Willpower is not enough to fight addiction

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Addicts cannot overcome their addiction with the will alone

To date, there is a widespread belief that successful addiction treatment is primarily a question of will. But this view does not do justice to the fact that most addiction disorders are chronic brain diseases, emphasize Michael Miller and colleagues from the American Society of Addiction Medicine (ASAM).

According to the experts, addiction disorders generally require comprehensive therapy in order to successfully combat them. The willpower of those affected plays an important role here, but other factors must also be taken into account, the US doctors explained. Michael Miller emphasized that successful addiction treatment is about much more than bad habits.

The American Society of Addiction Medicine therefore advocates the development of more effective treatment methods that also take into account the factor of addiction as a chronic illness. In addition, US medical practitioners are campaigning for a changed perception of addiction in public. Society must understand that addiction is a serious medical problem, the solution of which requires a lot of patience - also towards those affected. Addiction disorders should be treated with the same seriousness as, for example, diabetes or cardiovascular diseases, explained Miller and colleagues. The US doctors refer not only to addictions to alcohol and drugs, but also to compulsive eating behavior and gambling. All addiction treatment should be long-term therapy and always be prepared for possible relapses, explained the ASAM experts.

23 million Americans need addiction treatment The American National Institute on Drug Abuse (NIDA) welcomes the commitment of ASAM and is always trying to raise awareness among doctors, including in the everyday medical life of their patients routinely watch for signs of addictive behavior. The NIDA expert Nora Volkow emphasized that the addictions as "behavioral disorders are the result of a malfunction in the brain". Therapy must take this aspect into account accordingly. According to the U.S. Institute for Drug Abuse, approximately 23 million people in the US are currently in need of treatment for abuse of various addictive substances. However, only about two million patients actually receive professional support in fighting their addiction. In addition, taking part in a therapy does not automatically control addiction. According to NIDA, possible relapses represent a particularly high risk for the success of the treatment. Not only do these relatives often lack understanding, but they are also particularly frustrating for addicts, emphasized Nora Volkow. Volkow described the sentence as a typical statement by family members: "You were on a withdrawal treatment and now you are already taking drugs again." This often has a fatal effect on the motivation of those affected.

Addiction disorders as a chronic brain disease The lack of understanding for the difficulties of addicts does not do justice to the status of addictions as a chronic disease, the NIDA expert complained. The addicts' environment often lacks awareness that possible relapses in the treatment of a chronic illness are simply a part of it, according to Nora Volkow. The predisposition in the brain often persists years after the patients have successfully combated their addiction, Volkow explained. Regarding the processes that take place in the addict's brain, the expert explained that addictions are a complex interplay between emotional, cognitive and behavioral factors. In addition, genetic predisposition also plays an important role. For example, some people are fundamentally more susceptible to developing an addiction than others. Therefore, experimenting teenagers with drugs or administering strong pain relievers after an injury shows individually very different effects.

In addition, age can also have a significant influence on the development of an addiction, since the neuronal structures in the area of ​​the so-called frontal lobe are only consolidated relatively late. The frontal lobe mediates between the more rational and the more emotional sides of the brain, although this also plays a crucial role in switching off unhealthy behavior, the NIDA expert emphasized. Since the frontal lobes are not yet fully developed in younger people, this has greater difficulties in defending themselves against external influences and in switching off unhealthy behavior, Volkow continues. However, there is not only an increased risk of addiction among younger people and those at particular genetic risk, but also when people try to compensate for emotional stress such as stress or grief from alcohol, the NIDA expert explained.

Understanding of the neurological processes required The chronic disease of the brain, which underlies most addiction disorders, is described by the US doctors as disorders of the brain reward system. Volkow explained that due to the increased release of the so-called “happiness hormone” dopamine, which as a neurotransmitter triggers a feeling of satisfaction after the satisfaction of their addiction, the brain is conditioned, which has the effect that routines and rituals that are perceived as pleasant are solidified . Regardless of whether it is smoking, alcohol consumption, overeating or gambling, the expert continues. For the addicts, the distorted reward system means that they continue their behavior even if the brain is already used to satisfying the addiction and the original pleasant effects no longer occur, Volkow continues. According to Michael Miller, in order to overcome the addiction, not only the willpower of the patient is required, but also therapeutic support with a deeper understanding of the underlying causative neurological processes. "The feeling of shame associated with the topic" must also be reduced. According to Miller, numerous addicts would already be helped if the still frequent stigmatization of the disease did not occur.

Naturopathic treatment for addictions In the interests of those affected, it can be worthwhile to break new ground in addiction treatment. For example, around 500 addicts have been treated at the Salzburg Double Clinic in Austria since 2009 with the help of natural healing and relaxation methods. This innovative approach has greatly reduced the use of medicines, project manager and psychiatrist Stefan Brunnuber reported at the end of last year. In addition, the treatment methods such as acupuncture, liver wrap to detoxify the body or breathing exercises for anxiety and panic attacks would be very well received by the patients. Brunnuber emphasized that if the treatment of patients had previously been based on daily medication and psychotherapy, they could learn to take their lives into their own hands after the introduction of naturopathic treatments. As a result of the fact that those affected now have to take on more responsibility for themselves, they have also removed their passive inner attitude towards therapy, according to the expert. (fp)

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Image: Paul-Georg Meister / pixelio.de

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