Is Addiction A Brain Disease?

The cause of various addictions – such as drug addiction, alcohol addiction and even compulsive gambling – has long been debated among psychologists, behavioral scientists, physicians and researchers.  Many hope that by determining the root cause of addiction, the condition can better be treated.

Earlier this year the American Society of Addiction Medicine (ASAM) proposed a new definition of addiction in August 2011 announcing the proposed new definition.  In general, the ASAM defines addiction as a “chronic brain disorder and not simply a behavioral problem involving too much alcohol, drugs, gambling or sex.”   The new definition also describes addiction as a primary disease (rather than the result of other causes, such as emotional or psychiatric problems) and that addiction is a chronic disease, much like heart disease or diabetes, that can be treated, managed and monitored over the course of an individual’s lifetime.

The new definition was derived from an intensive, four-year process involving more than 80 experts, including top addiction authorities, addiction medicine clinicians and leading neuroscience researchers from across the country.  The proposed new definition and accompanying press release mark the first time that the ASAM has taken an official position that addiction is not solely related to problematic substance use.

Research findings over the past two decades convinced the ASAM that the definition of addiction needed to be reevaluated. Such research has shown that “the disease of addiction affects neurotransmission and interactions within reward circuitry of the brain, leading to addictive behaviors that supplant healthy behaviors, while memories of previous experiences with food, sex, alcohol and other drugs trigger craving and renewal of addictive behaviors. Meanwhile, brain circuitry that governs impulse control and judgment is also altered in this disease, resulting in the dysfunctional pursuit of rewards such as alcohol and other drugs. This area of the brain is still developing during teen-age years, which may be why early exposure to alcohol and drugs is related to greater likelihood of addiction later in life.”

According to Dr. Michael Miller, the past president of ASAM who oversaw the development of the new definition, “[a]t 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.”