The Disease Model Of Addiction Applied In Treatment
If you or a loved one are in need of addiction treatment, it is important to find a facility that understands the disease model. For example, the disease model provides insight into how addiction affects ones mental and physical health. This allows therapists and healthcare specialists to properly address any additional issues patients may face as a result of their addiction.
At CWC Recovery, we are educated on the causes, effects, and treatment of addiction. We understand what its like to deal with the struggles of substance abuse, mental health conditions, and trauma. As a result, we are better able to support and treat our patients. If you would like to recover from addiction and any other related issues, contact us today to get started.
Continuing Educationunderstanding The Disease Of Addiction
The disease of chemical dependency can be traced to neural pathways in the brain predating a diagnosis of addiction. A genetic predisposition alone is not enough to predict addiction. Typically, psychological and social influences drive the person to use the addicting substances, and the combination of genetic predisposition and these influences triggers the disease. Chemically dependent nurses are susceptible to the scrutiny of boards of authority if their addiction affects the workplace.Therefore, those in authority should understand the disease of addiction and use an effective, compassionate approach that will benefit both the addicted nurse and nursing as a whole.
Are People With Addiction Responsible For Their Actions
People do not choose how their brain and body respond to substances, which is why people with addiction cannot control their use while others can. People with addiction can still stop using substances its just much harder than it is for someone who has not become addicted. People with addiction should not be blamed for having a disease, but rather be able to get quality, evidence-based care to address it.
With the help and support of family, friends and peers to stay in treatment, they increase their chances of recovery and survival.
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Addiction Causes The Brain To Ask For More
Dopamine makes us feel good and want to keep doing what we’re doing. It also teaches the brain to repeat the behavior. Cues trigger the reward system, fuel cravings and create a habit loop. The smell of pie baking can make you salivate in anticipation of the taste. Addiction fuels habits toocraving a cigarette every morning with coffee or wanting a hit when you drive past the house where you used to do drugs.
When you take a drug, your brain releases a flood of dopamine, much more than it would when you’re eating your favorite pie. Your brain overreacts and cuts back on dopamine production to bring it down to a normal level.
As you continue to use drugs, your body produces less dopamine. Things that brought you pleasurethat pie, friends, and even drugsdon’t anymore. Once you’re addicted, it takes more and more drugs just to feel normal.
What About Choice Responsibility And Accountability
As previously discussed, the addiction disease model helps EXPLAIN the addicts behavior. This does not EXCUSE the behavior. For some, it can be challenging to reconcile disease and choice.
Indeed, there is a choice involved. If the addict never chose to use it in the first place, the neurobiological forces would never have been put into effect. And if there were no capacity to choose, an addict would never be able to stop once the physiological processes had taken control. Clearly, choices need to be made the choice to stop using, and the healthy choices to do the necessary recovery work.
There are incredible benefits that come with viewing addiction through the lens of disease.
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What Are The Stages Of Addiction
Different sources will say different things about the stages of addiction. Some will claim there are three stages while others attest to seven .
Although the stages and the language used to describe them can vary from source to source, the general timeline usually remains the same:
Recreational or experimental use: a person tries a drug for the first time.
Social or regular use: a person uses in social settings, on a more regular basis.
Problem or risky use: a person uses outside of socially accepted settings or in situations that put themselves at greater risk of negative consequences.
Dependence and addiction: a person uses frequently, experiences cravings and compulsions, and continues to use despite adverse outcomes.
When dependence forms, another process continually transpires: a person cycles between use, withdrawal and preoccupationa constant negative feedback loop.
Understanding The Pleasure Principle
Whether it is a psychoactive drug, sexual experience, or any other form of pleasure, the brain perceives them all in the same way. It stimulates dopamine release from the brains pleasure center.
The difference comes in the speed, intensity, and reliability with which the brain releases dopamine. Typically, drugs of abuse stimulate a high dopamine surge. Thats why they will always be so addictive. The high levels create an alternative route to the brains reward system, which causes dopamine to flood the brainand ultimately intensifies addiction.
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Recovery Is Possiblethere Is Hope
In addition to medications and therapy, successful recovery involves rebuilding a meaningful life. This process can be slow and challenging as you rebuild family and social relationships and begin to expand your role in your community. Unfortunately, the process can be difficult for those struggling with homelessness, financial instability, lack of social supports, or limited education.
Moreover, the recovery process can involve investing in new interests and provide meaning to your life. A successful recovery from addiction can include understanding that your problems usually are temporary. Recovery also involves acknowledging that life is not always supposed to be pleasurable.
An important step in recovery is having personal agency. There are many ways to heal by just being part of better things. By diversifying interests and goals, identifying and working through drawbacks, and remembering life has its highs and lows, recovery can be longer-lasting.
