What is addiction?
The American Society of Addiction Medicine has offered the following short definition:
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 premature death.
This definition tells us that when individuals become addicted to alcohol, or drugs, changes in the brain occur. In the addiction field we sometimes use a simple explanation for this complex problem, we say the “off switch” between the pleasure reward system and the pre-frontal cortex that regulates when we have had enough pleasure is broken. This explains why an alcoholic cannot have one glass of alcohol, but will consume more. What is important to note is that this is not an issue of willpower, or moral defect, it is based on the fact that permanent brain changes have occurred.
This definition also highlights that the disease of addiction has multiple areas of concern: the biological/physical aspect, the cognitive aspect (distorted thinking), the social aspect (unhealthy relationships), and the spiritual aspect (diminished connection to one`s spiritual beliefs).
Lastly, the disease of addiction parallels other chronic diseases that require life-style changes and studies show that relapse rates are similar. This does not mean that relapse is a necessary part of recovery, but it highlights the importance of a good recovery program and support.
How do I know I have become addicted?
How do we know when we have crossed the line between enjoying alcohol and becoming an alcoholic? Part of the problem in identifying alcoholism is that due to cognitive distortions many alcoholics are in denial about their disease. It is not uncommon for employers, loved ones and family members to begin to put pressure on a problem drinker to get help. Sometimes an ultimatum is set to either stop drinking, or ______. Many alcoholics have sought treatment in response to hitting a wall; yet, it is important to understand that true recovery has to come from the heart.
Some people will experience a moment of clarity in which they clearly see how alcohol is impacting their lives in a negative way. This moment of clarity is different for everybody. Often it revolves around the unmanageability of life, failed relationships, and health issues.
It is clear that alcoholism is a unique experience with many common threads. Some of the most obvious symptoms for alcoholism are:
• When drinking continues despite negative consequences (health, relationships, employment, legal system).
• When alcohol is needed to control physical withdrawal symptoms (please note that you can be an alcoholic and not have withdrawal symptoms).
• When individuals begin to obsess about drinking.
• When there is concern about the availability of alcohol.
• When there are blackouts.
• When drinking results in unacceptable behavior (belligerence, public urination, acting out behaviors).
Alcoholics Anonymous have made a self-test available on their website and there is a science based test online called the MAST.
Is there an addiction cure?
This is what Dr. Darryl Inaba, a capacity in the addiction field, has to say:
Can we cure addiction? Absolutely not! This is because addiction has caused unrecoverable changes, alterations, and deaths to brain cells. Brain cells are not readily regenerated like other cells, so the changes caused by drug [and alcohol] abuse are permanent. what we can do is arrest the illness, teach new living techniques, rewire the brain to bypass these addicted cells, and give the addict in recovery a worthwhile life. Although addiction can`t be cured, it can be effectively prevented and treated.
What are the goals of addiction treatment?
• To motivate individuals towards abstinence.
• To reconstruct their lives once the focus is redirected away from substance abuse.
Addiction specialists provide motivational interviewing, addiction education, do Cognitive Behavioral Therapy (CBT) to address distorted thinking, use Dialectical Behavioral Therapy (DBT) to effect long term change, offer psychological support, help people in recovery discover healthy ways to live, and introduce Alcoholics Anonymous (AA) as a possible recovery tool and support network.
Addiction treatment for alcoholism also includes addressing underlying issues of addiction, such as family of origin dysfunction, trauma, depression, fear, or anxiety. The reason for this is that some people who become addicted to alcohol have used it as a form of medication, a way to regulate negative feelings. It is vital to resolve underlying mental issues, as this sets the stage for long-term sobriety.
Holistic addiction treatment also includes the family of the alcoholic, because the family is a system and everyone within the family is affected by the disease of addiction. It is vital to understand family dynamics to make positive changes and offer support. Family members are also introduced to Al-Anon, a support network for the loved ones of alcoholics.
Uppers, Downers, All Arounders: Physical and Mental Effects of Psychoactive Drugs by Darryl S. Inaba, William E. Cohen, Elizabeth von Radics and Ellen K. Cholewa (Jul 15, 2011)