Pubdate: Mon, 17 Jan 2005
Source: Daily Times, The (TN)
Copyright: 2005 Horvitz Newspapers
Contact:  http://www.thedailytimes.com/
Details: http://www.mapinc.org/media/1455
Author: Steve Wildsmith

SCIENTIFIC APPROACHES TO ADDICTION WORTH THINKING ABOUT

As a recovering addict, I know addiction well in the ``street'' sense of the
term.

I know about conning and manipulating and hustling and chasing dope, but
I've never given much thought to the scientific approach to addiction. A
week ago, while attending a conference in New York sponsored by the
Addiction Studies Program for Journalists of the Wake Forest University
School of Medicine and National Families in Action, I received more
information than I know what to do with right now.

I'll be attempting to share some of that with you in the weeks to come, but
the bulk of the information that opened my eyes was a presentation on the
neurobiology of addiction, given by Dr. David Friedman, a professor of
physiology and deputy associate dean for research at the Wake Forest school
of medicine.

Very simply, addiction is a disease --research going on at Wake Forest and
other universities are discovering more and more concrete evidence of this
all the time, specifically how drugs affect the brain. The American Medical
Association -- along with the American Psychiatric Association, the American
Hospital Association, the American Public Health Association, the World
Health Organization and the American College of Physicians -- first declared
alcoholism a disease back in 1957. In 1961, a report by the AMA and the
American Bar Association concluded drug addiction is a disease and not a
crime.

So if the two are diseases, then how do they work? According to Dr.
Friedman, ``if the brain is the organ of the mind and controls behavior, and
drugs change thoughts, feelings and behavior by changing the way the brain
works, and if those changes are enduring -- addiction is a brain disorder.''

Dr. Friedman goes on to describe drug addiction as having the following
components:

n Loss of control of drug-taking behavior, including the inability to
control when and how much drugs are used, and using in the face of adverse
consequences;

n A tendency for chronic relapse;

n Brings about tolerance and physical and psychological dependence on the
part of drug addicts.

Dr. Friedman goes on to point out that, in active addiction, free will, or
the ability to make a choice when it comes to drug use, is impaired. Once an
addict is in recovery, free will reasserts itself . but ``because addicts
are self-destructive in terms of their drug use,'' he postulates, ``perhaps
drugs alter the function of brain structures central for survival.''

Arguing for addiction as a brain disorder flies in the face of public stigma
and the long-held belief that addiction is the result of a moral failing.
Such beliefs are why so many addicts are incarcerated, even though they may
pose no threat to society and are often found to be completely non-violent.

Establishing addiction as a brain disorder is a novel concept in that, if it
is physical in nature, the rational response is to treat addicts for it
instead of locking them up.

It's a round-about way of scientifically proving the concepts that have
floated around the rooms of 12-Step recovery for years. Addiction is a
disease; those caught in its grips need medical and psychiatric help, not
morality lectures and jail time.

Having a scientist like Dr. Friedman espouse such theories is the first step
toward shifting public policy in that direction. However, public discourse
on addiction and alcoholism has taken the moral high road for so long,
changing that policy will take years.

Dr. Friedman's work is just one small step. But for this addict, it's news
that's welcomed with relief and gratitude that someone in the medical
community finally understands not only what's wrong, but that the medical
community might one day treat addiction like it would hypertension, diabetes
and other long-term, often debilitating diseases. 
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