A Radical New Definition of Addiction Creates a Big Storm

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A Radical New Definition of Addiction Creates a Big Storm

Postby American Dream » Sat Aug 20, 2011 5:00 pm

A Radical New Definition of Addiction Creates a Big Storm

By Jennifer Matesa and Jed Bickman, The Fix
Posted on August 18, 2011


http://www.alternet.org/story/152102/a_ ... _big_storm


If you think addiction is all about booze, drugs, sex, gambling, food and other irresistible vices, think again. And if you believe that a person has a choice whether or not to indulge in an addictive behavior, get over it. The American Society of Addiction Medicine (ASAM) blew the whistle on these deeply held notions with its official release of a new document defining addiction as a chronic neurological disorder involving many brain functions, most notably a devastating imbalance in the so-called reward circuitry. This fundamental impairment in the experience of pleasure literally compels the addict to chase the chemical highs produced by substances like drugs and alcohol and obsessive behaviors like sex, food and gambling.

The definition, a result of a four-year process involving more than 80 leading experts in addiction and neurology, emphasizes that addiction is a primary illness—in other words, it’s not caused by mental health issues such as mood or personality disorders, putting to rest the popular notion that addictive behaviors are a form of "self-medication" to, say, ease the pain of depression or anxiety.

Indeed, the new neurologically focused definition debunks, in whole or in part, a host of common conceptions about addiction. Addiction, the statement declares, is a “bio-psycho-socio-spiritual” illness characterized by (a) damaged decision-making (affecting learning, perception, and judgment) and by (b) persistent risk and/or recurrence of relapse; the unambiguous implications are that (a) addicts have no control over their addictive behaviors and (b) total abstinence is, for some addicts, an unrealistic goal of effective treatment.

The bad behaviors themselves are all symptoms of addiction, not the disease itself. "The state of addiction is not the same as the state of intoxication," the ASAM takes pains to point out. Far from being evidence of a failure of will or morality, the behaviors are the addict's attempt to resolve the general "dysfunctional emotional state" that develops in tandem with the disease. In other words, conscious choice plays little or no role in the actual state of addiction; as a result, a person cannot choose not to be addicted. The most an addict can do is choose not to use the substance or engage in the behavior that reinforces the entire self-destructive reward-circuitry loop.

Yet ASAM pulls no punches when it comes to the negative consequences of addiction, declaring it an illness that “can cause disability or premature death, especially when left untreated or treated inadequately.”

The new definition leaves no doubt that all addictions—whether to alcohol, heroin or sex, say—are fundamentally the same. Dr. Raju Haleja, former president of the Canadian Society for Addiction Medicine and the chair of the ASAM committee that crafted the new definition, told The Fix, “We are looking at addiction as one disease, as opposed to those who see them as separate diseases. Addiction is addiction. It doesn’t matter what cranks your brain in that direction, once it has changed direction, you’re vulnerable to all addiction." That the society has stamped a diagnosis of sex or gambling or food addiction as every bit as medically valid as addiction to alcohol or heroin or crystal meth may spark more controversy than its subtler but equally far-reaching assertions.

The new definition comes as the American Psychiatric Association (APA) is undertaking a highly publicized, decade-in-the-making revision of its own definition of addiction in itsDiagnostic and Statistical Manual of Mental Disorders—the bible of the mental health profession. The APA’s DSM will have a larger effect on public health policies that guide addiction treatment, largely because insurance companies are mandated by law to use the DSM diagnostic categories and criteria to decide which treatments they will pay for.

Dr. Haleja told The Fix that the ASAM definition arose partly out of a disagreement with the DSM committee; although the DSM will define addiction as a disease, its symptoms (and therefore diagnostic criteria) will still be viewed mostly as discrete behaviors. Also, the DSM will define each type of addiction as a separate disease, instead of the singular and unified notion of disease that the ASAM proposes. “In terms of treatment, it becomes very important that people don’t focus on one aspect of the disease, but the disease as a whole,” says Haleja. Far from being a failure of will or morality, addictive behaviors are the addict's attempt to resolve the general "dysfunctional emotional state" that develops in tandem with the disease. In other words, conscious choice plays little or no role in the actual state of addiction; as a result, a person cannot choose not to be addicted.

