The Disease Model Of Addiction: History And Explanation
The traditional medical model of disease only requires the presence of an abnormal condition that induces distress, discomfort, or dysfunction to the affected person. However, the contemporary medical model states that addiction occurs due to changes in the mesolimbic pathway in the brain. It also addresses the fact that such disease may be influenced by other sociological, psychological or biological factors, even though the mechanisms of these factors are not completely understood. Using the contemporary medical model, addiction was categorised as a disease.
Brain Disease Or Plasticity
The brain disease model argues that changes in the brain from drug use are pathological and indicative of a brain disease. But many brain scientists have rejected this idea, based on studies of how the brain changes with regular drug use.
These scientists point out that the brain has internal mechanisms that allow it to change according to what is happening to it. We call this neuroplasticity. In other words, the brain is plastic and it changes, grows new connections, loses others, and creates greater sensitivity and tolerance. Neuroplasticity is not, however, like brain cancer or stroke. It doesnt cause massive brain cell death. Rather, neuroplasticity is what evolution gave us, presumably because it has some survival value.
is among many of these brain scientists who see addiction in terms of neuroplasticity. Lewis has argued that the disease model has outlived its usefulness and that treatment approaches based on the disease model are too often ineffective.
This is not to say the disease model is invalidonly that many experts on the brain do not agree that the effect of drugs creates a disease.
Initial Use Likely Voluntary
The to start taking drugs or drinking alcohol is usually voluntary. Substance use can begin as a result of trauma, stress, curiosity, or social or peer pressure. However, with continued use of the substance, the individuals ability to exert any kind of self-control over their choices can become seriously impaired. This impairment is considered to be the hallmark of addiction.
Brain images taken of people who are addicted show actual physical changes to the areas of the brain that are instrumental in decision-making, learning and memory, judgment, and behavior control. These brain changes help to explain the compulsive nature of the disease of addiction.
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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.
How Addiction Is Classified As A Disease
According to the disease model of addiction, chemical dependency is an illness that develops over time. Individuals who are already genetically predisposed to addiction will go through stages of this disease. We know that substance abuse does cause chemical changes in our brain, however, there are aspects of an individuals brain chemistry and genetic makeup that signal the possibility of the development of addiction.
Many people deny addictions status as a disease by claiming that because natural pleasures arent as commonly addictive, drug and alcohol addiction must be a flaw in morality and willpower. However, the National Institute of Drug and Alcohol Abuse has explained,
For the brain, the difference between normal rewards and drug rewards can be described as the difference between someone whispering into your ear and someone shouting into a microphone. Just as we turn down the volume on a radio that is too loud, the brain adjusts to the overwhelming surges in dopamine by producing less dopamine or by reducing the number of receptors that can receive signals. As a result, dopamines impact on the reward circuit of the brain of someone who abuses drugs can become abnormally low, and that persons ability to experience any pleasure is reduced.
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Belief In Free Will And The Brain Disease Model Of Addiction
There have been debates about the impact of a brain disease model of addiction on a number of interwoven issues such as free will, responsibility, and stigma . The core of the brain disease model of addiction is the brain-hijack theory . It posits that addiction is a brain disease caused by a dysfunction of brain systems involved in reward and pleasure seeking. According to this view, a greater emphasis on the biological aspects of addiction is a gateway to greater social acceptance of people with an addiction . Indeed, this interest in the impact of neuroscience discourse on belief in free will can be understood not only because of its philosophical dimensions but also because of its practical relevance for a number of issues .
Impact of neuroscience information of attribution of free will.
Neuroscience information on addiction and attribution of free will: Has now been generated as a result of the intensification of research activities on this topic in neuroscience. The implications of this research could be manifold, including for the basic understanding of the mechanisms of addiction, the development of treatment as well as prevention and policy .
Disease Model Of Addiction And Recovery Implications
According to the disease model, addiction is a brain disease. It is characterized by altered brain structure and functioning. These brain abnormalities cause persons with this disease to become addicted to substances or activities, once exposure to these substances or activities occurs. This model considers addiction irreversible once acquired.
Recovery consists of developing and maintaining complete abstinence from all addictive substances and activities. Abstinence arrests the disease. Once arrested, it remains dormant. Because complete abstinence is difficult to achieve, the disease model emphasizes the importance of peer group support. Research shows that peer support is helpful in the recovering from many diseases and disorders. For instance, cancer support groups provide hope to people struggling with cancer. Cancer survivors share with the group their personal experiences of the disease and of recovery. Similarly, addicts and alcoholics support each other in groups such as Alcoholics Anonymous. They share their personal experiences of addiction and recovery and provide hope and inspiration to each other. When people support each other in this manner, they become more hopeful. Therefore, they are more motivated to take the necessary steps toward recovery.
