| The entire concept of addiction has
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| | Unfortunately, we do not yet have a clear
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| suffered greatly from a misconception on
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| | biological or behavioral marker of that
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| the part of most people. The confusion
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| | transition from voluntary drug use to
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| comes about in part because of a
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| | addiction. However, evidence is rapidly
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| distinction between whether specific
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| | developing that point to an array of
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| drugs are "physically" or
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| | cellular and molecular changes in
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| "psychologically" addicting.
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| | specific brain circuits. Moreover, many
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| Historically the distinction revolved
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| | of these brain changes are common to all
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| around whether or not physical withdrawal
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| | chemical addictions and some also are
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| symptoms occur when an individual
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| | typical of other compulsive behaviors
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| discontinues using a drug; what we in the
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| | such as compulsive overeating.
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| field now call "physical dependence".
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| | The complexity of this brain disease is
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| However, years of research has
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| | not atypical, because virtually no brain
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| demonstrated to us that focusing on this
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| | diseases are simply biological in nature.
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| physical versus psychological distinction
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| | All, including stroke, Alzheimer's
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| is a distraction from the real issues at
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| | disease, schizophrenia, and clinical
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| hand.
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| | depression, include some behavioral and
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| Strictly from a clinical perspective, it
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| | social aspects. What may make drug
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| actually does not matter very much what
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| | addiction seem unique among brain
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| physical withdrawal symptoms occur.
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| | diseases, is that it does begin with a
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| Physical dependence is not that
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| | clearly voluntary behavior - the initial
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| important, because even the dramatic
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| | decision to use drugs or drink alcohol.
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| withdrawal symptoms of heroin and alcohol
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| | Moreover, not everyone who ever uses
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| addiction can now be easily managed with
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| | drugs goes on to become addicted.
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| appropriate medications. Even more
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| | Individuals differ substantially in how
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| important, many of the most dangerous and
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| | easily and quickly they become addicted
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| addicting drugs, including
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| | and in their preferences for particular
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| methamphetamine and crack cocaine, do not
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| | substances. Consistent with the
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| produce very severe physical dependence
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| | bio-behavioral nature of addiction, these
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| symptoms upon withdrawal. What really
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| | individual differences result from a
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| matters most is whether or not a drug
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| | combination of environmental and
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| causes what we now know to be addiction.
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| | biological, particularly genetic,
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| More specifically, the compulsive craving
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| | factors. In fact, estimates are that
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| and use, despite all of the negative
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| | between 50 and 70 percent of the
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| consequences.
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| | variability to becoming addicted can be
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| This is the crux of how the Institute of
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| | accounted for by genetic factors.
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| Medicine, the American Psychiatric
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| | Although genetic characteristics may
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| Association, and the American Medical
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| | predispose individuals to be more or less
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| Association define addiction and how we
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| | susceptible to becoming addicted, genes
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| all should use the term. It is really
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| | do not doom one to become an addict. Over
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| only this compulsive quality of addiction
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| | time the addict loses substantial control
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| that matters in the long run to the
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| | over his or her initially voluntary
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| addict and to his or her family. Thus,
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| | behavior, and it becomes compulsive. For
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| the majority of the biomedical community
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| | many people these behaviors are truly
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| now considers addiction, in its essence,
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| | uncontrollable, just like the behavioral
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| to be a brain disease - a condition
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| | expression of any other brain disease.
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| caused by persistent changes in brain
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| | Schizophrenics cannot control their
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| structure and function. The changes in
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| | hallucinations and delusions. Parkinson's
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| brain function results in compulsive
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| | patients cannot control their trembling.
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| craving that overwhelms all other
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| | Clinically depressed patients cannot
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| motivations and is the root cause of the
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| | voluntarily control their moods. Thus,
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| massive health and social problems
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| | once one is addicted, the characteristics
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| associated with drug addiction. A
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| | of the illness - and the addiction
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| definition of drug addiction that is
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| | treatment approaches - are not that
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| commonly referred to is "a brain disease
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| | different from most other brain diseases.
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| expressed in the form of compulsive
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| | No matter how one develops an illness,
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| behavior". It is important to correct the
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| | once one has it, one is in the diseased
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| common misimpression that drug use, abuse
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| | state and needs treatment. In the case of
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| and addiction are points on a single
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| | the addict or alcoholic treatment is best
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| continuum along which one slides back and
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| | defined as admission to a drug rehab,
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| forth over time, moving from user to
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| | addiction treatment facility or
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| addict, then back to occasional user,
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| | alcoholism treatment facility. Please
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| then back to addict. Extensive research
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| | note that not every person requires an
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| studies support the view that, once
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| | inpatient drug rehab or addiction
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| addicted, the individual has moved into a
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| | treatment facility, but research shows
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| different state of being. Very few people
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| | that most individuals do require
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| appear able to successfully return to
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| | structure of some kind to break the
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| occasional use after having been truly
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| | vicious compulsive cycle associated with
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| addicted.
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| | drug addiction and alcoholism.
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