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Addictions

The Biology of Addiction and Recovery

A. Tom Horvath, Ph.D., ABPP, Kaushik Misra, Ph.D., Amy K. Epner, Ph.D., and Galen Morgan Cooper, Ph.D.

So how do people get addicted anyway? The recent contributions of science and medicine during the past 50-60 years have greatly advanced our understanding of addiction. We are beginning to understand biological forces that affect behavior (both humans and animals). Addiction is easier to understand when we consider that our biology programs us to pursue pleasure. However, we are not slaves to our biology. The unrestrained pursuit of pleasure represents a type of developmental immaturity as depicted in the classic story of Peter Pan. Therefore, the psycho-social-spiritual portion of the Bio-Psycho-Social-Spiritual model (BPSS) influences whether we mature beyond our biological limitations.

In this section, we will explore the biological forces that drive addiction. In subsequent sections, we will discuss the psychological, the social, and the spiritual portions of the BPSS model.

Biology and Addictions Research: The Benefits of Science

man holding alcohol bottleUntil fairly recently, people with addictive disorders were viewed as selfish, weak-willed folks. They seemed to behave badly without regard for themselves, or others. However, during the past 30 years this perspective has begun to change. People with addictive problems will tell you, willpower is not enough. As we will soon see, our biological make-up explains why this is so.

Furthermore, advancements in neurobiological research have changed the way we view addiction. Addiction is no longer limited to problematic substance use. We now know that certain activities can also be addictive (eating, sex, gambling). This is because addiction is a problem of brain functioning. We become addicted to the chemicals our brain releases, not the substance or activity that causes this release. Thus, addiction is a problem of brain functioning and our genetics greatly determine this.

The American Society of Addictions Medicine (ASAM), the nation's largest professional society of addiction physicians, is dedicated to treating and preventing addiction. ASAM recently released (August 15, 2011) a new definition of addiction. It states that genetics account for about 50% of the likelihood that someone will develop an addiction http://www.asam.org. This ASAM definition of addiction describes addiction as a "chronic disease of the brain." It is quite different from our own definition.

It remains controversial whether or not we should reduce addiction to a "chronic disease of the brain." Nevertheless, there is strong evidence to suggest a genetic component to addiction. Clearly, addiction does not develop merely because someone is weak-willed. Addicted persons do not choose their genetics. Therefore, they do not control whether they are at risk for developing an addiction.

However, we are not slaves to our biology.  Biology does not completely drive our behavior. People are certainly capable of choosing recovery over addiction. This makes addictive disorders very similar to other diseases and disorders. Many health problems require lifestyle changes to restore health. For instance, people with diabetes must regularly check blood sugar levels and count carbohydrates. People with heart disease must choose a healthier diet and an exercise program. Obviously, these folks did not choose to have these health challenges. However, but they most certainly do choose how to handle them. The same is true for people with addictions.

 

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