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Officially Kicking the Habit

By Sara Calabro

Addiction officially is becoming a recognized medical specialty.

Yesterday The New York Times reported that 10 medical institutions, in reaction to a growing awareness that addiction physically alters the brain, are now offering accredited residency programs in addiction medicine. The programs seek to establish alcohol, drug and/or nicotine addiction “as a medical disease rather than a strictly psychological one,” says the Times.

The move to broaden addiction beyond the realm of psychiatry indicates that mainstream medicine may be inching closer to understanding the multifaceted nature of recovery. However, it also highlights the need for non-biomedical perspectives to be represented in discussions about the future of addiction treatment.

The head of the addiction residency at Boston University Medical Center tells the Times that new insights about the relationship between addiction and brain chemistry have shifted how doctors think about treatment. He says, “The management of folks with addiction becomes very much like the management of other chronic diseases, such as asthma, hypertension or diabetes.”

And this is a good thing? Chronic diseases such as asthma, hypertension and diabetes are the very ones that mainstream medicine, even by its own admission, has become notoriously deficient at managing.

Despite overwhelming evidence supporting lifestyle change as the most effective way to address these conditions (especially hypertension and diabetes), there remains an excessive reliance on pharmaceuticals. People are left, at best, managing symptoms, and at worst, coping with debilitating side effects—and in neither case making a dent in the underlying problem.

Pharmacology ultimately may contribute significantly to the advancement of addiction recovery. But these early stages of shaping addiction medicine present an opportunity to encourage new and broader perspectives.

True recovery, the kind that identifies and dismantles the cause of the addiction, cannot happen while leaning on a crutch. It requires ongoing awareness, significant lifestyle change, and a commitment to participating in outcomes. Acupuncture is just one of several non-biomedical modalities that are premised on these notions.

Pharmaceuticals encourage exactly the opposite: They force the body toward a particular result, which leaves little room for patient involvement; they allow people to disconnect from the process of becoming healthy.

By deeming addiction an official medical specialty, are we setting up addicts to replace one crutch with another?

As we’ve seen in other chronic-disease specialties, pharmaceuticals are a slippery slope. Initially intended as adjunct therapies to be used in combination with lifestyle measures, these drugs quickly become the dominant form of therapy. Even the best intentioned doctors—under the influence of pharmaceutical marketing, peer pressure, time constraints and patient demand—write more scripts than they should.

If we’re serious about helping addicts change their patterns, it seems only fair that the healthcare system into which we are introducing this new specialty look closely at its own.

The medical institutions that have commendably introduced these new residencies should consider incorporating into their curriculums other medical traditions, such as acupuncture, that address the underlying causes of addiction. The time is ripe to kick the habit of blindly accepting pharmaceuticals as the only path to recovery.

Photo by Sara Calabro

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