Addiction Has A New Definition

addicted_brain

I know you read articles where I indicate alcoholism’s an illness.

Whether alcoholism is a disease has been bantered about by addiction professionals and the recovery community.

I wanted to share a little in the way of support for the illness concept.

Asam definition

The American Society for Addiction Medicine (ASAM) in their April 12, 2011 policy statement Definition of Addiction (Long Version), “Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry.”

The effects of alcohol and other drugs (AOD) on brain function have been quite clear for some time. The new definition brings special attention to how dysfunctions of the brain in particular motivation, memory, and brain reward centers appear abnormal and thereby help to explain the behaviors of addiction.

Benefit of this definition

I have been an advocate for eliminating the stigma of addiction. When society defines addiction in moral terms it carries a moral stigma: people look down on the individual who is addicted.

What we see in terms of treating addiction will not immediately be affected by this new definition. It should however play a major part in where research is targeted in the future.

I think most people who are addicted or are in recovery from addiction wish there was a magic pill to take the addiction away. There is no such pill and the dream of it may be far into the future. However, this move to identify addiction as a ‘brain disease’ is a huge step toward other breakthroughs for addicts.

Factors

ASAM suggests half of all addictions relate to genetic factors and the others have to do with how environmental factors relate to the individuals biology. Resilience is also a factor in addiction. Some people simply are more resilient than others and these factors appear to be protective as they relate to addiction.

Characteristics

The characteristics of Addiction according to ASAM are:

  • Abstain- Inability to abstain
  • Behavioral-Impaired behavioral control
  • Cravings- increased cravings for rewarding experiences
  • Diminished- Recognition of significant problems with behavior is diminished
  • Emotional-Dysfunctional emotional response

The recommendation from ASAM in representing the new definition of addiction suggests recovery is achieved best achieved through:

  • Mutual Support
  • Self Management
  • Professional Care

I am encouraged by this new definition and hope our community of recovering people and the professionals who work with them will seize the opportunity to reduce or eliminate the stigma of addiction by supporting this definition.

How does your alcoholic fit into the new definition? Let us know in the comment section below.




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Here’s What 22 Other People Thought...

  1. robin

    time and again Derek relates that he likes his life . and he is not ready to quit living the way he lives. the only aspect that he is interested in right now is “self management ” I have natural consequence shaving off quantity. and he has done wellin the face of “it is what it is ” and him having no where to beg barrow or steal ,so to speak. living pay check to pay check with no cushion in savings , nothing left to pawn . He has been forced to deal with it. I rarely say much these days except to keep it real and call it what it is. he will be 57 tomorrow . I want to see 80 with him. Or more…

    • FreeMyAddict Team

      Natural consequences do escalate as the illness progresses. Truth telling is a great response to Derek. The truth actually has the potential of setting him free from alcoholism.

    • Robin i went threw that stage with Rod for three years, he wanted not to be told , not to be judged ,and was going to do what HE WANTED! I said well have at it got interested into my life and let him fall into his corner of heading straight into his drunkenness, i did not want a divorce, we had everything paid off and jobs are scarce, so i got into reading the bible and socializing with Christians more, when rod fell it was a huge help when i could talk to people who knew what i was going through and this page web is awesome for the help for others to relate

      • FreeMyAddict Team

        Thanks for your support of Robin. I’m glad you appreciate the website. We’re honored to be here for you.

  2. David

    My husband definitely matches the characteristics you describe in the article. While I can accept that there is some sort of malfunction in the brain, why is it that so many addicts keep at it until they hit rock bottom? Then they can do what they need to do to quit. It seems to me, there is a choice made there. This is the part I don’t get. If they can choose to quit then, why do they not choose to quit before then? It seems to me that they can choose, they simply choose not to until they percieve the benefit to them no long outweighs the consequences. I can understand some of the moral stigma attached to alcoholism. I don’t understand how you can talk about character in some of your articles and then not apply it to the daily choice alcolholics make to drink and to engage in their related behaviours. I get they are kidding themselves but isn’t that a character flaw? Isn’t that a choice?