Though addicts can’t choose not to be addicts, they can choose to get treatment. Recovery, ASAM says, is best realized not just by self-management and mutual support groups such as 12-step fellowships, but also with trained professional help.

Some addiction-medicine specialists see the sweeping new definition as a validation of what has, since the publication of Alcoholics Anonymous in 1939, come to be known as “the disease concept” of addiction. “Many people in the population at large see addiction as a moral problem—‘Why don’t they just stop?’” says Dr. Neil Capretto, medical director of Gateway Rehabilitation Center in Pittsburgh and an active ASAM member. “For experienced people working in addiction medicine for years, we know it’s a brain disease.”

Does this statement push the 12 steps, the mainstay of many treatment centers, programs and clinicians, toward obsolescence? After all, when a problem is declared to be a “medical” issue, doesn’t that imply that the solution should also be “medical”—as in doctors and drugs? “Both approaches have applicability,” says Dr. Marc Galanter, professor of psychiatry at New York University, founding director of its Division of Alcohol and Substance Abuse as well as director of its Fellowship Training Program in Addiction Psychiatry. “The fact that addiction is a disease doesn’t mean it’s only susceptible to drugs.” Says Capretto: “This new definition does not say that psychological or spiritual approaches are not important. My concern is that some people who really don’t understand the broader scope of addiction will see it only as a disease of brain cells. We’re not treating computers—it’s in the total human being who is, as the definition says, a 'bio-psycho-socio-spiritual' creature, and who will still need help in those areas.”

With its no-stone-unturned statement (it runs to eight pages, single-spaced, including footnotes), ASAM has come down—mostly—on one side of the chicken-and-egg question that has long befuddled people interested in addiction, physicians and recovering addicts alike: which came first, the neurological disorder or the compulsive behaviors and substance use? The definition states that abnormalities in the neurological system’s reward wiring—communication between areas of the brain, particularly those that process memory, emotional response and pleasure—come first, and drive the addict into a doomed pursuit to compensate for the reward-system imbalance through the addictive behavior. But later, the document notes that these behaviors themselves can damage the reward circuitry and lead to impaired impulse control and addiction.

The statement conforms, in its general outlines, with the prevailing premise in cutting-edge addiction science that the natural reward system designed to support human survival becomes overtaken or highjacked by the chemical payoff provided by substance use or addictive behaviors. “The reward circuitry bookmarks things that are important: eating food, nurturing children, having sex, sustaining intimate friendships,” says Dr. Mark Publicker, medical director of Mercy Recovery Center in Portland—Maine’s largest rehab—and former Regional Chief of Addiction Medicine for Kaiser Permanente Mid-Atlantic Region.

When we use alcohol or drugs, Publicker says, the chemical reward—the "high"—is many times more powerful than the natural circuitry’s reward, and the neurological system adapts to the flood of neurotransmitters. “But because we didn’t evolve as a species with OxyContin or crack cocaine, that adaptive mechanism overshoots. So it becomes impossible to experience a normal sense of pleasure,” he continues. “Use of the substance then happens at the expense of what otherwise would promote survival. If you think about it from that standpoint, it begins to account for illness and premature death.” An active addict has a very high risk of early death via sickness or suicide.

The statement raises repeated alarms about the danger posed by the development by teens and young adults of habits of consumption of substances because their brains are still in the process of maturation, and the chemical "hijacking" of the reward system may result in earlier and more serious addiction behaviors. While firmly grounded in the neurological disease model of addiction, the definition by no means discounts genes (it attributes about half of the cause to your DNA inheritance). It’s careful to say that environmental factors affect whether and how much the genetics will tip the scales. The statement notes that “resiliencies” acquired through parenting and life experience can inhibit genetic expression of addiction. “Genetics is tendency, not destiny,” Capretto says.

Psychological and environmental factors, such as exposure to trauma or overwhelming stress, distorted ideas about life’s meaning, a damaged sense of self, and breakdown in connections with others and with “the transcendent (referred to as God by many, the Higher Power by 12-steps groups, or higher consciousness by others)" are also acknowledged as having an influence.

