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Addiction & Recovery
In reply to the discussion: Is addiction really a disease? [View all]Jemmons
(711 posts)6. Fair points indeed.
I will note though, that:
1. The headline is not actually my wording but the headline from the Grauniad article that is linked in the OP. It also might be seen as click bait at some level.
2. The definitions that you refer to are not in any way hidden or secret. So either they dont have the desired effect or else you need to explain in a bit more detail what you think is going on.
3. Talking past each other is a real possibility and something a bit of common terminology can perhaps prevent. We agree so far. But I just dont find that a set of vague and varied definitions of a complex concept like "disease" is really going to make a big difference.
What I would consider a more fruitfull starting point would be the pathophysiological theory of drug addiction. This is the view that chemical effects of addictive drugs change the brain of an drug taking person to make that person addicted. And it thus provides a clear pragmatic test of viability: Can you find such chemical effects of addictive drugs or not?
Im not sure if this theory would cover your view or not.
This is best short representation that I can find:
"These consequences of drug use are thought to contribute to the maintenance of drug use and to the reinstatement of compulsive drug use that occurs during the early phase of abstinence. Even, however, after prolonged periods of abstinence, 80-90% of human addicts relapse to addiction suggesting that repeated drug use produces enduring changes in brain circuits that subserve incentive motivation and stimulus-response (habit) learning. A major goal of addiction research is the identification of the neural mechanisms by which drugs of abuse produce these effects. "
Quoted from the abstract of the paper:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2939016/
You will note that the last sentence points to the fact that the theory is so far just a hypothesis until the case can be argued that specific neural mechanisms are involved in producing addiction.
The authors go on to say "We will provide evidence that the repeated administration of cocaine and alcohol up-regulates the dynorphin/κ-opioid receptor system and that pharmacological treatments that target this system may prove effective in the treatment of drug addiction."
That might get closer, but it is still not a closed case. And it is just one article. Which means that so far there is no wide scientific consensus for the theory. It might still hold water, but we are not there yet.
It should also be noted that Wolfram Schultz, the leading expert on dopaminergic networks has so far not endorsed the patho physiological view of addiction. And if you read his work on dopamine you will find that rather than making people drug seeking addicts, changes to the dopamine system will change your risk preferences, your motivation and sense of opportunity. Which supports the view that addictive drugs can screw up your brain 7 ways from sunday without making you an addict in the narrow patho-physiological sense. And it might still screw you up enough to make it more likely that you take drugs out of desire, desperation or other non specific reasons rather that because of specific causes.
This link from non-specific brain changes to less stable emotional function and from there more emotion focused coping (drug taking and other), is for me the main phenomenon that produces additional tendencies towards drug taking. But you will note that this bundle of causes is mixed with other kinds of causes like stress, habits, physiology and social situation and that causes that originates in drug taking have no special status in the downstream effects produced.
In this view it is easy to see how changes to the brain, stress, cognitive problems like negative automatic thoughts, anxiety, lack of sound sleep and a host of other causes can work together to nudge people towards mood repair, emotion focused coping and thus drug taking. There is thus physiology involved, but not in a way that is specific enough to make the physiology an expression of "disease" and not by far something that is narrowly caused by addictive drugs.
4. "Each to their own" is a something that I can embrace with no hesitation. I just like to discuss in an open an honest way. Which is to say that I trust the facts to be an improvement over opinions, either mine or others.
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