• The Modern Definition Of Addiction And How It’s Changed

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    Our perspective and definition of addiction have changed wildly over the past 100 years. As our understanding of the psychology behind addiction and substance use disorder has evolved and expanded, so has our definition.

    As of today, Merriam Webster defines addiction as “a compulsive, chronic, physiological or psychological need for a habit-forming substance, behavior or activity” that leads to harmful effects and “well-defined symptoms (such as anxiety, irritability, tremors, or nausea) upon withdrawal or abstinence.”

    This definition of addiction is not just limited to alcohol or narcotics. Addiction comes in many forms, including chemical addictions to behavioral addictions.

    Common Types of Addiction

    CHEMICAL ADDICTIONS

    Chemical addiction reflects a dependency on substances like narcotics. These substances interact with the brain in potent craving-inducing manners that prompt the user to seek more. Not all people suffering from chemical addiction are considered addicts, like those who medically require dependency-causing treatments.1

    Types of chemical addictions can include:

    • Alcohol
    • Nicotine
    • Tobacco
    • Opioids
    • Stimulants

    BEHAVIORAL ADDICTIONS

    While many are familiar with chemical dependency, it is just as easy (if not easier) to become addicted to certain behaviors. Behavioral addictions begin similarly to substance addictions – the person engages in an activity that stimulates them and makes them feel good. Once that activity ends, the individual goes through a cycle of emotional and psychological side effects that prompt them to seek out that activity again.1

    Types of behavioral addictions can include:

    • Sex Addiction
    • Gambling Addiction
    • Eating Addiction
    • Internet Addiction
    • Video Game Addiction

    Early Models of Addiction

    MORAL MODEL

    As one of the earliest models of addiction, the Moral Model classified addiction as an indicator of one’s weak morality. This model positions addiction as an indication of deep flaws and character defects that ultimately cannot be fixed or helped. The Moral Model led to the development of social stigmas surrounding addiction.2

    TEMPERANCE MODEL

    The Temperance Model was born out of the Moral Model, but instead of blaming character flaws, it considers substances the cause of addiction. All it takes is a single encounter with a substance and an individual cannot help but become addicted.2

    This perspective on addiction led to heavy involvement from the government in developing policies and regulations limiting access to substances deemed dangerous.

    CHARACTEROLOGICAL MODEL

    The Characterological Model claims abnormal character defects are the root of the addiction. Unlike the Moral Model where addiction comes from weak character, the characterological model argues that some individuals are born with addictive personalities. These addictive personalities are accompanied by egocentricity, poor impulse-control, manipulative traits, low self-esteem, a need for power/control, and an inability to cope with stress.2

    EDUCATIONAL MODELS

    This model views addiction as resulting from learned behaviors and a lack of education. These learned behaviors stem from a combination of modeled behavior, cognitive processes, and genetic influences. This model prioritizes therapeutic techniques centered on identifying triggers, building new habits, and learning about the roots and effects of addiction.2

    MODERN VIEW ON ADDICTION

    Group of students thinking about the school project

    Today, we think of addiction like any other disease. Addiction is seen as a chronic illness that can be diagnosed, observed, and treated. This model recognizes that addiction stems from personal choice but ultimately grows out of control and sometimes needs assistance to get back under control.2

    Past Addiction Treatment

    Over the years, addiction treatment and preventative measures have evolved and adapted into the practices we hold in this day and age.3

    1750S- EARLY 1800S

    • Early addiction treatment consisted of sobriety circles and alcoholics mutual aid societies created by various Native American tribes. Therapeutic practices centered on native healing practices to treat alcoholism.
    • A physician named Benjamin Rush argued for treating alcoholism as a disease and helped launch the Temperance Movement.

    1800S

    • Homes and asylums began providing housing for alcoholics, giving them a place free from the temptations, involved moral reframing, non-medical detoxification, separation from drinking culture, and immersion in a sober lifestyle with fellow alcoholics.
    • The first medically monitored addiction treatment center opened in New York in 1864 under the direction of Dr. Joseph Edward Turner.
    • Sigmund Freud recommends cocaine to cure alcoholism.
    • Dr. Leslie Keeley began pushing a snake oil cure for alcoholism.
    • Newly opened inebriate homes and asylums began closing in the 1890s, and alcoholics were sent to hospital wards and drunk tanks.

