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It’s Time For a New Model for Addiction 

About 35 years ago a small group of people starting applying leading edge science and clinical research towards a better understanding of Addiction.   At the same time, politicians and governments decided that the best way to deal with problems associated with Addiction was to declare a war on drugs.  I prefer science over force.  Unfortunately, science does not produce the results that we desire in a timely fashion.  The irony is that it has taken us 35 years to realize that our knee-jerk quick-response hasn’t worked either.  Fortunately, our scientists and doctors now have an understanding of Addiction and Mental Health that fits well with all of the observations.  Today, we are finally able to address the problems of Addiction and Mental Health from a position of knowledge and intelligence; a position from which we will have meaningful and sustainable change.

Forms of Addiction & Public Opinion

Let’s look at what most people observe about Addiction.  People who use drugs are considered maladapted to society and can over dose and die.  People who use alcohol are also considered maladapted to society and are likely to die from organ failure or some sort of accident.  People who smoke cigarettes are addicted to nicotine, but don’t really seem maladapted, yet they are likely to get lung cancer and die.  People who eat too much or have poor nutrition may be maladapted, but they don’t really hurt anyone else, yet they are likely to get diabetes, have chronic pain, and may die.  People who use prescription drugs may be maladapted, but it is considered okay because they aren’t doing anything illegal, yet they are likely to develop physical health conditions that lead to organ failure and death.  People who work too much set a great example for achievement and success in society and we should all aspire to be more like them; except their families are neglected, they usually divorce and die from stress related organ failure.  People who have too much sex are ‘only indulging in the pleasures of life’ and they usually only do it with like-people, yet they are incapable of forming meaningful relationships and may die from a sexually transmitted disease.  We all talk about how we are addicted to something, but is it okay if we are addicted to something that is deemed ‘healthy’?

The Old Model of Addiction

How does the old model of Addiction relate to these observations?   In the old model, Addiction is a choice and if I can choose not to do something then why can’t other people?  According to this, Addiction must be moral weakness, yet we all know someone with Addiction that is an acceptable, productive member of society when they aren’t using.  The old model relies on what continues to be one of the most confusing theories today – that trauma must have caused Addiction.  People with Addiction have experienced so much trauma in their life that they must self-medicate just to get by (avoid committing suicide).

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The New Model for Addiction

What if there was a model that provided us with a more consistent understanding of Addiction and its symptoms?  Is there a model, based on leading edge science and clinical research that helps reconcile apparent contradictions in our observations?  The answer is yes.  The main difference between the old model and the new model is what we now understand to be symptoms and the centre of the disease.  The new model puts brain reward circuitry dysfunction as the centre of the typical characteristics of Addiction.  These characteristics include: drug use, depression, anxiety, maladaptation, obsessive behaviour, and continuing of unhealthy behaviour.  The very circuitry that evolved to ensure survival of individuals and the human species a whole has been hijacked.

This subtle but powerful shift in the model from centre to symptom of Addiction can be explained by using the example of ‘the common cold’.  Expecting someone to stop using drugs or other unhealthy behaviour is like expecting someone with a cold to stop coughing or sneezing.  A person naturally stops coughing and sneezing once the body’s own immune system (maybe with the help of antibiotics) has overcome the virus.  The same is true with Addiction.  A person naturally stops the unhealthy behaviour once the brain’s reward circuitry begins to repair.

Changes In The Models for Addiction

As with the changing models of the solar system, the changes in the model of Addiction are subtle yet profound.  Galileo was the one the first people to question the orbit of Mercury.  The moon, sun, stars and planets all seemed to move continuously in one direction around the Earth, yet from time to time, Mercury would move backwards.  Was Mercury really that special?  Or would an alternative model help us better understand the exact nature of our solar system?  Just as an alternative model for understanding the solar system was required, so is a new model for Addiction.

solarsystemmodelsThe Foundation for Addiction and Mental Health (FAMH) is a charitable organization committed to changing the way we think about Addiction.  FAMHs mission is to ensure the highest quality in early assessment and prevention is available to all.

FAMH hosts a public information session on Addiction and Mental health the 1st and 3rd Thursdays of the month. Please visit www.famh.ca to RSVP for a session.

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