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New definition of addiction

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New definition of addiction

Postby rabble » Sun Aug 21, 2011 4:12 pm

The American Society of Addiction Medicine (ASAM), which is skeptical of the notions of medical marijuana and video game addiction, has announced a new definition for addiction.

Most of what they say are things most of us with any experience already knew, but some of it surprised me.

Addiction, the statement declares, is a “bio-psycho-socio-spiritual” illness characterized by (a) damaged decision-making (affecting learning, perception, and judgment) and by (b) persistent risk and/or recurrence of relapse; the unambiguous implications are that (a) addicts have no control over their addictive behaviors and (b) total abstinence is, for some addicts, an unrealistic goal of effective treatment.


The idea that any doctor would say "Some addicts are not going to get completely clean no matter how badly they want or how hard they try" was unexpected. I knew about the damaged decision process and persistence parts.
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Re: New definition of addiction

Postby pjbogart » Sun Aug 21, 2011 6:25 pm

I think the notion is that abstinence alone is not a suitable treatment given the addict's proclivity toward the behavior. The doctors aren't admitting that an alcoholic is doomed and nothing can be done for them, they're just saying that alcoholics need professional treatment as opposed to simply quitting drinking.

What I found most interesting in the article is that they're tending toward "addiction" as a disease in and of itself. As in, there is essentially no difference between an alcoholic, heroin or sex addict. The addicted brain is one which has changed its chemical makeup and is essentially sickened by a messed up rewards system. Having one addiction makes you inclined toward all others and even if you treat your specific addiction, you still suffer from the disease of addiction. That's an interesting take and perhaps has been theorized for some time, but I've never heard it put that way.
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Re: New definition of addiction

Postby rabble » Sun Aug 21, 2011 7:13 pm

pjbogart wrote:I think the notion is that abstinence alone is not a suitable treatment given the addict's proclivity toward the behavior. The doctors aren't admitting that an alcoholic is doomed and nothing can be done for them, they're just saying that alcoholics need professional treatment as opposed to simply quitting drinking.

Yeah definitely, and in pretty much just those words. And they're saying genetics is a tendency, not a certainty.

I don't recall saying that they said an alcoholic is doomed, though. I said they're admitting that for some addicts, there won't ever be a complete withdrawal. And that's the first time I can recall any doctor saying that. The language I remember is, if complete withdrawal isn't reached it's a failure. And the one who failed is the patient. Now they're saying that for some people, success is a partial withdrawal. And that, in my experience, is the reality of it. Some of us are just too damaged.
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Re: New definition of addiction

Postby ilikebeans » Mon Aug 22, 2011 12:19 am

rabble wrote:Now they're saying that for some people, success is a partial withdrawal. And that, in my experience, is the reality of it. Some of us are just too damaged.

Those that move toward moderation but don't quit entirely are "damaged"?
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Re: New definition of addiction

Postby rabble » Mon Aug 22, 2011 8:17 am

ilikebeans wrote:
rabble wrote:Now they're saying that for some people, success is a partial withdrawal. And that, in my experience, is the reality of it. Some of us are just too damaged.

Those that move toward moderation but don't quit entirely are "damaged"?

If what they want is total abstinence but can't achieve it, what would you call it?

There's a longer answer to that question in the article.
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