“font-family: Verdana, Times, serif; font-size: 12px; text-decoration: none; line-height: 13px; color: #000000; font: normal normal normal 12px/normal verdana, helvetica, arial;”>
“font-family: Arial, Helvetica, sans-serif; font-size: 13px; -webkit-border-horizontal-spacing: 2px; -webkit-border-vertical-spacing: 2px;”>
WASHINGTON (AP) — Addiction isn’t just about willpower. It’s a
chronic brain disease, says a new definition aimed at helping
families and their doctors better understand the challenges of
treating it.
“font-family: Verdana, Times, serif; font-size: 12px; text-decoration: none; line-height: 13px; color: #000000; font: normal normal normal 12px/normal verdana, helvetica, arial;”>
“font-family: Arial, Helvetica, sans-serif; font-size: 13px; -webkit-border-horizontal-spacing: 2px; -webkit-border-vertical-spacing: 2px;”>
“Addiction is about a lot more than people behaving badly,” says
Dr. Michael M. Miller of the American Society for Addiction
Medicine.
“font-family: Verdana, Times, serif; font-size: 12px; text-decoration: none; line-height: 13px; color: #000000; font: normal normal normal 12px/normal verdana, helvetica, arial;”>
“font-family: Arial, Helvetica, sans-serif; font-size: 13px; -webkit-border-horizontal-spacing: 2px; -webkit-border-vertical-spacing: 2px;”>
That’s true whether it involves drugs and alcohol or gambling and
compulsive eating, the doctors group said Monday. And like other
chronic conditions such as heart disease or diabetes, treating
addiction and preventing relapse is a long-term endeavor, the
specialists concluded.
“font-family: Verdana, Times, serif; font-size: 12px; text-decoration: none; line-height: 13px; color: #000000; font: normal normal normal 12px/normal verdana, helvetica, arial;”>
“font-family: Arial, Helvetica, sans-serif; font-size: 13px; -webkit-border-horizontal-spacing: 2px; -webkit-border-vertical-spacing: 2px;”>
Addiction generally is described by its behavioral symptoms – the
highs, the cravings, and the things people will do to achieve one
and avoid the other. The new definition doesn’t disagree with the
standard guide for diagnosis based on those symptoms.
“font-family: Verdana, Times, serif; font-size: 12px; text-decoration: none; line-height: 13px; color: #000000; font: normal normal normal 12px/normal verdana, helvetica, arial;”>
“font-family: Arial, Helvetica, sans-serif; font-size: 13px; -webkit-border-horizontal-spacing: 2px; -webkit-border-vertical-spacing: 2px;”>
But two decades of neuroscience have uncovered how addiction
hijacks different parts of the brain, to explain what prompts those
behaviors and why they can be so hard to overcome. The society’s
policy statement, published on its website, isn’t a new direction
as much as part of an effort to translate those findings to primary
care doctors and the general public.
“font-family: Verdana, Times, serif; font-size: 12px; text-decoration: none; line-height: 13px; color: #000000; font: normal normal normal 12px/normal verdana, helvetica, arial;”>
“font-family: Arial, Helvetica, sans-serif; font-size: 13px; -webkit-border-horizontal-spacing: 2px; -webkit-border-vertical-spacing: 2px;”>
“The behavioral problem is a result of brain dysfunction,” agrees
Dr. Nora Volkow, director of the National Institute on Drug
Abuse.
“font-family: Verdana, Times, serif; font-size: 12px; text-decoration: none; line-height: 13px; color: #000000; font: normal normal normal 12px/normal verdana, helvetica, arial;”>
“font-family: Arial, Helvetica, sans-serif; font-size: 13px; -webkit-border-horizontal-spacing: 2px; -webkit-border-vertical-spacing: 2px;”>
She welcomed the statement as a way to help her own agency’s work
to spur more primary care physicians to screen their patients for
signs of addiction. NIDA estimates that 23 million Americans need
treatment for substance abuse but only about 2 million get that
help. Trying to add compassion to the brain findings, NIDA even has
made readings from Eugene O’Neill’s “Long Day’s Journey into Night”
a part of meetings where primary care doctors learn about
addiction.
“font-family: Verdana, Times, serif; font-size: 12px; text-decoration: none; line-height: 13px; color: #000000; font: normal normal normal 12px/normal verdana, helvetica, arial;”>
“font-family: Arial, Helvetica, sans-serif; font-size: 13px; -webkit-border-horizontal-spacing: 2px; -webkit-border-vertical-spacing: 2px;”>
Then there’s the frustration of relapses, which doctors and
families alike need to know are common for a chronic disease,
Volkow says.
“font-family: Verdana, Times, serif; font-size: 12px; text-decoration: none; line-height: 13px; color: #000000; font: normal normal normal 12px/normal verdana, helvetica, arial;”>
“font-family: Arial, Helvetica, sans-serif; font-size: 13px; -webkit-border-horizontal-spacing: 2px; -webkit-border-vertical-spacing: 2px;”>
“You have family members that say, `OK, you’ve been to a detox
program, how come you’re taking drugs?'” she says. “The pathology
in the brain persists for years after you’ve stopped taking the
drug.”
“font-family: Verdana, Times, serif; font-size: 12px; text-decoration: none; line-height: 13px; color: #000000; font: normal normal normal 12px/normal verdana, helvetica, arial;”>
“font-family: Arial, Helvetica, sans-serif; font-size: 13px; -webkit-border-horizontal-spacing: 2px; -webkit-border-vertical-spacing: 2px;”>
Just what does happen in the brain? It’s a complex interplay of
emotional, cognitive and behavioral networks.
