Addiction As a Brain Disorder
The American Society of Addiction Medicine (ASAM) recently released a new definition of addiction that classifies it as a chronic brain disorder, not just a behavioral issue involving problems with substance abuse. Though many people tend to identify and treat substance abuse issues and behaviors as the actual problem, ASAM believes that those behaviors are more like the symptoms of the underlying brain disease we’ve come to know as addiction.
As researchers learn more about how addiction affects the brain, they are finding that “addiction hijacks the brain’s reward system” and causes people to seek rewards and/or relief by using substances or participating in other damaging behaviors. These addictive behaviors replace “healthy” reward-seeking behaviors, while memories of previous experiences with drugs or alcohol trigger patients’ cravings, causing them to repeat the addictive behaviors. Looking from the outside in, it might be easy to say, “Remove the drugs, remove the problem.”
However, treating addiction is not so simple, especially since the disease of addiction also impairs impulse control and judgment—the absence of drugs or alcohol doesn’t change patients’ feelings about seeking them out. As a result, the treatment of addiction is similar to many other chronic diseases in that it should involve both drug management and behavioral rehabilitation. If patients with addiction are able to recognize their triggers and consciously choose healthier behaviors, they may experience better recovery outcomes.
If you’re familiar with the brain, you might know that the part of the brain housing the reward system mentioned earlier is called the frontal lobe. It is the area of the brain in charge of our reasoning, planning, parts of speech and movement, emotions, and problem-solving skills, so you can see why damage to this area can change the way people think, act, and feel.
You might also imagine that patients who have issues with addiction and who have experienced a brain injury in their frontal lobe are sort of dealing with a “double whammy” when it comes to their ability to control their behaviors related to addiction. This makes addressing the patient’s recovery needs from both the medical and behavioral standpoint even more important.
Sadly, there are sometimes limitations to the types of treatment insurance covers, so patients may receive a “detox only” approach when it comes to treating the substance abuse aspect of their condition. However, the recognition of addiction as a disease reinforces the idea that a narrow approach is simply not enough. In fact, a patient’s chances of relapsing are actually increased if their treatment does not provide them with opportunities to identify what triggers their cravings or learn ways to manage their emotions as sober individuals.
It’s essential to remember that, in addition to receiving other medical interventions, patients need help recognizing and making any necessary behavioral changes to help fight addiction during rehabilitation. It is often the case that the path to recovery is full of obstacles, but with more well-rounded treatment, more patients might make it on down the road.
[…] An interesting fact… Addiction As a Brain Disorder […]
Let us not forget to inform our patients with addiction (with history of TBI(s)) that the brain scanning methodology can only show evidence of major trauma (especially that of major brain tissue trauma and intracranial bleed). The CT (or MRI) cannot show evidence of neurochemical changes in the brain resultant of brain injury. Only neurocognitive testing will give evidence of the “finer” evidence of injury (and that is basically an indirect validity of an hypothesis that there is brain injury.
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