    1900-1950

    • The Charles B. Towns Hospital, led by Charles Towns, opened in New York City in 1901. It treated wealthy alcoholics with belladonna (a known poison), and Bill Wilson – one of the founders of Alcoholics Anonymous – sought treatment there.
    • The Emmanuel Clinic started creating therapy for alcoholism treatment using a church-based form of therapy that aimed to combine psychological with spiritual interventions.
    • The U.S. passed a law requiring the sterilization of the developmentally disabled, mentally ill, and alcoholics/addicts.
    • Morphine clinics were created in 1919 to help people move through morphine addiction but were closed soon after in 1924 for legal reasons.
    • The first federal narcotics farm to research drug treatment opened in 1935 in Lexington, Kentucky. This narco farm also served as a prison where researchers could experiment on human subjects.
    • Bill Wilson, Bob Smith, Rowland Hazard, and Ebby Thatcher found Alcoholics Anonymous in 1935.
    • In 1948, the Minnesota Model was created, featuring A.A.’s philosophy combined with a self-help model to achieve abstinence and habit change.
    • Disulfiram (aka Antabuse) is introduced as a treatment for alcoholism, in addition to amphetamines, barbiturates, and LSD.

    1950-2000

    • A.A. membership hit around 90,000 in the early 1950s.
    • In 1952, the American Medical Association (AMA) officially defined alcoholism, spreading alcoholism awareness through the United States.
    • In 1957 the Veterans Health Association began alcoholism treatment units.
    • The Association of Halfway House Alcoholism Programs of North America was founded in 1958, leading to the rise of halfway houses providing recovery-focused environments for people with substance use disorder.
    • The insurance industry began reimbursing treatment of alcoholism based on its new classification as a chronic disease.
    • The FDA approved methadone to help with opioid and heroin withdrawal.
    • The U.S. passed the Controlled Substances Act (CSA) in 1970, making it harder to access narcotics and other addictive substances.
    • FDA approved Narcan to counter opioid effects.
    • Many community-based support groups were founded, including Cocaine Anonymous, Rational Recovery, Secular Organizations for Sobriety, and SMART Recovery.
    • The American Medical Association labeled all drug addictions and substance use disorder as a disease.
    • Naltrexone was approved for alcoholism.

    PRESENT

    • Buprenorphine was approved by the FDA for opioid addiction treatment.
    • The Affordable Care Act expanded coverage to addiction treatments, so state health insurance plans cover substance abuse treatment and behavioral health services.
    • The Mental Health Parity Act and Addiction Equity Act passed, providing benefits for substance use and mental health treatment.
    • AMA petitioned to drop pain as a vital sign.

    Society’s Outlook on Addiction: From the Past to Present

    In the beginning, we saw addiction and the need for addiction treatment as a personal failing or weakness, as something shameful that reflected personal defects.

    Now, our understanding of addiction is entirely different. We tend to be more gracious in our understanding of addiction, though social stigmas still exist. Addiction can happen to anyone. It’s a disease that begins with a choice that ultimately turns into a habit that grows into an addiction.

    ADDICTION TREATMENT IN THE COMMON DAY

    Today, addiction is highly treatable, and there are several paths available to you.

    • Detox: Most wellness clinics and rehabilitation centers begin with detox. While detox can feel daunting, working with a team of professionals can make your withdrawal process less stressful.
    • Therapies: Therapy is a key component of achieving long-lasting sobriety, helping patients learn to identify triggering events, create new habits, and learn emotional coping tools to prevent relapse.
    • In-Patient/Out-patient Care: Depending on your needs, you can also opt to receive treatment while living at a rehabilitation center (in-patient care) or live at home and return for treatment (out-patient care.)

    When it comes to daily life, additional support comes in many forms. Peer support groups, sober living housing programs, and medications (i.e. benzodiazepines, anticonvulsants, antidepressants, clonidine) all offer aid to people on the road to recovery.

    IF YOU’RE STRUGGLING TO FIND YOUR WAY BACK TO YOURSELF, KNOW YOU’RE NOT ALONE.

    We at Brooks Healing Center are here for you and want to help you fall in love with everything life has to offer you. If you’re looking for some support on your road to recovery, reach out. We’re happy to discuss the pathway to recovery that works best for your lifestyle and goals.

    Resources

    1. https://www.ncbi.nlm.nih.
      gov/pmc/articles/
      PMC3361844/
    2. https://psychology.wikia.
      org/wiki/
      Models_of_addiction
    3. https://www.recovery.org/
      drug-treatment/history/