Why Addiction Is Considered a Chronic Brain Disease

Why Addiction Is Considered a Chronic Brain Disease Addiction Alcohol Use Print Why Addiction Is Considered a Chronic Brain Disease By Buddy T facebook twitter Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. Learn about our editorial policy Buddy T Medically reviewed by Medically reviewed by Steven Gans, MD on August 05, 2016 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on July 27, 2019 Witthaya Prasongsin / Getty Images More in Addiction Alcohol Use Binge Drinking Withdrawal and Relapse Children of Alcoholics Drunk Driving Addictive Behaviors Drug Use Nicotine Use Coping and Recovery Addiction is a chronic brain disease thats more about the neurology of the brain than the outward manifestations of behavioral problems and poor choices, according to a group of addiction medicine professionals. In April 2011, the American Society of Addiction Medicine (ASAM) released its new Definition of Addiction, which, for the first time, extends addiction to include behaviors other than problematic substance abuse. A group of 80 addiction experts worked for four years to arrive at the new definition of addiction  and concluded that addiction is about the underlying neurology of the brainâ€"not about outward behavior. Addiction Alters Your Brains Reward System Addiction affects your brains reward, motivation, memory, and related circuitry to the extent that your motivations are altered so that your addictive behaviors replace healthy, self-care behaviors. The brains reward system is also altered in such a way that the memory of previous rewardsâ€"be it food, sex, or drugsâ€"can trigger a biological and behavioral response to engage in the addictive behavior again, in spite of negative consequences, and sometimes even though you no longer even find pleasure in the activity. Impulse Control Is Also Altered Addiction also affects the frontal cortex of your brain in such a way as to alter your  impulse control and judgment. This results in the pathological pursuit of rewards, ASAM says when addicts return to their addictive behavior in order to feel normal. The frontal cortex is involved in inhibiting impulsivity and delaying gratification. Because this area of the brain continues to develop into young adulthood, the ASAM experts believe this is why early-onset exposure to substances is linked to the later development of addiction. Characteristics of Addiction According to the ASAM definition, addiction is characterized by: Inability to consistently abstainImpairment in behavioral controlCraving or increased “hunger” for drugs or rewarding experiencesDiminished recognition of problems with your  behaviors and relationshipsA dysfunctional emotional response Other Features of Addictive Behavior These conditions are also commonly present in addiction: Cravings and addictive  behaviors are triggered by external cuesA risk of relapse even after long periods of abstinenceResistance to change despite increasing problems Impaired Control and Judgment Problems ASAM says that behavioral manifestations and complications of addiction, due to impaired control, can include: Engaging in more addictive behavior than you intendedIncreased time lost from work or schoolContinued substance use despite physical or psychological consequencesNarrowing of your addictive behavior repertoire; for instance, you only drink one brand of a certain type of alcoholLack of readiness to get help, despite admitting a problem Addiction Can Cause Cognitive Changes Cognitive changes in addiction can include: Preoccupation with the substance or addictive behaviorAn altered sense of the pros and cons of addictive behaviorsA false belief that your problems are not predictable consequences of addiction Addiction Can Cause Emotional Changes ASAM believes emotional changes in addiction can include: Increased anxiety, dysphoria, and emotional painSituations seeming more stressful than they really areDifficulty identifying and expressing feelings The Reason for a New Definition of Addiction In the past, diagnosis of addiction has focused on outward manifestations of a persons behaviors, which can be observed and confirmed by standardized questionnaires. The new definition of addiction instead focuses on whats going on inside you, in your brain. The experts at ASAM hope their new definition leads to a better understanding of the disease process, which they say is biological, psychological, social, and spiritual in its manifestation. Addiction can manifest itself in many behaviors beyond substance abuse. The Implications for Treatment Traditionally, people with addictions have sought and received treatment for a particular substance or behavior. This has sometimes resulted in the person substituting one addiction for anotherâ€"what ASAM calls the pathological pursuit of rewardsâ€"because the underlying cause was not treated. ASAM suggests that comprehensive addiction treatment should focus on all active and potential substances and behaviors that could be addictive. ASAM was careful to point out that the fact that addiction is a primary, chronic brain disease does not absolve addicts from taking responsibility for their behaviors. Just as people with heart disease or diabetes have to take personal responsibility for managing their illness, if you have an addiction, you also must take the steps necessary to minimize your  chance of relapse, ASAM said.