In addition, ASAM further says that understanding reward systems is just a part of understanding addiction’s neurobiology. Scientists are still trying to comprehend how some addicts become preoccupied with certain drugs or behaviors and other addicts with others; how some addicts become triggered to use by some events that don’t affect others; and how cravings can persist for decades after a complete recovery.

The statement attempts to put forth diagnostic hallmarks, all of which are behavioral: inability to abstain; impaired impulse control; cravings; diminished grasp of one’s problems; and problematic emotional responses.

Is it a problem that the definition is incapable of pointing to a quantifiable diagnostic marker of this illness? “I may be stating the obvious, here,” Publicker says, sighing, “but you don’t need to do brain imaging to identify an active alcoholic.”

In fact it emphasizes that "the quantity and frequency" of addictive symptoms—like how many drinks you down in a day or how many hours you spend masturbating—is no more or less of a marker than the "qualitative [and] pathological way" the addict responds to stressors and cues by continued pursuit in the face of growing adverse consequences.

Publicker, an active ASAM member for 30 years and a proponent of medication-assisted therapy for addiction, notes that addiction recovery depends on treatment of psychological, social and spiritual aspects of the illness—not just its biological aspects. “It’s called medication-assisted therapy, not therapy-assisted medication,” he says. “Medication alone fails. I’ve seen this over a very long career. But it can really make a difference in people struggling to relapse.”

He draws the analogy with depression: “If you ask most people what depression is, they’ll answer it’s a serotonin deficiency disorder and that the solution is to put somebody on an SSRI [antidepressant medication]. But that’s a simplistic and inefficient way of managing depression. Medication can be helpful, but it needs to be combined with talk. We live in an era now where talk is not reimbursed.”It remains to be seen whether ASAM’s new branding of addiction as a full-bore biological illness will help addicts obtain reimbursement for treatment. In terms of insurers, clarifying that the illness has “biological roots”—stipulating that it’s not the patient’s fault he or she has the illness—may break down reimbursement roadblocks.

Capretto agrees: “Things like this definition help bring addiction more into the scope of other diseases, so for the future it will mean fewer barriers for people wanting to get help.”

One of ASAM's unstated goals was obviously to fight against the stubborn social stigma against addiction experienced by many addicts. “There’s no question they set out to de-stigmatize addiction,” Publicker says. “Nobody chooses to be an addict. The concern that I have is placing blame on the patient. It takes a very long time for the brain to normalize. While it’s waiting to happen, you’re feeling bad, your thinking is impaired, and it’s a setup for relapse. Patients are likely to be blamed for relapse, and families see them as unmotivated and weak. But that’s the disease of addiction.”




Jennifer Matesa writes about addiction and recovery issues on her blog, Guinevere Gets Sober. She is the author of two nonfiction books about health issues, including Navel-Gazing: The Days and Nights of a Mother in the Making.

Jed Bickman contributed additional reporting for this article. He has written for the Nation, Huffington Post and Counterpunch.com.
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Re: A Radical New Definition of Addiction Creates a Big Stor

Postby Project Willow » Sat Aug 20, 2011 7:11 pm

Matesa wrote:The definition, a result of a four-year process involving more than 80 leading experts in addiction and neurology, emphasizes that addiction is a primary illness—in other words, it’s not caused by mental health issues such as mood or personality disorders, putting to rest the popular notion that addictive behaviors are a form of "self-medication" to, say, ease the pain of depression or anxiety.

Indeed, the new neurologically focused definition debunks, in whole or in part, a host of common conceptions about addiction. Addiction, the statement declares, is a “bio-psycho-socio-spiritual” illness characterized by (a) damaged decision-making (affecting learning, perception, and judgment) and by (b) persistent risk and/or recurrence of relapse; the unambiguous implications are that (a) addicts have no control over their addictive behaviors and (b) total abstinence is, for some addicts, an unrealistic goal of effective treatment.


This seems to me like an distinction without an explained difference. Where does the psycho, socio, and spiritual come in if not in answer to pain?

Matesa wrote:The most an addict can do is choose not to use the substance or engage in the behavior that reinforces the entire self-destructive reward-circuitry loop.


So this disease corrupts the reward circuitry loop on its own without the need for some kind of activator process? Isn't the reward the dulling of pain? What have I missed here?

