The American Society of Addiction Medicine (ASAM) released a new definition of addiction after a 4-year process involving more than 80 experts. They have 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.”
One of the main messages seems to be that the disease is about brains, not drugs. Dr. Michael Miller, the past president of ASAM who oversaw the development of the new definition, 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.
ASAM wants to make it clear 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.
What brought about the need for a new definition of addiction? Two decades of advancements in neuroscience 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" (often in the form of alcohol or drugs) despite negative consequences.
This continues to counter the outdated idea that addiction is simply a matter of choice or willpower.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.
The retooled definition may not seem like big news to many, but it’s another important step in destigmatizing addiction and changing the perception of addiction as a moral failure to one of a medical condition.
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