A straightforward, 14-word sentence opens the American Society of Addiction Medicine’s (ASAM’s) newly adopted definition of addiction, leaving little doubt over ASAM’s position on what the field is treating:
“Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry.”
There will be plenty of opportunities taken to parse this statement and the others that make up a long-form definition that took a group of more than 80 addiction experts four years to create. Two items stand out in the opening sentence. Addiction is primary—this will inspire professionals who fear their interests being subsumed by those of individuals who attribute addiction exclusively to emotional/psychiatric causes. Addiction is a disease of the brain—this will motivate the ongoing work to erase stigma in places where services are delivered and policies are crafted.
“At its core, addiction isn’t just a social problem or a moral problem or a criminal problem. It’s a brain problem whose behaviors manifest in all these other areas,” Michael Miller, MD, the ASAM past president who oversaw development of the definition, said in a statement. (Miller in recent weeks was named the physician recipient of Addiction Professional’s 2011 Outstanding Clinicians Awards.)
Here are a few other eye-catching statements in ASAM’s definition, released to the public in the form of a public policy statement:
“Genetic factors account for about half of the likelihood that an individual will develop addiction. Environmental factors interact with the person’s biology and affect the extent to which genetic factors exert their influence.”
“In some cases of addiction, medication management can improve treatment outcomes. In most cases of addiction, the integration of psychosocial rehabilitation and ongoing care with evidence-based pharmacological therapy provides the best results.”
The statement closes with more compelling nuggets: “Recovery from addiction is best achieved through a combination of self-management, mutual support, and professional care provided by trained and certified professionals.”