I know stats show a high incidence of childhood abuse, trauma, and depression amongst addicts. I also know that, predilection or no, I use various mind and body altering substances to manage my own emotional and somatic pain.
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Re: A Radical New Definition of Addiction Creates a Big Stor

Postby Simulist » Sat Aug 20, 2011 9:31 pm

Dr. Raju Haleja wrote:It doesn’t matter what cranks your brain in that direction, once it has changed direction, you’re vulnerable to all addiction.

I'm not sure that Dr. Haleja actually meant those first words in that sentence to be taken literally but, when combined with the medical establishment's rather cowardly approach to the culture it emerges from, the remark also seems fairly telling.

One criticism of the medical establishment I've increasingly wanted to see called out over the years is that the medical establishment (which is part of "The Establishment," after all!) is too-often codependent with many of the societal problems that sometimes form the bases for disease, in this particular case: addiction. Not only do I think that it does "matter what cranks your brain" in the direction of addiction — I think that it matters a very great deal. One of the unmentionable causes of addiction (which needs to be mentioned — and often!) is the terrible toxicity of our entire culture, something many people feel the need to anesthetize themselves from in order simply to face it, day in and day out.

Were the medical establishment more interested in actually curing diseases — instead of just managing their symptoms — "what cranks your brain" in the direction of addiction (a.k.a. the underlying sociological causes of addiction, to name just one thing) might be more fully considered, and much more often, rather than being simply dismissed as if the concern itself were of little importance.
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Re: A Radical New Definition of Addiction Creates a Big Stor

Postby American Dream » Sat Aug 20, 2011 10:10 pm

The thread on Gabor Mate' on addiction also has material relevant to the issues concerned here...
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Re: A Radical New Definition of Addiction Creates a Big Stor

Postby RobinDaHood » Sun Aug 21, 2011 12:06 am

"And it seems to me perfectly in the cards that there will be within the next generation or so a pharmacological method of making people love their servitude, and producing … a kind of painless concentration camp for entire societies, so that people will in fact have their liberties taken away from them but will rather enjoy it, because they will be distracted from any desire to rebel by propaganda, brainwashing, or brainwashing enhanced by pharmacological methods."
Aldous Huxley, 1959
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Re: A Radical New Definition of Addiction Creates a Big Stor

Postby Marie Laveau » Sun Aug 21, 2011 12:14 am

American Dream wrote:The thread on Gabor Mate' on addiction also has material relevant to the issues concerned here...


His book, 'In the Realm of Hungry Ghosts,' absolutely changed the way I look at addictions.

Not that I believe his common sense ideas about the importance of pre-natal care of the mother - keeping her well fed, not under undue stress, etc.- will ever get one iota of acknowledgement in our sick society.
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Re: A Radical New Definition of Addiction Creates a Big Stor

Postby American Dream » Sun Aug 21, 2011 12:21 am

Here is a critical perspective from a writer who- despite working for Time Magazine- had written good expose's of institutional abuse of children in the "tough love" business for youth and in centers that use shocks for behavior modification:


http://healthland.time.com/2011/08/16/w ... lls-short/

Why the New Definition of Addiction, as 'Brain Disease,' Falls Short

By Maia Szalavitz Tuesday, August 16, 2011



In 1956, the American Medical Association declared alcoholism a "disease." More than half a century later, the American Society of Addiction Medicine (ASAM) has proclaimed addiction, including alcoholism and "process" addictions like gambling, to be the same.

According to the ASAM's definition, published on the group's website on Monday, addiction is a "primary, chronic disease of brain reward, motivation, memory and related circuitry." This clarification, which was based on consultations with more than 80 experts, is aimed in part at de-stigmatizing addictive disorders.

That's an admirable goal. The scientific evidence shows that addiction is rooted in distinct brain changes, just like other mental illnesses such as depression (though in both instances, the same changes are not found in all people with the conditions). The research does clearly show that evidence-based treatment is far more effective at resolving drug abuse problems than law enforcement efforts like incarceration. There's no justification for treating people with addiction any differently than other patients.

But if you want to reduce stigma, calling something a brain disease may not be the best way to go. Studies that have looked at this question have found that labeling a disorder as "neurobiological" tends to have either no effect on stigma or actually increases it.

