Once, as she wept in my arms, a dear friend who was fighting a mighty battle against the bottle said to me, “My family keeps telling me to ‘just try harder’ not to drink. But saying that to an alcoholic is like telling a cancer patient to promise not to grow a new tumor through sheer strength of will!”
My friend was right. Experts now understand that addiction—whether to alcohol, drugs, gambling or anything else—is a chronic brain disease, not merely a behavioral problem, moral failing or result of bad choices.
To help clarify this distinction, the American Society of Addiction Medicine (ASAM) recently issued a public policy statement that includes a new definition of addiction as “a primary, chronic disease of brain reward, motivation, memory and related circuitry.” The disease affects numerous parts of the brain, distorting the patient’s thinking and emotions and allowing harmful behaviors to supplant healthy self-care. What’s more, said ASAM acting president Stuart Gitlow, MD, MPH, although people tend to think of alcoholism, drug addiction, gambling addiction and other addictions as separate problems, all of these are basically one disease—with different manifestations of the same underlying brain abnormality.
Hopefully, this new understanding will help eliminate some of the stigma that can discourage addicts from getting the help they need. “Just as with hypertension, diabetes and other chronic diseases, patients suffering from addiction are not at fault for having the disease—but they do need to take personal responsibility for seeking treatment and following an ongoing health plan,” Dr. Gitlow said. “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.”
Addiction treatment typically involves a combination of physical and psychiatric evaluations, detoxification, psychological counseling, group support (such as participation in a 12-step program), medication and/or treatment for physical or behavioral complications of the disease. Visit the Web sites of ASAM (www.asam.org) and/or the American Psychological Association (http://locator.apa.org) to find health-care professionals trained in addiction therapies.
Can such measures really help? Absolutely. My friend, for instance, finally confided in her physician, spent a month in rehab, got a therapist and joined Alcoholics Anonymous (www.AA.org). Last spring, with a heart full of joy and gratitude, she celebrated eight years of continuous sobriety.