Opinion Its Misleading to Call Addiction a Disease The New York Times

We’ve done work here at Stanford where you take people who are addicted to, say, methamphetamine and you show them a picture of methamphetamine and you watch their nucleus accumbens light up like a Christmas tree. And so, we can observe things like that but what we can’t do is say, “That signature right there in the brain, I know that person is addicted and this person is not.” First, the originators of the concept did not say that addiction is only a brain disease; we acknowledged how important behavioral and social elements are to its development and to recovery. Despite the minimal attention paid to the details of framing, Heyman’s view strongly encourages a basic research program especially directed toward how to generate global rather than local framing of choices—in my view, a major contribution of this book. Such a program might be of clear benefit in the prevention and treatment of drug abuse—yet another illustration of how basic research not aimed directly at translation can provide important insights eventually leading to effective practical action.

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  • We’ve done work here at Stanford where you take people who are addicted to, say, methamphetamine and you show them a picture of methamphetamine and you watch their nucleus accumbens light up like a Christmas tree.
  • More broadly, we propose that these disagreements reveal the need for multidisciplinary research that integrates neuroscientific, behavioral, clinical, and sociocultural perspectives.
  • I mean, when people argue about whether an addiction’s a disease they’re usually arguing about something else.
  • Therapy can help individuals address the underlying issues that contribute to their addiction and develop healthy coping mechanisms.
  • Close to a quarter of a century ago, then director of the US National Institute on Drug Abuse Alan Leshner famously asserted that “addiction is a brain disease”, articulated a set of implications of this position, and outlined an agenda for realizing its promise [1].
  • Alcohol had the lowest rate, ranging from 987 to 1,039 per 100,000 individuals, of which 675 to 715 were single-substance hospitalizations.

We provide arguments to support this view, discuss why apparently spontaneous remission does not negate it, and how seemingly compulsive behaviors can co-exist with the sensitivity to alternative reinforcement in addiction. Most importantly, we argue that the brain is the biological substrate from which Sober House both addiction and the capacity for behavior change arise, arguing for an intensified neuroscientific study of recovery. More broadly, we propose that these disagreements reveal the need for multidisciplinary research that integrates neuroscientific, behavioral, clinical, and sociocultural perspectives.

Comment on Heilig et al.: The centrality of the brain and the fuzzy line of addiction

Regarding clinical diagnosis, as it is typically used in scientific and clinical parlance, addiction is not synonymous with the simple presence of SUD. Nowhere in DSM-5 is it articulated that the diagnostic threshold (or any specific number/type of symptoms) should be interpreted as reflecting addiction, which inherently connotes a high degree of severity. Indeed, concerns were raised about setting the diagnostic standard too low because of the issue of potentially conflating a low-severity SUD with addiction [116]. In scientific and clinical usage, addiction typically refers to individuals at a moderate or high severity of SUD. This is consistent with the fact that moderate-to-severe SUD has the closest correspondence with the more severe diagnosis in ICD [117–119].

  • Please note the date of last review or update on all articles.
  • In the last five years or so, I’ve been fortunate to be one of the leaders of a Wu Tsai Big Ideas Grant, along with Rob Malenka and Brian Knutson, focused on the neuroscience of addiction.
  • The disease model of addiction also suggests to people that they existing in a fragile state of recovery forever, always in danger of failing.
  • In recent decades, researchers began to label addiction as a disease rather than a behavioral choice.

The neurobiology of drug addiction: cross-species insights into the dysfunction and recovery of the prefrontal cortex

Shanahan opened her checkbook, funneling millions, per Kruse’s suggestion, into a clinical trial at the University of Texas at Austin that plans to treat autistic children with a headband emitting low-level infrared light in an effort to “improve” their behavior. She invested millions more in a company developing a blue light-free computer and efforts aimed at earlier detection, including a startup that says it can detect autism at the moment of birth from a single strand of hair. Kruse’s ideas — including that sunscreen is unnecessary, that genital sunbathing promotes fertility, and that Covid was a “compliance test” designed to keep people indoors, plotted by world leaders with plans to overturn the global economy — exist far outside the mainstream. Central to them all is the power of the sun to heal nearly all chronic disease, including autism.