For example, a 2010 study published in the American Journal of Psychiatry examined the levels of stigma associated with alcohol dependence, schizophrenia and major depression. In 1996 and again in 2006, researchers surveyed 630 participants about their views on alcoholism. While the percentage of people who said they believed alcoholism was a brain disorder increased from 38% to 47%, that shift was not linked with a decrease in stigma. In fact, over the same time period, the percentage of people who said they thought alcoholism was linked with "bad character" also increased significantly, from 49% to 65%.

Similarly, psychologist Steven Hayes of the University of Nevada found that people's implicit associations with the word "disease" were as negative as those linked with "drunk" or "intoxicated." The problem may be that people think of "brain diseases" as fixed and unchangeable; they may also view people whose brains are damaged as potentially dangerously out of control. Genetic explanations of mental illness, which are similarly associated with the perception that the condition is permanent, have also been linked with increased stigma.

The inclusion of the word "chronic" in the ASAM definition doesn't help here. Although addiction is indeed chronic in some cases, this is not always the case. Research shows that the majority of people who receive a diagnosis of addiction or alcoholism actually recover without treatment or participation in self-help groups. In a 2005 study involving 4,442 people with alcoholism who were not in treatment, researchers found that one year after their initial interview, a full 75% had improved to the point where they were no longer considered to be actively alcoholic.

Eighteen percent had quit drinking entirely, while another 18% had become low-risk drinkers; 12% were drinking at levels that were considered asymptomatic but potentially risky, and another 27% had cut down but not entirely eliminated their drinking problem. Only a quarter of the sample had gotten any type of outside help, including 12-step meetings.

Longer term studies of multiple types of addiction show similar trends: far more people meet the criteria for addiction in their youth and later recover than ever attend self-help groups or get treatment. Many simply "age out" of the problem and never look back.

Another problem with the ASAM definition is its description of the disorder's "characteristic bio-psycho-socio-spiritual manifestations." Addiction clearly involves problems with neurobiology, psychology and social connections, similar to other mental illnesses. But spirituality?

According to ASAM, the "spiritual" manifestations of addiction include "distortions in the connection with ... the transcendent (referred to as God by many, the Higher Power by 12-steps groups, or higher consciousness by others)."

When trying to convince doctors and the general public that a condition is a genuine disease, I would argue that it's probably best to leave God out of it. Definitions of cancer, diabetes, depression and schizophrenia manage just fine without intruding on territory better left to priests, rabbis, imams, ministers and the like.

Like depression, addiction is a real medical disorder that affects the brain. But if we want to reduce the stigma associated with it, emphasizing recovery and resilience is probably more useful than focusing on definitions of brain disease.

To increase the use of effective and non-stigmatizing care, let's stick to the empirical evidence, not the ineffable.





Maia Szalavitz is a health writer at TIME.com. Find her on Twitter at @maiasz. You can also continue the discussion on TIME Healthland's Facebook page and on Twitter at @TIMEHealthland.
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Re: A Radical New Definition of Addiction Creates a Big Stor

Postby Wombaticus Rex » Sun Aug 21, 2011 12:28 am

Damn, talk about sprinting in the wrong direction. Addiction is a learning pattern malfunctioning and I was figuring they'd expand the definition to recognize how prevalent and amorphous it really is....wow, was I being naive.

And word to this:

Simulist wrote:One of the unmentionable causes of addiction (which needs to be mentioned — and often!) is the terrible toxicity of our entire culture, something many people feel the need to anesthetize themselves from in order simply to face it, day in and day out.


Haleja was fucking up on a lot of levels with that quote. Quick to slap himself on the back for recognizing a pattern but too slow to ask himself where that pattern really starts and why it's there.

Great thread. I'd like to see critics of neuroscience focus more on the neurochemical paradigm and how fucking absurd it is -- like trying to control a vehicle via the exhaust system. There is a STEERING WHEEL and shit.
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Re: A Radical New Definition of Addiction Creates a Big Stor

Postby Marie Laveau » Sun Aug 21, 2011 12:45 am

I will have to go back and re-read the thread on Gabor Mate; however, his position that addictions are hardwired in-utero or shortly thereafter, due to either the stress of the mother or extreme stress to the infant and that the synapses are just sitting there BEGGING for the chemical that will relieve the hard-wired desire....well, that makes a lot of sense.

