Addictions, behavioral and chemical, declared brain diseases

No gain without a pain killer!

The American Society of Addiction Medicine has opened a Pandora’s box that will surely come back to haunt them. The LA Times reports, Addiction is a brain disease, experts declare. The problem here is that we’re not just talking alcoholism, speed and heroin, we’re also talking gambling, sex, and the internet.

Addiction is “not simply a behavioral problem involving too much alcohol, drugs, gambling or sex,” the American Society of Addiction Medicine declared this week. Instead, the society notes, “Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry.”

I don’t get the idea that anybody laying down solid evidence to support this thesis. I’d like to be shown an extracted brain circuit, for instance.

In other words, addiction is not just about the act of raising a bottle to the lips, drawing deeply on a cigarette or bingeing guiltily in chocolate bars in private. There just might be something amiss in your head that compels you to behave that way.

There you go…chocolate addiction! From what I’ve heard the DSM-V is set to include gambling as an addiction with sex and the internet in the appendix, sort of knocking at the gate if you will. I can’t help but think that ASAM is envisioning a greatly expanded DSM-VI already.

Sex addiction (hypersexuality) is an example of one of these so called behavioral addictions that readily lends itself to parody. What’s the difference between a sex addict and a mere enthusiast? Usually it’s a partner that the “addict” is in a supposedly committed relationship with. Alright, you’ve got a person who either ends the relationship, and can revert to enthusiast status, or you’ve got a person who is so addicted to this partner as to make such a reversion more difficult than usual. The partner is usually not such an enthusiast, and in fact, is usually if married on the way to divorce court, and if not married is in the process of transitioning to another partner. Unless, of course, he or she has been gulled into buying the sex addiction argument.

This is a first for ASAM, previous definitions have restricted the ground covered to substance abuse. Now every fad and fancy in the book is open to reassessment as a behavioral addiction, and a behavioral addiction equaling “brain disease”. Why? Because, of course, ASAM says so.

But just because something’s widely accepted professionally doesn’t mean it’s widely accepted out there in the world. At the website of the National Institute on Drug Abuse, you’ll see colorful PET scan images that attempt to drum home the point: One is of a normal brain and one of a cocaine abuser: metabolically, they look quite different. Right next to that pairing is another set of images, of two hearts – one healthy, one diseased. Again, the images look quite different. There would be no controversy over declaring one of the hearts physically diseased. That can’t be said for addiction, even in the face of all the evidence.

Right, now how different is the brain of an addicted internet user from a complete computer naif?

The health food obsession, as I made note of in an earlier post, has for some time, and in some quarters, been categorized under the mental disorder tag Orthorexia. This is amusing as junk food addiction has not yet entered the medical lexicon. Of course, there’s another disorder associated with pigging out on a fast food regimen, and that’s a growing problem in this country, obesity. Next thought, if only there were more exercise junkies around, and exercise junkies who could keep off the steroids.