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The Thirteenth StepAddiction in the Age of Brain Science$
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Markus Heilig

Print publication date: 2015

Print ISBN-13: 9780231172363

Published to Columbia Scholarship Online: November 2015

DOI: 10.7312/columbia/9780231172363.001.0001

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PRINTED FROM COLUMBIA SCHOLARSHIP ONLINE (www.columbia.universitypressscholarship.com). (c) Copyright University of Minnesota Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in CUPSO for personal use.date: 02 August 2021

A Chronic, Relapsing Disorder

A Chronic, Relapsing Disorder

Chapter:
(p.32) 4 A Chronic, Relapsing Disorder
Source:
The Thirteenth Step
Author(s):

Markus Heilig

Publisher:
Columbia University Press
DOI:10.7312/columbia/9780231172363.003.0004

This chapter argues that addiction is inherently a chronic, relapsing disease, not much different from diseases such as hypertension, diabetes, or asthma. Similar to those diseases, the risk for developing addiction has a strong genetic component. Likewise, the development and course of addiction are determined by an intricate interplay among genetic risk factors, environmental influences, and behavioral choices. Addiction cannot currently be cured but can be managed with a degree of success that is sufficient to allow patients to live a good life. If not managed, it disables, kills, and leads to significant costs and suffering. For these conditions, long-term disease management that combines pharmacological and behavioral approaches is an undisputed norm, and success is hardly assessed by the number of people completely cured of their ailment. At the same time, we continue to debate whether addiction really is a medical condition; focus on short-term fixes such as detoxification or twenty-eight-day residential programs; see anything other than complete abstinence as a failure; and frequently view the harm caused by addiction as self-inflicted.

Keywords:   addiction, disease, addictive disorder, genetics, risk factors, environmental influence, behavioral choices

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