Individuals are encouraged to focus on positive behaviors like:
- Creating realistic goals
- Assisting people
- Working to transform your mindset for the better
Whether practicing these behaviors alone or with loved ones, positivity can be a powerfuland successfulcomponent of the recovery process.
McLean is a leader in addiction treatment. Let us help you or a loved one. Call us today at , and well help you find the treatment option thats right for you.
What Is The Definition Of Addiction
Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individuals life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.
Prevention efforts and treatment approaches for addiction are generally as successful as those for other chronic diseases.
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Do You Have Addiction
Determining whether you have addiction isnt completely straightforward. And admitting it isnt easy, largely because of the stigma and shame associated with addiction. But acknowledging the problem is the first step toward recovery.
A yes answer to any of the following three questions suggests you might have a problem with addiction and shouldat the very leastconsult a health care provider for further evaluation and guidance.
- Do you use more of the substance or engage in the behavior more often than in the past?
- Do you have withdrawal symptoms when you dont have the substance or engage in the behavior?
- Have you ever lied to anyone about your use of the substance or extent of your behavior?
A Brain Disease Then Show Me The Brain Lesion
The notion of addiction as a brain disease is commonly criticized with the argument that a specific pathognomonic brain lesion has not been identified. Indeed, brain imaging findings in addiction are nowhere near the level of specificity and sensitivity required of clinical diagnostic tests. However, this criticism neglects the fact that neuroimaging is not used to diagnose many neurologic and psychiatric disorders, including epilepsy, ALS, migraine, Huntingtons disease, bipolar disorder, or schizophrenia. Even among conditions where signs of disease can be detected using brain imaging, such as Alzheimers and Parkinsons disease, a scan is best used in conjunction with clinical acumen when making the diagnosis. Thus, the requirement that addiction be detectable with a brain scan in order to be classified as a disease does not recognize the role of neuroimaging in the clinic.
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The Disease Model And Addiction Treatment
Now that weve covered the disease model, lets go over some of the ways that the disease model of addiction has informed how we view and treat addiction today.
For the most part, all treatment methods and techniques used in substance abuse treatment programs today are informed by the disease model. Because rather than working toward a cure for substance abuse, drug and alcohol addiction treatment centers approach the treatment of addiction much like a psychiatrist would approach the treatment of a mental or emotional disorder, which is to say that the goal is more about identifying and managing symptoms of the disorder.
Cognitive-behavioral therapy is often the backbone of a substance abuse treatment center, for instance. Also commonly called talk therapy, CBT is used to explore some of the underlying causes of addiction. Its also used to identify a persons triggers and teach strategies for avoiding or nullifying those triggers to safeguard sobriety. Again, CBT is largely for identifying and managing symptoms of addiction.
This is why you often see many holistic treatments and training in substance abuse treatment programs. For instance, its quite common for drug and alcohol treatment centers to offer life skills training or financial coaching, both of which address some of the common effects of long-term addiction.
Facts About Drug And Alcohol Dependence
According to the Substance Abuse and Mental Health Services Administrations survey in 2018, about 20.3 million individuals struggled with SUDs between 2017 and 2018. Another study from 2014 shows that 7.9 million people in the U.S. developed SUD and other mental illness simultaneously. Half of that population were men, even though the gender difference has been reducing since then.
Substance use disorder is a common mental condition that affects millions of people. In 2011, SAMHSA reported that an estimated 22.1 million persons, or 8.9% of the U.S. population aged 12 or older, would meet the diagnostic criteria for SUD.
SAMHSA broke down the percentage of users who will develop dependence on particular drugs:
- 8-9% of marijuana users
- 15-16% of cocaine users
- 67% of nicotine users
Alcohol is one of the most popularand most misusedsubstances in America. Statistics from the 2018 U.S. National Survey on Drug Use and Health found that 139.8 million Americans over age 12 drank during the past month. Of that group, 67.1 million were binge drinkers, while 16.6 million drank too much over the last month. Also, about 14.8 million of that group struggled with an alcohol-related disorder.
The CDCs report in the National Youth Tobacco Survey of 2018 recorded a 78% and 49% rise in e-cigarette smoking amongst high school and middle school students.
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Why Is Addiction Considered A Brain Disease
Scientific research has identified howbrain circuitry and brain chemistry are affected by long-term use of alcohol and other addictive substances. Simply put, sustained drug use alters brain function.Drug use increases the release of a powerful chemical called dopamine. Over time, if dopamine is routinely in abundance because of substance use, the brain attempts to balance things out by producing less dopamine. At that point, the brain relies on substances to trigger the release of dopamine. And that is when individuals start to use alcohol and other drugs just to feel “normal.”
