Addiction begins with a voluntary decision to use drugs. Nobody starts out hoping to become an addict, but as you use a drug repeatedly over time, control over its use decreases dramatically. The person who is initially a voluntary user can become a compulsive drug user, an addict. The brain disease addiction model has greatly contributed to the current view of substance use disorders.
Understanding the neurobiological changes to which the brain undergoes has allowed the development of new methods of intervention and prevention, while reducing stigma in general. Continued advances in neuroscientific research will serve to provide new and effective ways to combat the disease of substance use disorders. Addiction is now understood to be a brain disease. Whether it's alcohol, prescription pain relievers, nicotine, gambling, or something else, overcoming an addiction isn't as simple as stopping drinking or exercising greater control over impulses.
Some say that seeing addiction in this way minimizes its important social and environmental causes, as if saying that addiction is a disorder of the brain circuits means that social tensions such as loneliness, poverty, violence and other psychological and environmental factors do not play an important role. Addicts continue to avoid treatment for medical conditions caused by their addiction due in part to stigma, but also because of the lack of medicinal treatment to help with withdrawal. In addition to neurobiological changes, the addiction model of brain disease also points out that many genetic, environmental and social factors contribute to a person's vulnerability to starting to use drugs, continue to use drugs and undergo the progressive changes in the brain that characterize addiction. While there is a great deal of research on the brain regarding addiction (the brain's pleasure center), it is necessary to consider the enormous role that spirituality also plays within addiction.
In short, the notion of addiction as a disease of choice and of addiction as a brain disease can be understood as two sides of the same coin. Because addiction is a complex biobehavioral disorder whose development and expression largely depend on the social context, addiction treatment inevitably has many different components. As stated above, viewing addiction as a brain disease simply affirms that neurobiology is an undeniable component of addiction. I think that understanding that addiction is a brain disorder is very important in attracting people to help combat this epidemic and in the recovery process of both the addict and their families.
Understanding the biobehavioral nature of addiction also helps to think of strategies for dealing with addicted offenders. I have struggled as a member of a city's addiction task force on how best to communicate addiction as a disease to a general audience, his thoughtful blog brings together many pieces. One of the criticisms of the addiction model of brain diseases is that it does not reduce the moral stigma associated with addiction, but can instead add a new stigma by using the word illness. The concept of an addicted brain appeals to the intuitive idea that, since recreational drugs exert their actions (for example, by causing euphoria) through specific brain structures, there must be discernible and significant brain differences between those who suffer from addiction and those who are not.
