Although I am delighted to learn of ABAM's expansion, to allow general practitioners the opportunity to complete residencies in Addiction Medicine, I am disheartened to once again see the problem of addiction identified as EITHER a medical OR a psychological problem. Twenty years of working with addicts has convinced me that addiction is a dis-ease of body, mind AND spirit.
The disease model of addiction was developed specifically to facilitate more kindness and sympathy to people with addictions, who were previously seen as morally weak. And there is a basis for this -- recent leaps in addiction research have shown not only that addiction includes aspects of tolerance and withdrawal, even in behavioral addictions such as gambling, sex, food, and gaming addictions, but also that the brain undergoes complex self-reinforcing changes as addiction develops. Furthermore, Addiction Medicine is developing to offer newer, more sophisticated ways of helping people overcome addictions through medicine. But this does not mean that medicine alone is the cure for addiction. And in many cases, medicine is not an appropriate course of treatment, particularly when the issue is substance abuse, not substance dependence.
Psychology has made an enormous contribution to the understanding and treatment of addiction, and will continue to do so. As a discipline that recognizes the impact of both the social and the physical worlds on mental health, psychology has perhaps the most inclusive approach to helping addicts. Yet psychology is divided among those who believe that the scientific basis of psychology precludes any acknowledgement of spirituality, and those who believe that spirituality is an important part of the human experience, including addiction and recovery from addiction.
Similarly, the field of social work seems encumbered by political correctness, and is unable to come to terms with the question of spirituality, generally leaving clients to figure it out for themselves, then stepping in when they get it wrong.
And lets not forget the 12 step movement -- whether or not you are a fan of the approach, they have ensured that no addict is without fellowship, guidance and a framework for recovery, pretty much anywhere and at any time. Yet many are put off by the emphasis on spirituality.
Only by overcoming professional differences and recognizing all that people with addictions need in order to recover, will people gain the full benefit of the addiction treatment process. So as we move towards DSM-V, and develop new approaches to addiction treatment, let's move towards integration of the healing of mind, body and spirit.
This is way better than a brick & mortar esatblisehmnt.
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