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Addiction: A Chronic Brain Disease

Addiction: A Chronic Brain Disease




Since 2011, there has been a growing public understanding and acceptance of addiction as a chronic brain disease and the possibility of remission and recovery has increased. So, what exactly is addiction? According to the American Society of Addiction Medicine (ASAM):

“[Addiction is] a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences.  People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.

Prevention efforts and treatment approaches for addiction are generally as successful as those for other chronic illnesses.”

Drug addiction can be compared to other medical illnesses such as Atherosclerotic Heart Disease and Type 2 Diabetes. Like these illnesses, drug addiction:

  • Is not curable.
  • Must have certain criteria to make the diagnosis.
  • Is marked by a variable course of illness
  • May result in other serious health complications.
  • Requires the patient to adhere to a rigorous treatment routine.
  • Has a prognosis which may result in death if left untreated.

In terms of science and research, more strides are being made in the field of addiction more rapidly today than at any time in history.  Most of that is due to the use of Functional Magnetic Imaging — a form of MRI that relies on the fact that the activity of neurons (nerve cells) in a given region of the brain is proportional to the blood flow in that region of the brain. 

Because of that one fact, and the genius of many researchers, we are able to color code blood flow in accordance with neuronal activity and look at areas of the brain both microscopically and at “long range.” This allows us to gain new knowledge of structures within the limbic system of the brain where most addiction takes place.

In terms of research, there are a number of other areas where science is helping to identify causes of addiction and ways to make treatment more accurate and appropriate.

We know now that epigenetics, as well as genetics, plays a major role in drug addiction. Epigenetics is the study of Chromatin, the structures surrounding the DNA, being altered and resulting in an increased risk of addiction based on environmental factors such as childhood trauma. This risk is able to skip generations and still be transmitted.

Another term that is relatively new in the field of addiction, but is very important, is Neuroplasticity. We know through repetition of a given activity — i.e. opioid addiction and its attendant behavior — and a desire to group together, neurons are able to combine, showing plasticity, and to form new pathways. 

These pathways may be positive in nature – i.e. learning to play the piano, being a gifted hitter in baseball — or negative like drug addiction. Depending in part on the length and strength of the addiction, therapy or regular self-help group attendance teaches the opposite of the established addictive neuroplastic pathway, and weakens the addiction pathway.

Finally, stress and physical pain are two very important terms that are tied to drug addiction, its pathway in the brain, and its understanding as a disease.  With drug addiction, there can be no doubt we are dealing with a brain disease, despite the stigma that is still so prevalent in our community and country.


For more information on ASAM’s definition of addiction, visit this link: