In a new book, author Maia Szalavitz tackles the subject of drug addiction. At a time when heroin and opioids have become widely available across the United States, the book offers insights into the underlying nature of addiction that the author argues most traditional forms of addiction treatment have typically ignored.
According to Szalavitz, addiction is a brain problem, although it is not an indication of some type of degenerative disease as it is often portrayed, as reported by The New York Times. Nor is it an indication that the user is nothing more than a selfish criminal who deserves punishment or worse, which is still a conventional view in many places.
Instead, Szalavitz argues that addiction is a learning disorder which affects information processing about motivation, reward, and achievement.
Studies done by various neuroscientists show that addiction alters the way in which the brain regions involved with motivation/pleasure and those involved with decision-making/mediation interact. When these regions of the brain work as they should, they determine what we value from a biological standpoint: survival and reproduction.
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Addiction occurs when these regions of the brain are focused on the wrong objects, such as drugs or excessive gambling rather than a new sexual partner or a baby.
As the science of addiction becomes more precise and more accurate, there will be challenges to the way existing addiction treatment programs are run.
Jesse Singal of New York Magazine criticizes the concept of "rock bottom" within Alcoholics Anonymous from this perspective. The concept of "hitting rock bottom" essentially says that an addict is not really capable of fully overcoming his or her addiction until he or she has hit the "bottom" and has been kicked out of an apartment dwelling, is financially ruined, or is living in some other form of desperation.
In the second half of the 20th century, the embrace of the "rock bottom" concept in addiction treatment, in concert with the rise of mandatory 12-step treatment programs, led to some Draconian practices in certain programs which embraced the idea of forcing patients to hit rock bottom and "obliterating" perceived character defects.
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But now, as Szalavitz argues persuasively, the old consensus on addiction treatment is simply outdated. The scientific evidence presented by Szalavitz overwhelmingly points to addiction treatments that should be counseled with care and love for the patient, not used as a way to make the patient experience pain.