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The Disease Model Of Addiction Explained
Addiction is a disease related to the brain. It is recognised as a chronic disease that must be treated, managed and monitored over a persons lifetime. Addiction involves changes in the functioning of the brain and body. The disease theory of addiction defines addiction as a compulsive disorder that occurs due to chemical changes in the brain, which is induced by regular abuse of drugs and or alcohol rather than a conscious decision.
The Evolution Of Addiction Medicine As A Medical Specialty
Addiction medicine, the study and treatment of addictive disease, has come of age by way of a long and winding road.
Alcoholism was clearly described as a disease as long ago as the late 1700s by Dr. Benjamin Rush, a physician and signer of the Declaration of Independence. However, it wasnt until the founding of Alcoholics Anonymous in the 1930s by New Yorker Bill Wilson and Dr. Bob Smith , both of whom sought recovery from alcoholism, that the concept of alcoholism as disease spread throughout the United States and then the world. Again, it was a physician, Dr. William Duncan Silkworth, who in AAs Alcoholics Anonymous: The Big Book claimed the disease was caused by an allergic reaction of the body to alcohol and a compulsion of the mind .
The modern addiction medicine movement began with the formation of the New York City Medical Society on Alcoholism in 1954 and its recognition of alcoholism as a disease . This organization eventually became the American Medical Society on Alcoholism. Narcotics Anonymous began in California in the 1950s because Alcoholics Anonymous specifically excluded addiction to other drugs from its scope, describing them as outside issues . NA adopted AAs Twelve Steps but included recovery from all drugs of addiction, particularly opiates such as heroin, initially using the catchphrase clean and sober.
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Find Yourself At Discover Recovery Treatment Center
There are so many people who misunderstand addiction. In fact, the misconceptions about addiction that have been so common have stigmatized substance abuse and often discourage people from seeking treatment. As a result, a very low percentage of people who are chemically dependent actually receive the care they need to get sober.
At Discovery Recovery Treatment Center, our prioritize is to use innovative treatments and techniques to help those in need. Additionally, we have built our programs around our core values of integrity, transparency, passion, and community.
To learn more about our programs, or to find out how Discover Recovery can help, contact us today.
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The Problem Of Compulsion
The brain disease model argues that addiction is a compulsion to use drugs. Compulsion means that people will use the drug even if they dont want to and even if they derive no pleasure from it. Many believe that the act of using drugs may even be outside of conscious awareness.
But is drug use really about compulsion? Although the brain disease model is quite firm on this point, many addiction experts dont buy the argument.
Its interesting that philosophers who examine addiction dismiss compulsion on grounds of logic. The most obvious point they raise is that if compulsion were accurate, then how would anyone ever recover?
Weve already pointed out that some brain scientists argue that the real issue of drugs in the brain is not a disease, but neuroplasticity, the idea that the brain adapts to drug use. According to these brain scientists, drug use is learned behavior, not a compulsion.
Another problem of arguing that addiction is compulsion is that scientists are basically forced to decide on what a normal brain is. A person using a drug for the first time does not use compulsively. But after a number of episodes, the drug hijacks the brain, and the person uses drugs compulsively. So what is this magical line that gets crossed in the brain between not being addicted and being addicted? Because the brain is so spectacularly complicated, a lot of experts believe that it is impossible to define this point.
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Defined As A Disease By Experts
Alcoholism was first classified as a disease by the American Medical Association in 1956. The organization included the classification of addiction as a disease in 1987. The American Society of Addiction Medicine defined addiction as a chronic brain disorder in 2011, distinguishing it from being a behavior problem or the result of poor decision making.
Research conducted by top addiction authorities, healthcare providers, neuroscientists, and National Institute on Drug Abuse experts also supports the idea of classifying addiction as a disease. They are still learning how and why the disease develops in certain people and not others.
Strengths And Limitations Of The Brain Disease Model Of Addiction
Of all the theories of addiction that researchers have proposed, the biomedical model of addiction seems to get the most attention. This model says that addiction is a brain disease. Its defining feature is that a drug hijacks the brain, leaving the person no choice but to continue using the drug. Most followers of the brain disease model accept that a persons psychology and environment play some role, but the real issue is the negative effect of the drug on the physical brain. Those who believe in the disease model believe that it provides the best chance we have to significantly advance our understanding, treatment, and prevention of addiction.