    • FreeMyAddict Team

      The best way I can describe why an alcoholic doesn’t find recovery before they ‘hit bottom’ is this. The perceived benefit outweighs the cost of using. When your alcoholic gets to a place the cost outweighs the benefit recovery is possible. The essential idea behind an intervention is to bring the bottom up to meet the present in the alcoholic’s life.

      To the issue of stigma, if a person is impaired in their thinking because of the illness how then can you find it a moral issue. In fact, the alcoholic has obsessive thoughts about alcohol or getting ‘high’. Even though they don’t meet criteria for obsessive compulsion, I would suggest the urge to use is almost impossible for an alcoholic to resist when the obsession takes place.

      This is one of the reasons I’m adamantly committed to support as an essential element of EVERYONE who’s in recovery. If there’s no support the likelihood is near 100%.

      The stigma society held and many still hold is that it’s a willful intention to get high regardless of anything else.

      In thirty years working with alcoholics and addicts, I’ve not found any who decided to become alcoholic. Most of them end up hate being out of control (with alcohol) and experience mental anguish, emotional pain, deterioration in social life, regret poor choices, experience physical consequences and feel estranged spiritually.

      Admittedly, alcoholics come to admit character flaws as they examine their life and how addiction has affected them. This is a process and AA is a wonderful way for it to happen (4th step).

    • I believe they chose to hit rock bottom because they don;t know any other way

      • FreeMyAddict Team

        They end up with few alternatives. Dr Jellinek in his early study of alcoholism suggested three alternatives death, insanity or recovery.

      • Amen to that too! rod had to end up in jail before he got a wakeup call, actually it was seeing teens in there that could have been his daughter he now realizes the example he has set and she is in his footsteps, it’s a horrible wakeup call but he has a goal now to show her life can be better without he is abstain, he also just got his sentencing so far he got the felony d chares dropped because I wrote a letter of compassion to the prosecuting attorney she took passion on him and let him off with 50 fine 750 for attorney and anger managements classes
        I explained to the pros he was sick and ill not a criminal

      • FreeMyAddict Team

        I trust Rod will recognize how serious this illness actually is and commit to recovery even if it’s not easy.

    • A Dad

      All the advice from Free My Addict is good and sound and helpful. Good job Wendell. Understanding just a little as to why and how things work on the brain circuitry I am finding helpful, though there is no easy way and no magic bullet.

      The only book I have found so far that explains how sufferers and therapists can utilise this developing science of the brain is Joe Griffin and Ivan Tyrell’s book ‘How to Beat Addiction Fast’ which I recommend.

      They explain how the disease is a brain malfunction in the reward, motivation, memory and related circuitry. They explain how this translates into what appears to us as intransigent denial.

      I wonder how can we get our loved one back into the real world? What happened to logical reasoning and communication when this issue is being discussed?

      The authors explain the good effect on the brain circuitry of support, why some therapy techniques work better than others, when and why to choose your moment when trying to discuss the subject, and a whole lot more.

      Having read and re-read the book I now think of the disease afflicted person as the Real Person we love and admire but now in denial – under the control of a puppeteer most of the time. The puppeteer is the malfunctioning circuitry in the brain involving reward, motivation, and memory, devoted solely to continuation of the habit. When the habit is under discussion the pupeteer has total control – most of the time – over the logical, reasoning, considerate Real Person’s conscious mind. The Real Person has NO CHOICE in this matter while capable of behaving normally in so many other ways.

      • FreeMyAddict Team

        I really appreciate your thoughtful comment. When we come to understand what alcohol does to the alcoholic it becomes much more difficult to be dispassionate about their plight. What’s needed is strong therapeutic interventions to address the effects alcohol has on the brain. Maybe best practices in treatment will eventually get there.

  3. Stephanie

    I have always known and understood addiction as a disease or illness and have done my share to help and even forgive those in need of such things. I have, however, come to the end of rope at this point and I can’t go any further. I have been tremendously hurt by my alcoholic and I am totally exhausted with the struggle to keep his head above water. I have found myself to be drowning and he just really isn’t a good source of safety for me anymore. I feel as though I have love unloved and have taken on demons that were never mine to battle. I am sure that peace will find its way back to me but for now, I am allowing myself to just be angry for a little while. I can no longer be the ‘doctor’ for this disease.

