Author: Gary Jackson

Addiction as a brain disease revised: why it still matters, and the need for consilience PMC

This is consistent with the fact that moderate-to-severe SUD has the closest correspondence with the more severe diagnosis in ICD [117–119]. Nonetheless, akin to the undefined overlap between hazardous use and SUD, the field has not identified the exact thresholds of SUD symptoms above which addiction would be definitively present. Like treatment for other chronic diseases such as heart disease or asthma, addiction treatment is not a cure, but a way of managing the condition. Treatment enables people to counteract addiction’s disruptive effects on their brain and behavior and regain control of their lives. Research on the science of addiction and the treatment of substance use disorders has led to the development of research-based methods that help people to stop using drugs and resume productive lives, also known as being in recovery. Because of this, neurobiology is a critical level of analysis for understanding addiction, although certainly not the only one.

This is not possible, as having the same variables in your life can cause you to relapse again. You must be honest with yourself, commit to changing your life, and ask for help no matter how many times you lapse. This can prevent relapses in the future and allow for treatment adjustments that sustain recovery. CBS News provided one tip that chronic relapses must recognize that they cannot use willpower alone to combat their addiction. Just as 12-step programs say, the report mentions that surrendering can be much more helpful than the stress of trying to stop your cravings on your own.

Treatment and Recovery

As a person continues to use drugs, the brain adapts by reducing the ability of cells in the reward circuit to respond to it. This reduces the high that the person feels compared to the high they felt when first taking the drug—an effect known as tolerance. These brain adaptations often lead to the person becoming less and less able to derive pleasure from other things they once enjoyed, like food, sex, or social activities.

The critical role of alternative reinforcers was elegantly brought into modern neuroscience by Ahmed et al., who showed that rats extensively trained to self-administer cocaine would readily forego the drug if offered a sweet solution as an alternative [103]. This was later also found to be the case for heroin [103], methamphetamine [104] and alcohol [105]. Early residential laboratory studies on alcohol use disorder indeed revealed orderly operant control over alcohol consumption [106]. Furthermore, efficacy of treatment approaches such as contingency management, which provides systematic incentives for abstinence [107], supports the notion that behavioral choices in patients with addictions remain sensitive to reward contingencies. The notion of addiction as a brain disease is commonly criticized with the argument that a specific pathognomonic brain lesion has not been identified.