His position that familial addictions are a generations-long continual process due to the fact that people tend to raise children the way they were raised confirms something I've thought for years was probabl true: that there really isn't a huge gap between nature and nurture. People tend to nurture (or not) the way they were (or weren't) nurtured, and it's a cycle that becomes nature in most families.

Of course, there are those people who are able to divorce themselves from the abusive/addictive way they were raised, but that isn't the norm. And so people tend to pass addictions along not because they see mommy and daddy tippling the bottle, but because mommy's mental and physical actions during pregnancy (stress, addictions, etc.) hardwire it rigth into the developing fetus.
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Re: A Radical New Definition of Addiction Creates a Big Stor

Postby Joe Hillshoist » Sun Aug 21, 2011 4:25 am

Project Willow wrote:
Matesa wrote:The definition, a result of a four-year process involving more than 80 leading experts in addiction and neurology, emphasizes that addiction is a primary illness—in other words, it’s not caused by mental health issues such as mood or personality disorders, putting to rest the popular notion that addictive behaviors are a form of "self-medication" to, say, ease the pain of depression or anxiety.

Indeed, the new neurologically focused definition debunks, in whole or in part, a host of common conceptions about addiction. Addiction, the statement declares, is a “bio-psycho-socio-spiritual” illness characterized by (a) damaged decision-making (affecting learning, perception, and judgment) and by (b) persistent risk and/or recurrence of relapse; the unambiguous implications are that (a) addicts have no control over their addictive behaviors and (b) total abstinence is, for some addicts, an unrealistic goal of effective treatment.


This seems to me like an distinction without an explained difference. Where does the psycho, socio, and spiritual come in if not in answer to pain?

Matesa wrote:The most an addict can do is choose not to use the substance or engage in the behavior that reinforces the entire self-destructive reward-circuitry loop.


So this disease corrupts the reward circuitry loop on its own without the need for some kind of activator process? Isn't the reward the dulling of pain? What have I missed here?

I know stats show a high incidence of childhood abuse, trauma, and depression amongst addicts. I also know that, predilection or no, I use various mind and body altering substances to manage my own emotional and somatic pain.



I think they are suggesting that a trauma, especially a childhood one, can trigger a vulnerability to addiction. I don't think the two ideas are as far apart as it seems actually. In some ways you could read the article as reinforcing not "putting to rest the popular notion that addictive behaviors are a form of "self-medication" to, say, ease the pain of depression or anxiety."

I think thats just poorly written, possibly aimed at people who would view self medication as "an excuse".
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Re: A Radical New Definition of Addiction Creates a Big Stor

Postby MacCruiskeen » Wed Sep 14, 2011 6:35 pm

Gabor Maté was mentioned earlier. This looks like another book well worth reading:

The Globalization of Addiction: A Study in Poverty of the Spirit [Paperback]

Bruce Alexander

http://www.amazon.co.uk/Globalization-A ... 0199588716

Review

Alexander's watershed study could not be more timely. Mainstream commentators, who are now grasping for explanations for an epidemic of dangerous addictions, will find it indispensible. (Catholic Herald )

This immensely important and original book will completely reframe your understanding of the wider social, historical, economic and cultural context of addiction (The Scientific and Medical Network )

This is, without a doubt, the most intriguing and painstaking book on addiction I have read for some time..."The Globalisation of Addiction" is scholarly, meticulously researched, passionately critical of the free-market economy, biased, speculative, selective, and quite wonderful...highly recommended...this is one of the most remarkable addiction texts of the decade. (John B. Davies, Addiction Research and Theory )

This fascinating and unique book explores the problem of addiction using a nontraditional approach...a refreshing look at an age-old problem. (Doody's Notes )