    • FreeMyAddict Team

      Stephanie, you used an illustration about keeping his head above water. You know one of the things suggested about saving a drowning person is to not be taken down by them. Your alcoholic is responsible for his behaviors and the consequences of each one. You don’t have to fix him or the illness. In fact, I suggest you find ways to make sure YOU are okay. I’m glad you give up doctoring his illness. Thanks for your comments.

  4. Viki

    What I like about this definition is that it speaks to addiction, not just to alcoholism. I have noticed that even when J.D. is abstaining from alcohol, he must find a replacement. In his case it has been golf. While golf might seem an innocuous enough replacement, when it’s carried to the extreme (37 holes every day), it can serve as an escape from reality and an avoidance of responsibilities. Others have eating disorders, sexual addiction, etc. that serve the same purpose. All are addictions with same brain abnormalities. If they should happen to find that magic pill, it could be used to treat a whole host of disorders.

    Thanks for sharing.

    • FreeMyAddict Team

      You’re right on. Addictions across many types have similar brain function. I’m not surprised, the same issues are in play.
      I remember almost 20 years the anticipation of a drug that would cure alcoholism was being projected into the future. Well, we’re here and there’s not a ‘magic pill’. Those seeking recovery still have to do the hard work it takes for sobriety.

  5. Does this not free the addict from self responsibility. “I can’t help it. I have a disease” is an open excuse to ok all of the addicts abusive and irresponsible behavior. I have had this said to me by an addictive person before. Apparently this is a catch-all for some people to do irresponsible things and than explain it all away by the “I have a disease” statement. That shifts the monkey to our backs because we are not “understanding and caring.” Those of us who have to deal with the addictive person
    becomes the bad guy.

    • FreeMyAddict Team

      In my opinion it doesn’t free an alcoholic from the responsibility for their actions. Understanding what happens with the illness, what it looks like and what can be expected from a chronic disorder goes a long way toward developing strategies to help them recover.

      If a person had seizures on a regular basis, as a result weren’t allowed to drive, decided to get into the car and take a cross country trip. Would you absolve them of the responsibility for the accident? NO. But you can certainly understand why they shouldn’t have been driving and the accident is no surprise.

      Pat, the more you speak truth into the life of your alcoholic and make sure you care for yourself the less you’ll feel like the bad guy.

  6. David

    I feel like Stephanie. I have tried to be understanding and non-judgemental. I’m trying to focus on fixing me. But I am so so tired of the whole thing. I feel like the fact that he has been able to function so well even with the drinking means that he will never really hit a rock bottom until it’s too late. Maybe that’s my biggest fear. I really think that the drinking has a worse effect on me and my health than it does on his. He just got a clean bill of health, great heart, great cholesteral, great liver. He’s healthier then men half his age. And he looks pretty good too except for a beer gut. He is just so freaking able about everything. I’m the only one who seems to be falling apart. Maybe I’m jealous that he is so able to keep it all together.

    • FreeMyAddict Team

      Alcoholism will extract it’s toll on your husband in time. Eventually it all catches up. The most important thing you can do is make sure you’re okay in the mean time. Keep speaking the truth into his life.

  7. WELL U DID IT AGAIN HITTING IT RIGHT ON THE NAIL, THE ADDICTION IS AND ILLNESS! While most of us think we don’t have an addiction think again, I have to have a coffee, addiction, caffeine, coke , pop of any kind with caffeine tea, chocolate, eating movies, reading travel , we all have addictions, that can move us, rather it moves us into good or bad, how do u relate, the factor is you cannot let your addiction hurt someone else, the bible is very vivid on how we should treat one another read it, the addictions hinder us , to start read the chapter john in the bible it tell us how we should act and be as a disciple for Christ , it will help with any addiction, I love your comment here they have open up a whole new world of understanding for me

    • FreeMyAddict Team

      There are many addictions and they all tend to have similar characteristics. There are some very significant differences. When your addiction is to exercise it’s much less likely to be harmful to self or others. Alcoholism and drug addiction take a high toll physically over time.

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