Addiction is a "chronic brain disorder" per new ASAM definition

Hello. Dr. Heinzerling here. News from the American Society of Addiction Medicine. They recently released a revised definition of addiction (press release)! The new definition describes addiction as:

"a chronic brain disorder and not simply a behavioral problem involving too much alcohol, drugs, gambling or sex."

It's hard not to ask what took them so long to come to this conclusion, given the volumes of scientific research on this topic that has accumulated over the past 30 years, but I guess better late than never!

After a quick review of the new definition (you can check out the details of the definition for yourself here) I have a few thoughts. First, I think the definition does a decent job of including both biological and psycho-social aspects of addiction. In addition, they present the following handy rubric (maybe they should call it the A, B, C, D, E's of addiction), to describe addiction:

Addiction is characterized by:
   a. Inability to consistently Abstain;
   b. Impairment in Behavioral control;
   c. Craving; or increased “hunger” for drugs or rewarding experiences;
   d. Diminished recognition of significant problems with one’s behaviors and interpersonal relationships; and
   e. A dysfunctional Emotional response.

Another E they include is the power of external cues. They make the point that this rubric should not be used as a means of clinically diagnosing patients with addiction (wait for the DSM-V for that!) but I think it is handy and relatively easy to remember and could be a great teaching tool for medical students and residents to remember some important clinical characteristics that accompany addiction.

Anyway, you may be asking what difference does this new definition of addiction make? Well first it has generated some press and attention and interest in the topic which can never hurt, particularly when it is highlighting the biological aspects of addiction. But frankly it probably won't change much outside of ASAM. Still I would consider it an important step for ASAM in acknowledging the important role that biology does play in drug addiction, while continuing to recognize the importance of non-biological factors as well, as ASAM has not always been up to speed on the biological side in the past (not meant to be a criticism, just my opinion). So good work ASAM and keep it up.

Well, let us know what you think of the new definition and/or our take on it. If you have questions or comments-- post below, e-mail us or send a message via Twitter @UCLASARx! We welcome your feedback! Thanks for tuning in.