MEDICAL MODEL OF ADDICTION
Many people ask themselves, “is addiction really a disease?” According to Merriam-Webster, the definition of the word “disease” is, “a condition of the living animal or plant or one of its parts that impairs normal functioning and is typically manifested by distinguishing signs and symptoms.”
The medical definition of “disease” is, “A morbid entity ordinarily characterized by two or more of the following criteria: recognized etiologic agent(s), identifiable group of signs and symptoms, or consistent anatomic alterations.”
As such, drug addiction and alcoholism clearly meet the criteria to be defined as a disease and are diseases. A disorder is defined as, “a physical or mental condition that is not normal or healthy.”
So, drug addiction and alcoholism also meet the criteria for the term “disorder.”
In 1956, the American Medical Association classified alcoholism as a disease, far prior to classifying drug addiction as a disease in 1987. This was mostly due to an early abundance of research on how alcohol and alcohol withdrawal affects the brain and body, both in structure and function. Drug addiction research came about later than the research on alcoholism.
Gambling Disorder is also now considered to be a diagnosable disease, according to the DSM-5. This is, again, because of research and the similarities to alcoholism in behaviors and the changes in neurologic structure and function that occur in gambling addiction. Imaging samples of persons addicted to drugs demonstrate that there are changes in brain function and structure in regions related to judgment and decision-making, which can lead one to make poor life choices. Other areas that are affected are those responsible for learning and memory and behavioral regulation.
Social, environmental and genetic factors are all considerations when seeking the origin of drug addiction and alcoholism, as each plays a separate role. It is important to note that drug addiction and alcoholism are both medical and psychiatric diseases and that they are chronic, treatable, and fatal, if they progress. Medical care is available and typically occurs in a drug or alcohol rehab, a psychiatric facility or a medical hospital for those who are experiencing severe and life-threatening withdrawal.
Currently, research is ongoing for other behavioral addictions including food, sex, eating, exercise, shopping, internet usage, internet gaming, and hoarding, among others. It is likely that evidence will show that the behavioral addictions will also meet the criteria to be called addictive diseases and/or disorders.
Treatment for the behavioral addictions is available, even though they haven’t been formally classified as diseases. According to the American Society of Addiction Medicine, “Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry.”
The medical model, or disease model, of addiction is centered around the fact that an addicted brain does not function the same as a normal brain in terms of decision making and free-will. Because drug addiction and alcoholism affect both the structure and function of the brain, medical treatment is part of the care that one will receive when undergoing drug and alcohol treatment. Further, there are now genetic tests that can identify markers for alcoholism and some specific drug addictions. Genetic testing is being used to determine how specific persons metabolize drugs and medications, to determine the best course of medical treatment. More and more physicians are specializing in the treatment of addiction, and currently there is a board certification for those physicians, who are called addictionologists.
The basic idea behind the disease model of addiction is that addiction is a disease and has biologic, neurologic, genetic and environmental components that all work together to create the emergence of drug addiction and alcoholism. In the medical model, because of the different components that create drug addiction and alcoholism, the treatment is multifaceted. Typically, a course of drug and alcohol rehab will address mental health, environmental, medical, social and spiritual issues. Nutrition and exercise are also key factors.
When seeking help for a drug or alcohol addiction, it is important to locate a facility that treats them as disease, rather than a moral or social problem. Many facilities offer treatment for dual diagnosis disorders and use a multidisciplinary treatment approach.
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