On September 15, 2019, the American Society of Addiction Medicine’s Boards of Directors adopted its newest definition of addiction:
“Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.
Prevention efforts and treatment approaches for addiction are generally as successful as those for other chronic diseases.”
Personally, I like the short version they released in 2011 (ASAM News, Newsletter of the American Society of Addiction Medicine, v26, n3, 2011) much better. It seems pretty involved for a ‘short version’, but I like it because I think it gives a much better description of addiction.
“Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviours*. Addiction is characterized by inability to consistently abstain, impairment in behavioural control, craving, diminished recognition of significant problems with one’s behaviours and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.”
My definition of addiction is simple: “Addiction is living every minute of every day in your own personal hell!” I remember times toward the end of my active using, my mother trying to get a hold of me. When I finally answered she would say, in that tone and way only mothers have of saying things, “it must be nice to sleep until 2 o’clock in the afternoon!” But what she didn’t know, what I couldn’t tell her, was that I hadn’t been sleeping. I was in too much pain to sleep, physically, mentally, emotionally. Instead, I had spent hours curled up in the fetal position, dope sick, cursing myself out for being so fucking stupid, saying “I hate this!” over and over, and begging God to just let me die already, “PLEASE, GOD, JUST LET ME DIE ALREADY!” Until finally, my boyfriend hustled something up, or dude finally called back to say he was good. Then, miraculously, I felt better. I was no longer in physical pain (at least not as much), mentally I was completely focused on getting high, emotionally I was numb. I could now unfold myself and stand up. Now, I have gratitude, as twisted as it was. Now, instead of begging God for death I’m thanking God for making this deal happen. And when I finally got that drug in me, whatever drug I was able to get my hands on, all that pain, all that sickness, all that cursing myself out, all that pleading to God for death was forgotten, and I no longer “hated this!” So, the madness continued another day.
*Because I used a direct quote, I did not change the spelling of behaviour to the preferred spelling in American English, behavior.
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