The Disease of Addiction

In 1956 the American Medical Association (AMA) declared Addiction to alcohol and other drugs, to be a disease.  The American Psychiatric Association (APA) followed the AMA, in 1960.  Addiction to AOD qualifies as a disease by meeting the following criteria:

1. Primary: The illness exists in and of itself. (But may manifest in addition to other illnesses.)
2. Chronic: Does not go away, heal spontaneously or remit.
3. Progressive: Over time it gets worse.
4. Symptomatic: Can be diagnosed by the way it manifests in a person's physiology, behavior and lifestyle.
5. Fatal: If left untreated will result in death.
6. Treatable: Proven medication, therapies, and lifestyle changes do result in the ability to live without the abused substance.

Development of an addiction begins with the voluntary decision to use drugs. No one starts out hoping to become an addict, but as one uses over a lengthy period of time, control of use decreases proportionately.

One who is initially a voluntary user can become a compulsive and obsessive drug user, or addict. An ever-increasing body of scientific evidence suggests that the transition from voluntary user to addict occurs through a combination of processes, including a series of brain changes affecting neuro-transmitters (brain chemicals) that result from repeated drug abuse.

Because changes in brain structure and function are fundamental to the development and expression of addiction, it qualifies as a brain disease--a brain disease that translates into compulsive behavior and obsession with the drug.

We have finally learned that we do not have separate minds and bodies.  We understand biology and behavior to be inseparable. Addiction proves this link. This physiological-behavioral view of addiction brings about new drug issues our society must face? First, the fact that addiction is a brain disease does not make the addict a victim with no responsibilities.

Addiction begins with a decision to use drugs (no one thinks they will become addicted), and the addict has to be actively involved in their own treatment for it to work.

But we do need to overcome the moral dilemma that the addict became ill as a result of their own behavior and deal with the brain disease once it is there.

That addiction is a brain disease helps explain why people need treatment; why most cannot just stop through exerted will power.

They literally have a changed brain. Because addiction is a complex bio-behavioral disorder, that's development and expression are tightly woven into social context, addiction treatment inevitably has many different variations and techniques, sometimes including medicines and behavioral therapies.

As a brain disease, addiction is much more complicated than using a lot of drugs. Addiction has wide range of medical, behavioral and social consequences that affect one's ability to function in virtually every area of life and society.

Thus, treatment cannot be just abstention from drug use; it must be restoring the individual to fully functioning in the family system, on the job and in overall society.

The best treatment combines medications, behavioral therapies and necessary psychosocial services in different combinations as are appropriate on an individual basis.

That they have this brain disease helps us to understand and explain why untreated addicted criminal offenders have such high post-incarceration rates of recidivism to both drug use and crime.

Untreated, the disease returns to previous severity nearly immediately after they are released back into the community.

On the other hand, initiation of a well-assessed, individual treatment plan, has proven to be greatly effective and numerous studies reflect that even a single treatment episode can dramatically reduce later criminality and drug abuse.

These facts seem to be leading to a national trend to blend both health and public safety approaches in dealing with addicted criminal offenders. Examples include diversion to treatment programs, drug courts and incarceration-based treatment programs.

A combination of Research, Medical professionals, Psychologists, and Certified Counselors are advancing success in treating the Disease of Addiction, monumentally.  If society can overcome the stigma attached to mental illnesses and in particular addiction, as it did with leperacy, cancer, and other misunderstood diseases, with proper funding, addiction will become a commonly, successfully treated affliction.