How the New Definition of Addiction Corrects Long-Standing Misconceptions

By David Sack, M.D.

For decades, many people have gotten the wrong idea about addiction. Even as scientific research piled up supporting the theory that addiction is a brain disease, misunderstandings about addiction have persisted.

In August 2011, the American Society of Addiction Medicine (ASAM) took an important step toward refuting some of these long-held misconceptions, redefining addiction as a chronic brain disease. After four years of research and 80 expert opinions, ASAM’s definition responds to some of the most widespread misunderstandings about addiction.

Misconception #1: Addiction is a choice.

According to ASAM, addiction is a chronic disease, similar to diabetes or heart disease, caused by abnormalities in the reward system in the brain. What is originally experienced as a euphoric high over time becomes less rewarding as the brain adapts to changes in neurochemistry. This is followed by deep emotional lows, reinforcing the addictive behavior.

ASAM clarifies that just as a person cannot choose to be addicted, they cannot choose not to be addicted. The reward system of the brain responds to external cues, triggering a compulsion to use drugs and alcohol and engage in compulsive behaviors such as gambling, food and sex. (more…)

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