Medical Model Of Addiction
Part of the stigma associated with addiction comes about because it is sometimes viewed as a choice, a type of character flaw that leads to substance abuse. An unwillingness or lack of desire to stop using drugs or alcohol is associated with addiction as well. However, the medical model of addiction more often points to the fact that addiction is a disease that requires appropriate treatment.
What Is The Treatment For Substance Use Disorder
Effective treatments are available for substance use disorder. Treatment is highly individualized one person may need different types of treatment at different times.
Treatment for SUD often requires continuing care to be effective, as SUD is a chronic condition with the potential for both recovery and relapse.
As people with SUD often have co-occurring mental health conditions, treating them together rather than separately is generally better.
The three main forms of treatment include:
- Detoxification.
- Long-term therapeutic communities, such as sober living communities.
Detoxification
In detoxification, you stop taking the substance, allowing them to leave your body. Depending on the severity of the SUD, the substance or an alternative may be tapered off to lessen the effects of withdrawal. Its the first major step of treatment for SUD. You can go through detoxification in both inpatient and outpatient settings.
Cognitive and behavioral therapies
Psychotherapy can help treat SUD and any other co-occurring mental health conditions. Therapy also teaches healthy coping mechanisms.
Healthcare providers may recommend cognitive and behavioral therapies alone or in combination with medications.
Some examples of effective therapies for adults with SUDs include the following:
Participating in self-help programs, like Narcotics Anonymous, can also play a significant role in SUD treatment.
Medication
Medication-assisted treatments are available for:
The Brain Continues To Develop Into Adulthood And Undergoes Dramatic Changes During Adolescence
One of the brain areas still maturing during adolescence is the prefrontal cortexthe part of the brain that allows people to assess situations, make sound decisions, and keep emotions and desires under control. The fact that this critical part of a teens brain is still a work in progress puts them at increased risk for trying drugs or continuing to take them. Introducing drugs during this period of development may cause brain changes that have profound and long-lasting consequences.
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Similarities And Differences Between Dsm
The criteria are summarized in Table 1. DSM-IV has more optional criteria for both dependence and abuse than ICD-10. In the DSM-IV, 3 of 7 criteria are needed, whereas in the ICD-10, 3 of 5 criteria are needed, including the obligatory criterion of use or desire to use. Therefore, the DSM-IV diagnosis is less restrictive, resulting in higher prevalences for DSM vs. ICD in studies where both set of criteria have been applied to the same populations . The milder abuse/harmful use diagnoses have no overlapping criteria, and are clearly not the same thing. Therefore, agreement between the two dependence diagnoses is generally better than between the harmful use and abuse diagnoses .
Why The Disease Definition Of Addiction Does Far More Harm Than Good
Among other problems, it has obstructed other channels of investigation, including the social, psychological and societal roots of addiction
Over the past year and a half, Scientific American has published a number of fine articles arguing that addiction is not a disease, that drugs are not the cause of addiction, and that social and societal factors are fundamental contributors to opioid addiction in general and the overdose crisis in particular. The dominant view, that addiction is a disease resulting from drug use, is gradually being eroded by these and other incisive critiques. Yet the disease model and its corollaries still prevail in the domains of research, policy setting, knowledge dissemination and treatment delivery, more in the United States than in any other country in the developed world. You might wonder: what are we waiting for?
The disease model remains dominant in the U.S. because of its stakeholders. First, the rehab industry, worth an estimated $35 billion per year, uses the disease nomenclature in a vast majority of its ads and slogans. Despite consistently low success rates, that’s not likely to stop because it pulls in the cash. Second, as long as addiction is labeled a disease, medical insurance providers can be required to pay for it.
But why does the definition of addiction matter? Isn’t this just a word game?
The views expressed are those of the author and are not necessarily those of Scientific American.
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What Is The Prognosis For Substance Use Disorder
The prognosis for substance use disorder varies based on several factors, including:
- The type and severity of the SUD.
- The degree of dependence and withdrawal.
- The level of commitment to abstinence.
- Treatment time frame.
- How you cope during stressful situations.
Substance use disorder is a lifelong disease. But people can recover from it and lead full lives. Getting help is essential to recovery. Different tools work for different people, but ongoing therapy and self-help groups such as Narcotics Anonymous help many.
SUD is a relapsing disease. People who are in recovery have a higher chance of using substances again. Recurrence can happen even years after you last took the substance.
Because of the possibility of relapse, you need ongoing treatment. Your healthcare provider should review your treatment plan with you and change it based on your changing needs.
How Substance Use Changes The Brain
People feel pleasure when basic needs such as hunger, thirst and sex are satisfied. In most cases, these feelings of pleasure are caused by the release of certain chemicals in the brain, which reinforce these life-sustaining functions by incentivizing the individual to repeat the behaviors that produce those rewarding feelings . Most addictive substances cause the brain to release high levels of these same chemicals that are associated with natural pleasure or reward.
