Up until the early twentieth century it was common to view addiction as a moral failing. Those individuals who fell into such behaviors were viewed as bad people who were willfully doing wrong. This view changed in the 1940s with the arrival of groups such as Alcoholics Anonymous – people began to look upon addiction as a type of disease that could be treated. In the last decade the medical establishment has further endorsed the idea that such behaviors are a brain disease by creating a new specialty to treat it.
Western medicine has been involved in the treatment of addiction for many years – albeit sometimes in a limited role. One of the reasons for this is that alcoholics have traditionally turned to their physician when they decided to get help for their addiction. The physician would then usually refer them to a psychiatrist, addiction therapist, or self-help group. Things are changing and now the medical establishment is viewing addiction as a disease that they can treat. This has led to the rise of a new specialty of addiction medicine.
In the past it was not unknown for physicians to be highly knowledgeable about addiction. Those who are regularly dealing with such patients may decide to do additional courses so as to increase their ability to help. The American Society of Addiction Medicine has worked hard to provide this training to those who can benefit from it. It is this group that has also been the driving force for ensuring that addiction medicine became a recognized specialty – they achieved this goal in 1988.
Addiction has consequences for not only the individual and their family but also society as a whole. At the moment there are many different professionals involved in providing care for addicts including:
* Addiction therapists
* Addiction counselors
* Social workers
* Psychiatric nurses
* Public health professionals
Despite the number of health disciplines already involved in helping the addict there is a need for the specialty of addiction medicine because:
* There is increasing evidence that alcoholism is a physical disease – a primary, chronic disease of brain reward, motivation, memory and related circuitry. If it is a medical condition then it is only natural that there should be a medical specialty that is focused on offering the most effective possible treatment.
* High resonance imaging shows that addiction does actually cause damage to the brain – this means that it is a medical problem.
* There are now a number of medical institutions in the US offering accredited one year programs where doctors can gain the knowledge they need for the treatment of addiction – in the past such courses were not accredited. This means that these physicians will be in a much better position to offer the help their patients need.
* The lack of knowledge about addiction is viewed as a gap that needs to be filled. By creating an addiction specialty in medicine it helps to fill this gap.
* Addiction is viewed as similar to other chronic conditions such as diabetes. When it is not possible to offer a cure the focus should be on medical management of the symptoms.
* The medical management of addiction can focus on relapse prevention. Getting somebody to stop abusing alcohol or drugs is just half the battle – the real task is to help them stay stopped.
* There are a number of pharmaceutical drugs that can people overcome their addictions – of particular interest are drugs that may reduce the intensity of cravings or help the individual pass through withdrawals easier.
* Sending addicts to psychiatrists might not always be the best course of action because many of these individuals do not have psychiatric problems – although a high percentage of them do.
* Physicians often feel helpless to help addicts. The growth of the specialty of addiction medicine means that they can do more than merely patch them up and send them back out to the world.
* The physician is often in a good position to recognize the symptoms of an addiction.
Now that addiction has become a bona fide medical specialty it should mean improvements in the care of addicts such as:
* There will be an increasing number of physicians who have a good understanding of addiction and treatment. These professionals will be able to help ensure that addicts who pass through the medical system receive adequate treatment.
* It is likely to mean that there will be increased research into pharmaceutical and other treatments that may be of value to those struggling with addiction.
* It should mean that physicians can do more than just pass the addict onto another specialty.
* Physicians will be able to play a key role in relapse prevention.
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