Alcohol, Drugs, and Health: Highlights from The Surgeon General's Report Tom Horvath, Ph.D., and Thaddeus Camlin, Psy.D. Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs and Health, released in November, has received considerable attention. The massive effort involved in creating this document is in itself worthy of respect. The opening pages list seven science editors, three managing editors, five contributing editors, 21 contributing authors, one science writer, 117 reviewers, and 10 other contributors (these individuals apparently being mostly involved in production). The professionals involved include many of the most important individuals in the fields of addiction and recovery. You may have heard the expression that a camel is a horse that was des...

Addiction as a Brain Disease? Cherry-Picking the Surgeon General’s Report by Thaddeus Camlin, Psy.D. The Surgeon General’s “landmark” report is generating a fair amount of media attention and discussion.  While it is valuable that substance use and related issues are receiving more attention, the aspects of the report receiving the lion’s share of the limelight are disappointing. Addiction as a Brain Disease? Yes it is true, as many media stories highlight, the report refers to addiction as a brain disease multiple times – 10 times in 428 pages by my count.  Unfortunately, the reporting stops there.  What is not covered in the media is that the Surgeon General’s report specifically states that addiction is a chronic brain disease, and the term addiction refers only to the most s...

by Thaddeus Camlin, Psy.D. This week’s topic is the sixth and final installment in a series exploring lies that have permeated the recovery culture.  Thus far, lies about success, failure, everyone in recovery being the same, shaming, and labeling have been challenged.  While there are many more lies than six that have infiltrated the consciousness of recovery, I am forcing myself to stop here.  This final article may have saved the most controversial topic for last.  This article challenges the lie that we know “addiction” is a disease. There is no consensus amongst professionals or conclusive research that puts an end to the lively debate over whether or not “addiction” is a disease.  What research does show, however, is that believing “addiction” is a disease combined with a la...

By Reya Kost, Psy.D. According to Fonthill Counseling, “Insurance companies count on your ignorance, laziness and distractibility to avoid paying for services they are legally obligated to cover.”  Any person who has been responsible for getting treatment authorized, or utilization review, will tell you it is like going to battle.  The treatment staff is armed with what they believe is undeniable evidence of their client meeting “medical necessity.”  The insurance caremanager is tasked with finding anyway possible to justify a lower level of care, hence a lower payout, for the insurance providers.  For any veteran of the rehab industry, this is a tale as old as time.  “It’s not enough time.” “How can they expect someone to make it after only a week?”  “They have barely finished detox...

Does the recovery community inadvertently contribute to the stigma of addiction? by Tom Horvath, Ph.D., ABPP Although the recovery community opposes stigmatizing individuals with addiction, the widespread use of the labels “addict” and “alcoholic,” and the view that addiction is a disease, actually contribute to the stigma of addiction. Alternative language, suggested here, could work against stigma rather than contribute to it. What is stigma? The Oxford English Dictionary defines stigma as 1) “a mark made upon the skin by burning with a hot iron (rarely, by cutting or pricking) as a token of infamy or subjection,” 2) “a mark of disgrace or infamy; a sign of severe censure or condemnation, regarded as impressed on a person or thing; a ‘brand,’” (this meaning is introduced as...

Addiction is a Habit? In the traditional addiction approach, which used by almost all treatment programs and support groups in the United States, addiction is a medical and spiritual problem. Attending Alcoholics Anonymous (AA) or other 12-step groups is seen as necessary for recovery. AA’s 12 steps describe how recovery occurs by turning over one’s will and one’s life to the care of a higher power (God, as understood by each individual). A Fresh Perspective But there is an alternative viewpoint, in which addiction in its varying degrees is an extreme version of habit. Overcoming addiction then occurs using the same processes by which one changes other habits. To be sure, severe addiction can result in horrendous consequences, but even severe addiction can be changed using normal hum...

Is Addiction a Disease? If you believe addiction is a disease, you won’t like this article.  I am writing for individuals who are not sure what to believe about addiction.  My hope is to persuade you that addiction is not a disease, but a type of habit you can learn to change just as you change other habits. With the substantial attention given lately to pictures of the brain on drugs, it would be easy to overlook the fact that the brain will look different moment to moment, and that anything we do (or take into our bodies) will show up somehow in a brain picture.  That different parts of the brain “light up” for different experiences is a basic fact of interest to neuroscientists, but what does it mean? Is addiction a disease? Then How Do You Stop? Let’s approach the question...

Although individuals will view addictive behavior in many ways, based on their own beliefs and situations, society needs a comprehensive view of it. Addiction is one of the compelling problems of modern life. Almost all individuals need to manage desire better in a world increasingly filled with tempting activities and substances, and decreasingly filled with counterbalancing forces. Rather than just relying on individual self-control, perhaps our larger communities and society itself can help us respond better to our desires. Here are some thoughts on how society should view addiction. From Food to Drugs, Most People Are Affected by Addiction Addiction affects nearly everyone. Currently in the US approximately 2/3 of the population is overweight. This proportion was only about 5% in ...