“font-family: Verdana, Times, serif; font-size: 12px; text-decoration: none; line-height: 13px; color: #000000; font: normal normal normal 12px/normal verdana, helvetica, arial;”>
“font-family: Arial, Helvetica, sans-serif; font-size: 13px; -webkit-border-horizontal-spacing: 2px; -webkit-border-vertical-spacing: 2px;”>
Genetics plays a role, meaning some people are more vulnerable to
an addiction if they, say, experiment with drugs as a teenager or
wind up on potent prescription painkillers after an
injury.
“font-family: Verdana, Times, serif; font-size: 12px; text-decoration: none; line-height: 13px; color: #000000; font: normal normal normal 12px/normal verdana, helvetica, arial;”>
“font-family: Arial, Helvetica, sans-serif; font-size: 13px; -webkit-border-horizontal-spacing: 2px; -webkit-border-vertical-spacing: 2px;”>
Age does, too. The frontal cortex helps put the brakes on unhealthy
behaviors, Volkow explains. It’s where the brain’s reasoning side
connects to emotion-related areas. It’s among the last neural
regions to mature, one reason that it’s harder for a teenager to
withstand peer pressure to experiment with drugs.
“font-family: Verdana, Times, serif; font-size: 12px; text-decoration: none; line-height: 13px; color: #000000; font: normal normal normal 12px/normal verdana, helvetica, arial;”>
“font-family: Arial, Helvetica, sans-serif; font-size: 13px; -webkit-border-horizontal-spacing: 2px; -webkit-border-vertical-spacing: 2px;”>
Even if you’re not biologically vulnerable to begin with, perhaps
you try alcohol or drugs to cope with a stressful or painful
environment, Volkow says. Whatever the reason, the brain’s reward
system can change as a chemical named dopamine conditions it to
rituals and routines that are linked to getting something you’ve
found pleasurable, whether it’s a pack of cigarettes or a few
drinks or even overeating. When someone’s truly addicted, that
warped system keeps them going back even after the brain gets so
used to the high that it’s no longer pleasurable.
“font-family: Verdana, Times, serif; font-size: 12px; text-decoration: none; line-height: 13px; color: #000000; font: normal normal normal 12px/normal verdana, helvetica, arial;”>
“font-family: Arial, Helvetica, sans-serif; font-size: 13px; -webkit-border-horizontal-spacing: 2px; -webkit-border-vertical-spacing: 2px;”>
Make no mistake: Patients still must choose to fight back and treat
an addiction, stresses Miller, medical director of the Herrington
Recovery Center at Rogers Memorial Hospital in Oconomowoc,
Wis.
“font-family: Verdana, Times, serif; font-size: 12px; text-decoration: none; line-height: 13px; color: #000000; font: normal normal normal 12px/normal verdana, helvetica, arial;”>
“font-family: Arial, Helvetica, sans-serif; font-size: 13px; -webkit-border-horizontal-spacing: 2px; -webkit-border-vertical-spacing: 2px;”>
But understanding some of the brain reactions at the root of the
problem will “hopefully reduce some of the shame about some of
these issues, hopefully reduce stigma,” he says.
“font-family: Verdana, Times, serif; font-size: 12px; text-decoration: none; line-height: 13px; color: #000000; font: normal normal normal 12px/normal verdana, helvetica, arial;”>
“font-family: Arial, Helvetica, sans-serif; font-size: 13px; -webkit-border-horizontal-spacing: 2px; -webkit-border-vertical-spacing: 2px;”>
And while most of the neuroscience centers on drug and alcohol
addiction, the society notes that it’s possible to become addicted
to gambling, sex or food although there’s no good data on how often
that happens. It’s time for better study to find out, Miller
says.
“font-family: Verdana, Times, serif; font-size: 12px; text-decoration: none; line-height: 13px; color: #000000; font: normal normal normal 12px/normal verdana, helvetica, arial;”>
“font-family: Arial, Helvetica, sans-serif; font-size: 13px; -webkit-border-horizontal-spacing: 2px; -webkit-border-vertical-spacing: 2px;”>
Meanwhile, Volkow says intriguing research is under way to use
those brain findings to develop better treatments – not just to
temporarily block an addict’s high but to strengthen the underlying
brain circuitry to fend off relapse.
“font-family: Verdana, Times, serif; font-size: 12px; text-decoration: none; line-height: 13px; color: #000000; font: normal normal normal 12px/normal verdana, helvetica, arial;”>
“font-family: Arial, Helvetica, sans-serif; font-size: 13px; -webkit-border-horizontal-spacing: 2px; -webkit-border-vertical-spacing: 2px;”>
Topping Miller’s wish list: Learning why some people find recovery
easier and faster than others, and “what does brain healing look
like.”
“font-family: Verdana, Times, serif; font-size: 12px; text-decoration: none; line-height: 13px; color: #000000; font: normal normal normal 12px/normal verdana, helvetica, arial;”>
“font-family: Arial, Helvetica, sans-serif; font-size: 13px; -webkit-border-horizontal-spacing: 2px; -webkit-border-vertical-spacing: 2px;”>
—
“font-family: Verdana, Times, serif; font-size: 12px; text-decoration: none; line-height: 13px; color: #000000; font: normal normal normal 12px/normal verdana, helvetica, arial;”>
“font-family: Arial, Helvetica, sans-serif; font-size: 13px; -webkit-border-horizontal-spacing: 2px; -webkit-border-vertical-spacing: 2px;”>
EDITOR’S NOTE – Lauran Neergaard covers health and medical issues
for The Associated Press.
“font-family: Verdana, Times, serif; font-size: 12px; text-decoration: none; line-height: 13px; color: #000000; font: normal normal normal 12px/normal verdana, helvetica, arial;”>
about our“http://hosted2.ap.org/APDEFAULT/privacy”>Privacy
Policy