Many addiction experts question whether the model will help us. A common complaint is that focusing on brain chemicals ignores peoples motivations to use drugs. Some complain that the disease model is too mechanical, or too neat and tidy, to offer a sound explanation. Others point out that telling individuals with chronic drug problems that they are powerless over using has led to fewer people overcoming addiction on their own .
In this blog, we examine a few key features of the brain disease model to discover its strengths and limitations.
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The Personality Model Of Addiction
- This characterological approach to addiction views chemical dependency as rooted in abnormalities of personality. It is argued that an “addictive personality” exists in some individuals and their traits of poor impulse control low self-esteem inability to cope with stress egocentricity manipulative traits and a need for control and power, while feeling impotent and powerless all contribute to their addiction. As a consequence successful therapy is thought to require a substantial restructuring of the their personality.
Treatment Under The Disease Model Of Addiction
The disease model of addiction recognises that adequate treatment is possible. The treatment programme largely depends on your exact needs and goals. Rehab facilities offer two types of programmes: outpatient and inpatient treatments. In inpatient treatment, patients live at the rehab centre full-time ranging from a few weeks to a few months. In outpatient treatment, patients commute from their homes or sober living houses.
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Developmental Model Of Addiction
The developmental model states that immaturity is the underlying cause of addiction. Humans continue to develop throughout life. However, their most important segment of development happens during childhood and adolescence. As they move through these stages, they develop the skills they need to:
- Delay acting for immediate gratification of impulses
- Learn to think about situations rationally to make wise decisions
- Consider their actions in terms of their relationships with others and their impact on society
For some people, a lack of development results in a failure to mature and rise above the level of pursuing selfish desires. They focus on achieving immediate pleasure, which is the payoff that results from addictive behavior. Another concern with this type of person is that they often fail to consider the consequences of their choices on themselves or the people around them.
This lack of big picture thinking indicates the persons lack of maturity or development and needs to be addressed in treatment.
The developmental model of addiction assumes that if an addict can somehow accelerate their emotional maturity, or grow up, they can learn to make better choices and the addiction will not be a problem any longer, while the medical model states that the addiction is a chronic brain disease the addict has no control over.
Behavioral And Medical Interventions
The findings from neurobiologic research show that addiction is a disease that emerges gradually and that has its onset predominantly during a particular risk period: adolescence. Adolescence is a time when the still-developing brain is particularly sensitive to the effects of drugs, a factor that contributes to adolescents greater vulnerability to drug experimentation and addiction. Adolescence is also a period of enhanced neuroplasticity during which the underdeveloped neural networks necessary for adult-level judgment cannot yet properly regulate emotion. Studies have also shown that children and adolescents with evidence of structural or functional changes in frontal cortical regions or with traits of novelty seeking or impulsivity are at greater risk for substance-use disorders. Awareness of individual and social risk factors and the identification of early signs of substance-use problems make it possible to tailor prevention strategies to the patient. According to research related to the brain disease model of addiction, preventive in-terventions should be designed to enhance social skills and improve self-regulation. Also important are early screening and intervention for the prodromal presentation of mental illness and the provision of social opportunities for personal educational and emotional development.
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Helps To Remove Stigma About Drug And Alcohol Addiction
There is still a stigma around drug and alcohol addiction that is not present when discussing diabetes, heart disease or cancer. All of these health challenges have a lifestyle component attached to them in the same manner that addiction does. It is much less likely that a client who is diagnosed with one of them will be told they are responsible for their health concern or that it is the result of a bad habit and not a real disease, as some people living with addiction have heard from friends and family members.
The medical model explains that not everyone who experiments with drugs and alcohol becomes addicted. Similarly, not everyone with the same risk factors will develop diabetes, heart disease or cancer. There are a number of factors determining who will ultimately become symptomatic. Some of these factors are present in a persons genetic makeup, while others have to do with their upbringing and the types of experiences they had while growing up.
Another factor that must be included is each persons personal makeup, which includes their ability to deal with stressors in their environment. Some people develop different coping methods that do not involve turning to chemicals, or they try them and for whatever reason dont find them effective. Others will use chemicals and be attracted to this method of dealing with stressors and continue using it to the point where they become addicted.