Addiction Is a Chronic Brain Disease, Not Just Problem Behavior

Addiction Is a Chronic Brain Disease, Not Just Problem Behavior

The American Society of Addiction Medicine (ASAM) has released its updated, official definition of addiction, calling it “a chronic brain disorder,” that is “not solely related to problematic substance abuse,” according to a press release issued by the society on August 15.

Although physicians and addiction experts have been referring to addiction as a chronic disorder—and backed up by a sufficient body of scientific evidence—for several years now, this is the first time ASAM has taken an official stance regarding addiction as a chronic brain disease, hoping it will generate more public awareness among both the general population and the medical community. Following a four-year investigation involving more than 80 field experts, the entire ASAM board and its chapter presidents, and a review of twenty years worth of neuroscientific developments, ASAM found it necessary to bring the definition up to date with today’s clinical understanding of addiction. Under the new criteria, addiction is not just a social, behavioral, or moral problem, according to former ASAM president Dr. Michael Miller—but is rather categorized as a primary chronic condition that, not dissimilar to cardiovascular disease or diabetes, requires lifelong treatment and management.

ASAM’s long definition of addiction, available on the society’s website (, explains how addiction is much more than just poor decision making and behavioral choices involving excess drinking, smoking, other recreational drugs, gambling, or sex. ASAM hopes that the new definition will take the focus off drugs and onto the brain when dealing with addictive disorders. Addictions are often pigeonholed by the public’s common assumption that they are the result of dysfunctional personalities or mental problems, making addiction sufferers feel stigmatized and hesitant to seek help for their conditions. Yet the substance abuse and compulsive behavior are not the root of the problem, but rather manifestations of a more complex brain disorder that affects multiple regions of the brain. Addiction causes these regions to undergo various changes like dysfunctional neurotransmission, resulting in altered behavior and decisions that may be considered otherwise uncharacteristic of the individual, and can worsen over time. Just like any other chronic condition, addiction needs to be better understood by the public so everyone recognizes the crucial need to seek treatment and prevent future threats to health. Addiction presents all the criteria for a chronic disease, including exhibiting signs and symptoms, necessitating medical intervention and monitoring, requiring lifelong adherence, and (if untreated) can pose as a serious risk for lifelong deficits or death.

In basic terms, addiction is a disease, not a choice. The chronic disease causes an addict’s judgment, control, feelings, and perceptions to become rewired by continual dysfunctions in the brain’s reward system, which may leave them feeling powerless to their addictions. However, the ASAM advisors stress that people with addictions still do have a conscious choice: to seek treatment for their conditions. Because addiction can lead to unhealthy lifestyles, poor decision making, and other added risks, making the choice to seek recovery and treatment is the best way to overcome the primary cause of all these symptoms and achieve a more healthful quality of life.

With the confirmation of the new definition, ASAM seeks to help remove the stigmatization of addiction and offer better opportunities for individuals and their family members to gain access to treatment and resources. ASAM’s original press release can be viewed here:

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