Addiction Is a Brain Disease, Not Just Bad Behavior

A new definition of addiction says it's a disease rooted in the brain

Your definition of an addict probably shapes how you remember Amy Winehouse: someone who willfully indulged in all sorts of substance abuse, and who threw away her life because she just didn’t want to stop drinking and doing drugs. Likewise, you may think of an alcoholic as someone who simply drinks too much. True, but that doesn’t even begin to a paint the full portrait of an addict, says the American Society of Addiction Medicine (ASAM), who just this week updated their medical definition of addiction.

According to the ASAM, addiction is not just a string of bad behavior or bad choices or a moral failing -- it’s a chronic disease that has more to do with the chemicals in your head than the chemicals you’re ingesting. Destructive, compulsive behavior isn’t the problem but the symptom of an underlying disease that disrupts several areas of the brain, say the new guidelines. This is an important distinction that aims to settle the longstanding controversy regarding whether or not addicts have control over their drinking and drugging. As a chronic condition, it also means that just because someone quits, it doesn’t mean he or she is all better. Addiction is now considered a disease that must be managed for the rest of the person’s life.

"The disease creates distortions in thinking, feelings and perceptions, which drive people to behave in ways that are not understandable to others around them. Simply put, addiction is not a choice," explained Raju Hajela, M.D., who chaired the ASAM committee that came up with the new definition. In other words, chalking up an addict’s relapse to poor self-control would be similar to berating a narcoleptic for falling asleep again.

Still, he says, this doesn’t let addicts off the hook entirely. Many chronic conditions must be managed through personal choices. Heart disease and diabetes, for instance, are largely preventable -- and even somewhat reversible -- when patients follow a healthful lifestyle. So, you might argue that people with heart disease who refuse to give up red meat and French fries deserve a heart attack, or that diabetics with a sweet tooth should have exercised self-restraint before having their foot amputated. Sure, different choices might have led to better outcomes, but do they deserve to be judged?

"We have to stop moralizing, blaming, controlling or smirking at the person with the disease of addiction, and start creating opportunities for individuals and families to get help and providing assistance in choosing proper treatment," said past president of ASAM Michael Miller.

People struggling with addiction still have to make the decision to seek help, but, as we all know, Amy Winehouse was too consumed by her disease that her attempts at rehab didn't stick. She might have been the tabloids’ favorite fodder, but Winehouse was also a very sick person who didn’t want, or deserve, to die. Hopefully, this new definition of addiction will help people be more sympathetic to those suffering from it, Charlie Sheen included. If he's not the poster boy for addiction-induced brain changes, I'm not sure who is.

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