Over time, continued release of these chemicals causes changes in the brain systems involved in reward, motivation and memory. The brain tries to get back to a balanced state by minimizing its reaction to those rewarding chemicals or releasing stress hormones. As a result, a person may need to use increasing amounts of the substance just to feel closer to normal. The individual may experience intense desires or cravings for the substance and will continue to use it despite harmful or dangerous consequences. The person may also prefer the substance to other healthy pleasures and may lose interest in normal life activities. In the most chronic form of the disease, a severe substance use disorder can cause a person to stop caring about their own or others well-being or survival.
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Can Someone Overcome Addiction Alone
Rarely. In some cases, someone could overcome addiction without medical intervention or the support of others. However, its highly unlikely and one shouldnt expect to do this or feel as if they are a failure if they cannot manage their addiction alone.
In almost every case, a person with a substance use disorder needs professional treatment. As strong and determined as someone might feel, willpower is rarely enough to overcome an addiction.
This isnt to say willpower plays no role in addiction recovery. It might be the factor that leads you to seek treatment. But even if someone lacks willpower or loses willpower over time, certain therapies like cognitive-behavioral therapy will help them cope with and manage their addiction.
Willpower also helps people make lifestyle changes that reduce their risk of relapse. Its like any illness: making healthy lifestyle choices wont eliminate your risk of developing cancer, but in many cases, it does reduce that risk.
The same is true for addiction. Willpower alone is not enough, but it doesnt hurt.
What Are The Signs Of Addiction
There are many signs of addiction. A person need not have them all to have substance use disorder.
Signs of addiction include:
- Ensuring a supply of the drug of choice, regardless of the consequences
- Neglecting careers, school, family, and social obligations and responsibilities
- Using the drug despite the problems it causes in ones life or with ones health
- Investing a great deal of time and money in getting the drug
- Failing to stop using the drug despite wanting to and experiencing harmful consequences from use
- Experiencing withdrawal symptoms when not using the drug
- Needing more and more of the drug to achieve the same result
- Using more of the drug than intended
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What Is Drug Addiction
Drug addiction is a term used to describe a physical and/or emotional dependence on drugs.
According to the American Psychiatric Association , the medical community no longer uses this term. They use substance use disorder instead. Addiction or SUD both describe compulsive and habitual use of a substance.
Addiction encompasses all types of substances, including prescription and illicit drugs, alcohol, nicotine, and marijuana. People addicted to these substances continue using the substance regardless of the harm it causes to their health and in their lives.
Addiction can begin in a variety of different ways. Some people experiment with substances, using them recreationally in social situations. Others receive a prescription for a legitimate medical purpose, only to develop a long-term addiction to the drug.
People with substance use disorder need more and more of their drug of choice to achieve the same effect. Many need the drug just to function in their normal lives. Many attempts to stop using the drug but cannot without professional addiction treatment.
Is Addiction A Habit
Habits are behavioral routines that are repeated so often they get wired into the brain as a matter of efficiency. The brain is always changing and adapting to experienceeven now, as you read this. Habits are a kind of mental shortcut, fast-tracking the neural connections involved in an activity so that you dont need to consciously think out every step. The brain is designed to work that way. Unfortunately, that wired-in efficiency is what makes habits hard to break.
Consuming certain substances or engaging in certain activities is so pleasurable for some people they are driven to repeat the experience. Habits make behaviors near-automatic in response to any elements related to that activityin other words, hard to control. Recognizing that addiction is a habit in the scientific sense of the word makes clear that recovery is possible with deliberate action to change, which reverses the changes to the brain.
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What Does Science Tell Us About Drug Abuse And Dependence
The behavioral health field has struggled for decades to debunk the myths and misconceptions about the nature of drug and alcohol addiction. People with a substance use disorder were thought to be morally flawed and lacking in willpower rather than seen as suffering from a disease.Labels and terms such as “addict” and “alcoholic”even substance “abuse” and “drug abuse”persist today and further stigmatize the disease and individuals who have the condition.This language and these views shape society’s responses to substance use disorder, treating the condition as a moral failing rather than a complex behavioral health issue, which leads to an emphasis on punishment rather than disease prevention and treatment.
Today, thanks to science and advocacy, our understanding of substance use disorders and addictive behaviors has come a long way, andparityin health care insurance coverage has provided more people with access toeffective treatment.
Despite these advances, misconceptions about why people become addicted or a lack of understanding about how drug use changes the brain persist. Watch the video to learn more about addictive substances and the science of addiction.
An Overview Of The Neurobiology Of Addiction
Chemical dependency is defined as the compulsive use of mood-altering chemicals or continued engagement in addictive behaviors despite adverse consequences. Much research and clinical study has been done to further document and recognize chemical dependency as a disease. A percentage of the population has a biogenetic predisposition to chemicals and/or addictive behaviors however, early life traumatic experience, such as isolation or abuse, can also contribute to a predisposition to addiction.
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How Is Addiction A Disease
Many factors go into determining whether something can be described as a disease. When it comes to substance use and addictive disorders, the Diagnostic and Statistical Manual of Mental Disorders criteria include:
- Using larger amounts for longer periods of time than intended
- Repeated attempts to quit or control the use
- Spending a lot of time obtaining, using, or recovering from a substance
- Developing physical or psychological problems related to use
- Giving up activities in order to spend that time using
How Is The Disease Model Of Addiction Working Out For You
What exactly is Addiction?
