Changes in the Definition of Addiction
The definition of addiction, released by The American Society of Addiction Medicine (ASAM), is the result of a 4-year process involving more than 80 experts. ASAM has determined that, “Addiction is a chronic brain disorder and not simply a behavior problem involving alcohol, drugs, gambling or sex, one that is not solely related to problematic substance abuse.”
Addiction is about brains, not drugs. Dr. Michael Miller, the past president of ASAM who oversaw the development of the new definition of addiction, says, “At its core, addiction isn’t just a social problem or a moral problem or a criminal problem. It’s a brain problem whose behaviors manifest in all these other areas.” While addiction may cause other social and behavioral problems or even result in criminal acts in some cases, it is about underlying neurology and not outward actions.
Definition of Addiction: A “Primary Disease”
ASAM wants to make it clear in the new definition of addiction that addiction exists as a primary disease. It is not the result of other causes such as emotional or mental health problems. While there may be coexisting mental health issues that benefit from being treated together, addiction as a disorder stands alone. It is a chronic disease that requires management and monitoring over the course of a person’s lifetime.
Addiction Isn’t A Choice
What brought about the need for a new definition of addiction? Advancements in neuroscience over the last two decades convinced ASAM officials that addiction should be redefined by what is going on in the brain. Studies show that addiction affects the brain reward centers, the circuitry responsible for transmitting craving messages and governing impulse control and judgment. These areas are altered in the brains of addicted individuals, resulting in the pursuit of “rewards” (in the form of alcohol or drugs) despite negative consequences.
Diseases Need to be Treated
This continues to counter the outdated idea that addiction is a choice, moral dilemma, or lacking willpower. Addictive behaviors are a manifestation of the disease, not a cause. Still, choosing recovery is necessary, so choice does play a role in getting better, but this choice can be compared to someone at risk for heart disease having the choice to eat healthy and exercise to avoid adverse health issues.
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