However, 38 States and the District of Columbia have enacted laws allowing individuals to use marijuana under certain circumstances for medical purposes. Outside of the Federal- and State-sanctioned medical use of marijuana, individuals are using marijuana on their own initiative for medical, as well as nonmedical, purposes. Epidemiological data related to nonmedical use of marijuana is detailed in HHS’s analysis of Factor 4. HHS found that there is a lack of evidence of significant diversion of marijuana from legitimate drug channels.

Lessons from genetics

Providing individuals with the tools and support they need to cope with stress, trauma, and peer pressure can greatly improve their chances of recovery. Genetics can play a role in addiction, but it is not the sole cause. Studies have shown that certain genes may increase an individual’s risk for addiction, but environmental factors also play a significant role.

  • In fact, as shown by the studies correlating dopamine receptors with social experience, imaging is capable of capturing the impact of the social environment on brain function.
  • When a person begins abusing a substance or regularly uses prescription drugs for too long, their body will begin to adapt itself to account for its presence in order to maintain homeostasis, or balance.
  • The treatment of drug effects, at the patient’s request, is well within the domain of medicine, what passes as evidence for the theory that addiction is a disease is merely clinical folklore.
  • I mean, half of Americans are overweight and yet we have a certain amount of mercy.
  • This blog post aims to explore both sides of the debate and debunk common misconceptions surrounding addiction.
  • In 2021, there were 1,326,205 drug reports from State and local forensic laboratories in the United States, an increase of 3 percent from 2020.

is addiction a disease debate

We can be mad at people who disappoint us or people who hurt us and there are multiple diseases where that happens. People get mad when their mate gets Alzheimer’s and not because they don’t love their mate but because it’s frustrating and they lose memories and there’s a lot of hurt and things like that. The other thing is they’re arguing about responsibility and they’re saying something like, “Oh, you’re saying this person didn’t do anything to bring this about,” or that they deserve a blank check for everything they do. I think we all know at this point that addiction is another major epidemic that is sweeping our country and the world, but there are few topics that are more misunderstood than addiction. In fact, many people question whether addiction is even truly a disease.

is addiction a disease debate

Nationally, the number of cannabis/THC reports as well as the number of cases in which cannabis/THC was identified decreased from 2015 through 2021, including a decrease from 188,735 to 167,669 from 2020 to 2021. In considering current patterns of use and abuse of marijuana and marijuana-derived products, HHS analyzed epidemiological databases from 2015 to the most recent years of available data (which vary among data sources). A wide variety of epidemiological databases provide necessary data for HHS’s analyses. Drug discrimination is a method in which animals indicate whether a test drug produces sensations similar to those produced by a training drug with a known pharmacological mechanism of action. Drug discrimination is considered to be an abuse-related study only when the training drug is a known drug of abuse that is scheduled under the CSA and the test drug may have abusable effects similar to the training drug based on having a similar mechanism of action to the training drug.

  • They have a problem and they did something wrong and that there can still be accountability despite the fact that they have a disease, which we recognize with many other places where people have diminished capacity, doesn’t mean they have zero responsibility.
  • These spontaneous remission rates are argued to invalidate the concept of a chronic, relapsing disease [4].
  • Addiction is a complex condition that affects individuals from all walks of life.

Understanding the neurobiology of addiction is crucial for developing effective treatments and interventions. By targeting the brain’s reward system, researchers and clinicians can develop strategies to help individuals with addiction regain control over their lives and reduce their risk of relapse. FDA also reviewed results from State reporting data from 37 States with medical marijuana programs and surveys of patients https://thecupertinodigest.com/top-5-advantages-of-staying-in-a-sober-living-house/ using marijuana in Maryland and Minnesota, which had data available for review. Surveys of patients using marijuana in these two States found most patients did not report any side effects and those that did report side effects mostly described them as mild. Neither State’s databases included patients who chose to stop using marijuana, which FDA noted might result in an overestimation of positive experiences.