Addiction redefined to encompass neurologic aspects

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Addiction is a chronic brain disorder and should be treated as any other chronic illness, according to a revised definition of addiction released in a recent policy statement from the American Society of Addiction Medicine (ASAM).

The statement emphasizes the neurological aspects of addiction, including interruptions in neurotransmission, the brain's reward system and impulse control, and is based on more than 20 years of neurology research.

“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,” past ASAM president Michael Miller, MD, said in a press release.

The new definition marks the first time that health officials have categorized addiction as a primary disease and not one that results from substance abuse, emotional or psychological problems. Long term monitoring and management is necessary to diminish the risk of relapse and optimize patient functioning, the statement emphasized.

Treatment must include psychosocial rehabilitation as well as pharmacological interventions, according to ASAM.

“Many chronic diseases require behavioral choices, such as people with heart disease choosing to eat healthier or begin exercising, in addition to medical or surgical interventions,” Miller explained. “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.”

The ASAM statement is the product of a four-year process that inovled more than 80 experts in addiction medicine and neuroscience and involved collaboration with the National Institute on Drug abuse.

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