiction as manifested by different behaviors. In fact, the definition doesn’t limit the behaviors to any group, but rather focuses on the illness.
Finally, because addiction is a real illness, not just a set of behaviors, it doesn’t go away when the behavior stops. It’s chronic and progressive.
I think that we will get many more people to understand the nature of addiction and the burden the illness places on our society with this new definition.
I also think more people who see the new definition will seek treatment and that more funders of treatment will be willing to help them.