Many published “authorities,” as well as
some workers within the addiction treatment field, assert that addiction is not
a disease. Rather, they say, it relates more to poor choices people make based on
a distorted value system. This is an old and outdated argument that views persons
who develop addictions as being weak-willed, morally corrupt, and irresponsible
individuals. Such perspectives ignore the evidence-based findings of modern neuroscience.
Using advanced techniques, research scientists have been able to conclusively demonstrate
that there are chemical, anatomical, and functional changes in the brains of substance-addicted
persons. For example, the pictures below depict SPECT
images (from Amen 2001) demonstrating that addictions, as well as mental disorders,
affect brain structure (and consequent functioning) just as much as a physical impairment
such as stroke. Single-photon emission computed tomography (SPECT) uses small doses
of radioisotope tracers to study regional cerebral blood flow and thus, indirectly,
brain function during health and disease states.
The images graphically show the cerebral regions of different patients. As can be
seen, compared with a normal subject, there are severe and multiple disruptions
in the brains of these patients. The Swiss cheese appearance indicates defects in
blood circulation and, hence, abnormal cerebral activity. Portions of the cerebral
cortex are responsible for executive functions of cognition, judgement, and impulse
control – which become critically dysfunctional in mental and addictive disorders.
Also, deeper areas of the brain are adversely affected (though not depicted in the
scans here).
Thus, substance addiction may best be understood as a neurological disease process.
With effective medical and psychological treatment, patients benefit from at least
partial “normalization” of brain activity in the affected regions.
Sources:
Amen DG. Why don’t psychiatrists look at the brain? The case for greater use of
SPECT imaging in neuropsychiatry. Neuropsychiatry Rev. 2001;2(1).