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Addiction
Assessment, Intervention, Treatment & Continuing Care
The American Medical Association formally recognized alcoholism as a disease in 1956.  Since this time, research and debate has confirmed addiction as a disease. 

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 behaviors (American Society of Addiction Medicine 2011).

Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission.  Without continuity of care which monitors a individuals engagement in recovery programing vulnerability to relapse and the perpetuation of pre-treatment dysfunction is a significant risk (American Society of Addiction Medicine 2011).

Clinically, the manifestations occur along biological, psychological, sociological and spiritual dimensions. Common features are change in mood, relief from negative emotions, provision of pleasure, pre-occupation with the use of substance(s) or ritualistic behavior(s); and continued use of the substance(s) and/or engagement in behavior(s) despite adverse physical, psychological and/or social consequences. Addiction is driven by genetic vulnerability and the resulting dysregulation of the mesolimbic dopamine system or "reward pathway".

Research has shown, through brain imaging and a variety of diagnostic technologies, that long term drug and alcohol abuse results in significant changes in brain function that can persist long after the individual stops using.  The anatomical changes in brain functioning not only result in the failure to achieve long term abstinence but have behavioural repercussions that result in an individual's inability to  exert control over the impulse to use, despite adverse consequences - the defining characteristic of addiction (NIDA U.S. Department of Health and Human Services No. 094180, revised April 2009).

Addiction as a disease is not the symptom of an underlying motional or physical disorder, but aggravates other existing problems and needs to be treated first.
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