“Hello. My name is Bill. I’m an alcoholic.” For millions of people, Alcoholics Anonymous is a recognized route for overcoming alcoholism and relearning to live a “clean
and sober life.”
As we learn more about alcohol addiction and its link to the brain, more
approaches to its treatment are emerging.
Wine, beer and spirits have been consumed for thousands of years, but it
wasn’t until 1956 that the American Medical Association recognized alcoholism
as a disease.
In 2011, the American Society of Addiction Medicine redefined all types of
addictions, describing them as “a brain disorder and not simply a behavioral
problem involving too much alcohol, drugs, gambling or sex.”
Dr. Michael Miller, a past president of ASAM who helped develop the new
definition, says “many behaviours driven by addiction are real problems and
sometimes criminal acts. But the disease is about brains, not drugs. It’s about
underlying neurology, not outward actions.”
Dr. Raju Hajela, a past president of the Canadian Society of Addiction
Medicine and chair of the ASAM committee on the new definition, tackled a
long-debated view about whether people with addictions choose to perform
anti-social and dangerous behaviours. “The disease creates distortions in
thinking, feelings and perceptions, which drive people to behave in ways that
are not understandable to others around them. Simply put, addiction is not a
Recovery, however, always begins with individual choice, although the choice
can be difficult for the afflicted person.
The roots of addiction
Well before an addiction takes hold, brain development plays a critical role
in a person’s susceptibility to it. Early childhood experiences, including pre-and postnatal periods, can change brain architecture in ways that may make
addiction more likely.