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.
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An Addicted Brain Impacts Behavior
Research has shown how addiction changes the areas of the brain in charge of judgment, decision making, learning and memory, and controlling behavior. Those changes can lead to a good student flunking out, a wife lying about draining the family savings account or an overdose in a grocery parking lot, with kids watching from their car seats.
Once substance use changes the brain, willpower changes too. If you try to quit using substances, your brain tries to protect you from the pain and intensity of withdrawal symptoms. Addiction fuels your brain’s response to do whatever it takes to stop the cravings and discomfort. That can mean overruling the will to “just say no” by taking a drink or using a drug.
Box 1 Whats In A Name Differentiating Hazardous Use Substance Use Disorder And Addiction
Although our principal focus is on the brain disease model of addiction, the definition of addiction itself is a source of ambiguity. Here, we provide a perspective on the major forms of terminology in the field.
Hazardous Substance Use
Hazardous substance use refers to quantitative levels of consumption that increase an individuals risk for adverse health consequences. In practice, this pertains to alcohol use . Clinically, alcohol consumption that exceeds guidelines for moderate drinking has been used to prompt brief interventions or referral for specialist care . More recently, a reduction in these quantitative levels has been validated as treatment endpoints .
Substance Use Disorder
SUD refers to the DSM-5 diagnosis category that encompasses significant impairment or distress resulting from specific categories of psychoactive drug use. The diagnosis of SUD is operationalized as 2 or more of 11 symptoms over the past year. As a result, the diagnosis is heterogenous, with more than 1100 symptom permutations possible. The diagnosis in DSM-5 is the result of combining two diagnoses from the DSM-IV, abuse and dependence, which proved to be less valid than a single dimensional approach . Critically, SUD includes three levels of severity: mild , moderate , and severe . The International Classification of Diseases system retains two diagnoses, harmful use and substance dependence .
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The Chronic Disease Of Addiction
It is important to recognize that addiction is a disease that is chronic in nature. It can sometimes take just a single use to develop and sometimes a lifetime to overcome.
That doesnât mean that there arenât effective treatments to help someone stay in remission for â there are many. But it does mean that itâs important to remember that a loved one who is in recovery from addiction may struggle significantly to avoid relapse, or a return to drug and alcohol use, in the first few years of recovery and during periods of emotional hardship.
While it may be a simple concept to understand in theory, it can be harder to process in practice
- Therapy may need to continue for years or even life long
- Support group attendance can be helpful
- Use of Medication for Addiction Treatment may be recommended for many years or indefinitely.
- Relapse can and likely will occur more than once when someone is trying to recover
- Periods of great stress â the loss of a loved one, divorce, or financial difficulties âincrease the risk of relapse. Your loved one may need extra support during difficult times.
It is important to have realistic expectations: a brief 30-day inpatient treatment or 6-month outpatient program is rarely a cure long term. Long-term support and dedication to an ongoing treatment plan are recommended for anyone with a history of SUD
Understanding Addiction As A Disease
This article is part one of a new series, Understanding Addiction.
The dictionary defines addiction as the fact or condition of being addicted to a particular substance, thing, or activity. The same source defines cancer as a disease caused by an uncontrolled division of abnormal cells in a part of the body.
Do you notice a difference? We only refer to one of the two as a disease.
Unfortunately, this difference in definition is also a common misconception that many have regarding addiction. Many people believe it is not a disease but a choice of the person addicted.
Dr. Mike Wilkerson, Corporate Medical Director for Bradford Health Services, helps us better understand the disease of addiction.
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The Brain On Addiction
Research has identified a number of areas in the brain key to the development and persistence of addiction. In particular, pathways containing dopamine are where many drugs exert their effects. Dopamine is a small chemical in the brain important for carrying signals from one brain cell to the next, similar to how a train carries cargo between stations. Pathways where dopamine is present are involved in many different functions, one of which is reward-motivated behavior.
In the healthy brain, dopamine is released in response to natural rewards, such as food or exercise, as a way of saying, that was good. But drugs hijack dopamine pathways, teaching the brain that drugs are good, too. For example, some drugs have a structure similar to other chemical messengers in the brain, allowing them to bind to brain cells and release dopamine. Therefore, taking a drug produces a euphoric feeling, which in turn strongly reinforces drug-using behavior.
Drugs release two to 10 times the amount of dopamine that natural rewards release. How much is released depends on the type of drug amphetamines, for example, release more dopamine than cocaine. As a result, the increased and sometimes constant influx of dopamine means feelings of reward, motivation or pleasure are also increased.