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January 17, 2005 - The Daily Times (TN)

Scientific Approaches To Addiction Worth Thinking About

By Steve Wildsmith

Return to Drug War News: Don't Miss Archive

As a recovering addict, I know addiction well in the ``street'' sense of the term.

I know about conning and manipulating and hustling and chasing dope, but I've never given much thought to the scientific approach to addiction.

A week ago, while attending a conference in New York sponsored by the Addiction Studies Program for Journalists of the Wake Forest University School of Medicine and National Families in Action, I received more information than I know what to do with right now.

I'll be attempting to share some of that with you in the weeks to come, but the bulk of the information that opened my eyes was a presentation on the neurobiology of addiction, given by Dr. David Friedman, a professor of physiology and deputy associate dean for research at the Wake Forest school of medicine.

Very simply, addiction is a disease -- research going on at Wake Forest and other universities are discovering more and more concrete evidence of this all the time, specifically how drugs affect the brain.

The American Medical Association -- along with the American Psychiatric Association, the American Hospital Association, the American Public Health Association, the World Health Organization and the American College of Physicians -- first declared alcoholism a disease back in 1957.

In 1961, a report by the AMA and the American Bar Association concluded drug addiction is a disease and not a crime.

So if the two are diseases, then how do they work? According to Dr. Friedman, ``if the brain is the organ of the mind and controls behavior, and drugs change thoughts, feelings and behavior by changing the way the brain works, and if those changes are enduring -- addiction is a brain disorder.''

Dr. Friedman goes on to describe drug addiction as having the following components:

  • Loss of control of drug-taking behavior, including the inability to control when and how much drugs are used, and using in the face of adverse consequences;
  • A tendency for chronic relapse;
  • Brings about tolerance and physical and psychological dependence on the part of drug addicts.

Dr. Friedman goes on to point out that, in active addiction, free will, or the ability to make a choice when it comes to drug use, is impaired. Once an addict is in recovery, free will reasserts itself . but ``because addicts are self-destructive in terms of their drug use,'' he postulates, ``perhaps drugs alter the function of brain structures central for survival.''

Arguing for addiction as a brain disorder flies in the face of public stigma and the long-held belief that addiction is the result of a moral failing. Such beliefs are why so many addicts are incarcerated, even though they may pose no threat to society and are often found to be completely non-violent.

Establishing addiction as a brain disorder is a novel concept in that, if it is physical in nature, the rational response is to treat addicts for it instead of locking them up.

It's a round-about way of scientifically proving the concepts that have floated around the rooms of 12-Step recovery for years. Addiction is a disease; those caught in its grips need medical and psychiatric help, not morality lectures and jail time.

Having a scientist like Dr. Friedman espouse such theories is the first step toward shifting public policy in that direction. However, public discourse on addiction and alcoholism has taken the moral high road for so long, changing that policy will take years.

Dr. Friedman's work is just one small step. But for this addict, it's news that's welcomed with relief and gratitude that someone in the medical community finally understands not only what's wrong, but that the medical community might one day treat addiction like it would hypertension, diabetes and other long-term, often debilitating diseases.

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