Ask an addict if they have a disease, and the most common answer you will get is, I dont feel like I have a disease, but everyone tells me I do so I guess I do.
Why do the medical community and most experts follow the disease model when its obvious it isnt working? It has to do with brain change. The assumption is that the brain change they see in addicts is abnormal and this abnormality decreases and adversely affects normal brain function. They say this brain change causes reduced cognitive abilities and increased compulsivity, leading to a lack of control. This cognitive dysfunction and impaired response is the disease,caused by your substance addiction.
The medical community by and large believes addiction is a chronic disease because its a long-lasting condition that can be controlled but not cured. What theyre trying to say is addiction is just like diabetes. Diabetes changes how the pancreas works, and diabetes is a disease. Addiction changes how the brain works. So why shouldnt it be classified as a disease?
Is Addiction a Disease?
Does your brain lose its normal functionality in addiction, or does your brain change because of what you focus on? While I think its the latter, I am not saying that taking copious amounts of a substance doesnt change how the brain works. Our American sugar and processed food diet changes our brains too, and even falling in love changes our brain.
Falling In Love Is An Addiction
Until next week!
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Addiction Treatment In Portland
The disease you struggle with is a common but serious affliction. Fortunately, treatment is available that can help reverse the effects of your habit and prepare you for lasting change.
We treat a variety of addictions, including:
- Heroin addiction
- Cocaine addiction
Crestview Recovery offers the quality treatment programs and services that you need to beat this disease. Therefore, take advantage of this opportunity to successfully recover by contacting our rehab specialists today at .
How Is Substance Use Disorder Treated
Effective treatments for substance use disorders are available.
The first step is recognition of the problem. The recovery process can be delayed when a person lacks awareness of problematic substance use. Although interventions by concerned friends and family often prompt treatment, self-referrals are always welcome and encouraged.
A medical professional should conduct a formal assessment of symptoms to identify if a substance use disorder is present. All patients can benefit from treatment, regardless of whether the disorder is mild, moderate, or severe. Unfortunately, many people who meet criteria for a substance use disorder and could benefit from treatment dont receive help.
Because SUDs affect many aspects of a persons life, multiple types of treatment are often required. For most, a combination of medication and individual or group therapy is most effective. Treatment approaches that address an individuals specific situation and any co-occurring medical, psychiatric, and social problems is optimal for leading to sustained recovery.
Medications are used to control drug cravings, relieve symptoms of withdrawal, and to prevent relapses. Psychotherapy can help individuals with SUD better understand their behavior and motivations, develop higher self-esteem, cope with stress, and address other psychiatric problems.
A person’s recovery plan is unique to the person’s specific needs and may include strategies outside of formal treatment. These may include:
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What Is The Difference Between Substance Use Disorder And Addiction
Substance use disorder can be mild, moderate or severe. Addiction is the most severe form of SUD. It involves continued substance use despite negative consequences. Addiction to substances happens when the reward system in your brain takes over and amplifies compulsive substance-seeking.
Both involve the development of physical dependence and psychological dependence.
People are psychologically dependent when a drug is so central to their thoughts, emotions and activities that the need to continue its use becomes a craving or compulsion despite negative consequences.
With physical dependence, your body has adapted to the presence of the substance, and withdrawal symptoms happen if you suddenly stop taking the drug or you take a reduced dosage.
In the past, healthcare providers, organizations and members of the public often used the terms addiction/addict, abuse/abuser and dependence when referring to substance use.
Mental health condition classification systems, including the Diagnostic and Statistical Manual of Mental Disorders , have become more sophisticated over time. The term substance use disorder allows for more clarity in diagnosis. SUD also recognizes a spectrum of problematic substance use, not just physiologic addiction.
Addiction Recognized As A Disease
Weve been saying it for years addiction is a disorder of the brain and not a matter of personal choice. Modern medicine is fully embracing this reality and we hope it will lead to more humane treatment of the sufferers of alcoholism and drug addiction.
Addiction experts have released a new definition of addiction, describing it as a chronic brain disorder and not just a behavioral problem. This new definition from the American Society of Addiction Medicine applies to multiple addictions, including gambling, compulsive eating and sex in addition to alcohol and drugs. It was formulated following a four-year process that involved more than 80 experts.
The new long definition of addiction describes it as a primary disease, meaning it is not a symptom or effect of other psychiatric or emotional issues. Like diabetes and cardiovascular disease, the new definition says that addiction is a chronic disorder that must be treated and monitored over an entire lifetime. The definition also recognizes the role of genetics in determining who will be vulnerable for addiction.
Addictionologist Kevin McCauley told us: Addiction is a chronic brain disorder and not just a behavioral problem.
Addiction is not a choice but people who are suffering from addiction do have the power to choose recovery.
Learn more about addiction by browsing our site. Learn what to say to a family member as well, and contact an interventionist with our help.
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