Addiction isn't just about willpower. It's a chronic brain disease, says a new definition aimed at helping families and their doctors better understand the challenges of treating it.
"Addiction is about a lot more than people behaving badly," says Dr. Michael M. Miller of the American Society for Addiction Medicine.
The National Institute on Drug Abuse estimates that 23 million Americans need treatment for substance abuse but only about 2 million get that help. Then there's the frustration of relapses, which doctors and families alike need to know are common for a chronic disease.
Twenty years ago neuroscience uncovered how addiction hijacks different parts of the brain, to explain what prompts those behaviors and why they can be so hard to overcome. Genetics plays a role, meaning some people are more vulnerable to an addiction. Experimentation with drugs as a teenager or winding up on potent prescription painkillers after an injury can lead to addiction for those who are predisposed.
Even if you're not biologically vulnerable to begin with, perhaps you try alcohol or drugs to cope with a stressful or painful environment, Volkow says. Whatever the reason, the brain's reward system can change as a chemical named dopamine conditions it to rituals and routines that are linked to getting something you've found pleasurable, whether it's a pack of cigarettes or a few drinks or even overeating. When someone's truly addicted, that warped system keeps them going back even after the brain gets so used to the high that it's no longer pleasurable.
References and further reading:
Lauran Neergaard, AP Medical Writer, retrieved from: http://www.google.com/hostednews/ap/article/ALeqM5ileBiXpDz9zZaBqwyvmJx-5Mzlmw?docId=cf6b85bae54c43ea8624c8bd257752b7
ASAM: retrieved from: http://www.asam.org/DefinitionofAddiction-LongVersion.html
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