Defining addiction, with more humanity?

Abstract

Dependence on mind-altering chemicals (‘addiction’) is a common, world-wide phenomenon with a long history and implications for health, family stability, economic prosperity and public safety. Currently, a vocal group of clinicians in North America has redefined addiction just in terms of neuroscience, focusing on disordered brain circuitry. Over the centuries, various narrow ‘definitions’ of addiction have not helped save lives or made humanity saner or more resilient. This paper challenges the reduction of a multi-faceted phenomenon to some microscopic pathology in individual addicts. The dependence syndrome combines biological, inter-personal and societal dimensions. Many people affected personally would add trans-personal (e.g. spiritual) and inter-generational (e.g. family system) dimensions to that syndrome. Addiction appears either to grow or to recover within the whole complex milieu that links individuals and their society.