Product Description

'The Globalization of Addiction' presents a radical rethink about the nature of addiction. Scientific medicine has failed when it comes to addiction. There are no reliable methods to cure it, prevent it, or take the pain out of it. There is no durable consensus on what addiction is, what causes it, or what should be done about it. Meanwhile, it continues to increase around the world. This book argues that the cause of this failure to control addiction is that the conventional wisdom of the 19th and 20th centuries focused too single-mindedly on the afflicted individual addict. Although addiction obviously manifests itself in individual cases, its prevalence differs dramatically between societies. For example, it can be quite rare in a society for centuries, and then become common when a tribal culture is destroyed or a highly developed civilization collapses. When addiction becomes commonplace in a society, people become addicted not only to alcohol and drugs, but to a thousand other destructive pursuits: money, power, dysfunctional relationships, or video games. A social perspective on addiction does not deny individual differences in vulnerability to addiction, but it removes them from the foreground of attention, because social determinants are more powerful. This book shows that the social circumstances that spread addiction in a conquered tribe or a falling civilisation are also built into today's globalizing free-market society. A free-market society is magnificently productive, but it subjects people to irresistible pressures towards individualism and competition, tearing rich and poor alike from the close social and spiritual ties that normally constitute human life. People adapt to their dislocation by finding the best substitutes for a sustaining social and spiritual life that they can, and addiction serves this function all too well. The book argues that the most effective response to a growing addiction problem is a social and political one, rather than an individual one. Such a solution would not put the doctors, psychologists, social workers, policemen, and priests out of work, but it would incorporate their practices in a larger social project. The project is to reshape society with enough force and imagination to enable people to find social integration and meaning in everyday life. Then great numbers of them would not need to fill their inner void with addictions.

http://www.amazon.co.uk/Globalization-A ... =pd_sim_b6


First pages of Bruce Alexander's book.
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Re: A Radical New Definition of Addiction Creates a Big Stor

Postby Nordic » Wed Sep 14, 2011 8:34 pm

My own experience with getting addicted to nicotine was pretty interesting. I didn't smoke, at all, till I was 30 years old. Up until that time, I hated the smell of cigarettes, cigars, pipes, almost everything, just couldn't stand to be around it.

After I got addicted, my perception of the smell was completely different.

I remember once when I was trying to quit, and I was sitting in traffic, and someone in a car nearby was smoking a cigarette. I turned and my brain and eyes zoomed in on her like I was some kind of falcon or something. Like a snap-zoom, almost instant, instinctual. I'll never forget it, or the image of that woman langorously putting that cigarette to her back-lit lips. It was like sex.

Still, to this day, I can smell cigarette smoke, and rather than being repulsed, I want one.

It changed my brain! Permanently. Now it's a constant choice not to smoke, whereas prior to getting addicted it was unthinkable (well, up until I did it, but that's a whole nuther story)
"He who wounds the ecosphere literally wounds God" -- Philip K. Dick
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Re: A Radical New Definition of Addiction Creates a Big Stor

Postby Harvey » Thu Sep 15, 2011 5:48 am

American Dream wrote:defining addiction as a chronic neurological disorder involving many brain functions, most notably a devastating imbalance in the so-called reward circuitry.


Like anything else, it's only true in strict isolation, yes it's true in terms of susceptibility, but I'm guessing it's not the last word.
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You'll ever learn
Is just to love
And be loved
In return"


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Re: A Radical New Definition of Addiction Creates a Big Stor

Postby Harvey » Thu Sep 15, 2011 5:56 am

Wombaticus Rex wrote:Damn, talk about sprinting in the wrong direction. Addiction is a learning pattern malfunctioning and I was figuring they'd expand the definition to recognize how prevalent and amorphous it really is....wow, was I being naive.

And word to this:

Simulist wrote:One of the unmentionable causes of addiction (which needs to be mentioned — and often!) is the terrible toxicity of our entire culture, something many people feel the need to anesthetize themselves from in order simply to face it, day in and day out.


Haleja was fucking up on a lot of levels with that quote. Quick to slap himself on the back for recognizing a pattern but too slow to ask himself where that pattern really starts and why it's there.

Great thread. I'd like to see critics of neuroscience focus more on the neurochemical paradigm and how fucking absurd it is -- like trying to control a vehicle via the exhaust system. There is a STEERING WHEEL and shit.


I've known for a long time that addiction is an anesthetic. It took me this long to realise why I needed medication. I had to be forced to look within. As simulist says, swimming in a toxic environment, it's hard not drink some of the poison. The good news is, until your last breath, it's never too late to heal.
And while we spoke of many things, fools and kings
This he said to me
"The greatest thing
You'll ever learn
Is just to love
And be loved
In return"


Eden Ahbez
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