Addiction: The Medical & Mental Health Approach

Mental Health ApproachAs we have discussed many times on this forum, and according to The American Society of Addiction Medicine, addiction has been defined as a deadly disease. We wanted to take a closer look at the approach the ASOAM takes in defining and characterizing it. The ASOAM defines addiction as “a primary, chronic, neurobiological disease, with genetic, psychosocial and environmental factors influencing its development and manifestations.” Those who are addicted to a substance (i.e. alcohol, prescription drugs, street drugs), or to an activity (i.e. gambling, shopping, sex) tend to partake in neurologically programmed behaviors that demonstrate a lack of control, constant cravings, and continued use despite their dire consequences. As we know some addictions are more deadly than others, often times forcing individuals to not only face them, but to attempt recovering from them to avoid death. Addiction in many forms is far more common than you may think; eight percent of all adults in the U.S. have had some form of substance use disorder or addiction in the past 12 months. Many consider substance dependence to be a step down, or a lesser version of substance abuse. Most of this 8 percent develop some form of physical tolerance, and withdrawal symptoms if the substance or activity is taken away from them for too long.

Lets look at the neurobiology of addiction, what exactly is going on in the brain for addiction to occur, or if addiction is already present, why? Neuroscientists have studied animal models of addiction for some time now, and have found evidence that developing an addiction alters some of the pathways in your brain, sometimes permanently. Many drugs like cocaine and heroin directly increase the amount of dopamine in the neuro-pathways, causing instant feelings of pleasure; then changing the pathways and making them more dependent on the increased dopamine levels and rewarding feelings. Eventually through this process of rewiring, and receiving unnatural amounts of dopamine, a person is unable to feel positive reinforcement or pleasurable feelings for natural rewards like food or sex.

It can be discouraging for individuals trying to get their brain chemistry back on track once they choose the road of recovery; which for many, while worth it, is a long road. Addiction is often hardwired into one’s brain, making recovery possible, but typically with commitment and hard work. Most consider addiction recovery to be a lifelong journey, filled with ups and downs, possible relapses, and also large strides of improvement. To achieve a full and sustainable recovery, substance abusers typically require long-term, comprehensive and residential treatment. Often it is beneficial to follow this with maintenance therapy, sober living, 12-step programs, social support, etc. The good news is that there are so many levels and types of treatment available today. So treatment can really be catered to different addicts and what they need on an individual level; be it mental health, addiction, or both. Whether you are suffering from addiction or other mental illness, or a loved one is suffering, it is important to understand the brain’s role in these diseases. Understanding that addiction and mental health are diseases harbored in the brain, is the first step in realizing its not in the individual's morals, or conscience choices. To fully grasp exactly what is going on in the brain helps everyone get on board to fight these medical conditions.

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