Addiction: Definition Makeover
News of the the American Society of Addiction Medicine’s (ASAM) new definition of “addiction” has taken the recovery world by storm. Some are calling it radical because they suggest the new definition essentially invalidates many common perceptions regarding what addiction means to recovering addicts. Critics also suggest this new meaning deflates the common belief that mental health issues, like mood or personality disorders could be the underlying cause of one’s addiction. In other words, self-medicating to treat an anxiety or a mood disorder is not an inherently addictive behavior according to this new definition. It’s definitely a sticky subject, and not one many recovering addicts want to try to wrap their minds around. Change is difficult for many of us, but change that could belie one’s own personal identification with their addiction and their recovery could be frightening.
The ASAM’s new definition states:
“Addiction is a primary, chronic disease of brain reward, motivation, memory and relatedcircuitry. Dysfunction in these circuits leads to characteristic biological, psychological,social and spiritual manifestations. This is reflected in an individual pathologically
pursuing reward and/or relief by substance use and other behaviors.
Addiction is characterized by inability to consistently abstain, impairment in behavioralcontrol, craving, diminished recognition of significant problems with one’s behaviors andinterpersonal relationships, and a dysfunctional emotional response. Like other chronicdiseases, addiction often involves cycles of relapse and remission. Without treatment orengagement in recovery activities, addiction is progressive and can result in disability orpremature death.”
Still, the ASAM does continue to outline the negative consequences of addiction and recognizes its often deadly outcome. It maintains that all addictions are essentially the same, whether they are to alcohol, drugs, sex, et cetera. The difference now is, they are defining it primarily as a neurological disorder.
The timing of this new definition is in line with the highly-publicized revision of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM), which includes diagnostic criteria for addiction and the corresponding guidelines for its treatment. There are certainly differences between the ASAM’s definition and the DSM, which will define “each type of addiction as a separate disease” with its symptoms continuing “to be viewed mostly as discrete behaviors.”
In many ways, this new definition is an attempt to destigmatize addiction. It looks to treat the disease as a whole rather than treating acute, compartmentalized symptoms.
The program of AA has always looked at alcoholism as a disease; those of us working in the recovery industry can tell you that it’s a brain disease. In many ways, this new definition confirms something we’ve known or suspected for some time. When we begin to address this with a critical mind, we’ll see that the threat of AA’s potential for obsolescence is more or less fear talking and not reality, and that what’s at stake here isn’t really the 12-step support groups, but the way in which insurance companies will allow the management of addiction treatment. However, digging deeper into that mess may uncover more to fear than a definition of addiction, so we’ll leave that alone for now.
So, let’s not forget the true beauty of the 12-step programs, where “The only requirement for membership is a desire to stop drinking (using, etc).” As any addict/alcoholic can tell you, we’re here because our lives depend on it. The definition may change, but our sobriety and dedication to recovery cannot.
Articles used for reference and which are beneficial for further information:
A Radical New Definition of Addiction Creates a Big Storm (Alternet.org)
Addiction Gets Medical Makeover (thefix.com)
The Definition of Addiction (asam.org) (long form)