What Is Addiction?

Is drug addiction a disease? In 2011, the American Society of Addiction Medicine (ASAM) adapted the following definition of addiction:

“Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.

Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.”

Since 2011, the public understanding and acceptance of addiction as a chronic brain disease and the possibility of remission and recovery have increased. At the same time, there is growing acknowledgment of the roles of prevention and harm reduction in the spectrum of addiction and recovery. In response, ASAM recognized the need for an updated definition of addiction.

Updated Definition of Addiction: 

”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 diseases.”

Risk and protective factors associated with addiction: 

There are several risk and protective factors associated with developing substance use disorders (medical, personal, family and community).

Risk factors:

• Genetic predisposition
• Family history of substance use
• Psychiatric disorders
• Impulsiveness
• Rebelliousness
• Low social support
• Interpersonal conflict with others
• Norms, customs and policies that promote substance use

Protective factors:

• Strong social skills
• Problem solving skills
• Sense of purpose
• Positive sense of self
• Trust and lack of severe criticism within family
• Involvement in activities not involving substance use
• Skills to resist negative influence of peers
• Reasonably high expectations at school/work

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