Questions Any Definition of Addiction Must Explain
To organize my thinking in defining addiction, I have a set of questions which I think must be answered by anything that purports to be a defining model of addiction. Needless to say DSM falls far short in this regard. Hopefully, more recent efforts by other organizations will do better. Here is my list of questions, though I’m sure you can come up with more, as I probably will in the future:
If addiction is a disease, what organ or system is it a malfunction of?
What is the neurobiology of the illness?
Can the neurobiology explain the chronicity, the progression, the sudden relapse, the mental obsession?
What biologically differentiates people who have the illness from those who do not?
What are the core phenomena of the illness and what is the biology behind them?
What are the common epiphenomena confused with the illness and what is the biology behind those?
What is the biological reason that low bottom drunks are easier to treat?
Why do some people get better with no medicine if addiction is a disease?
Why do some addicts use opioids and not like cocaine and some addicts use cocaine and don’t like opioids?
What is the neurobiology of the spiritual aspect of the illness and the recovery?
What is the neurobiological correlate of craving?
Can you have addiction before you use a drug?
Can addiction involve other rewarding behaviors besides drugs and alcohol?
What is the neurobiology of addiction caused from drug use?
What is the neurobiology of addiction caused by genetics?
What is the neurobiology of addiction caused by stress?
What is the biology of how all three can work together in the disease?
Is addiction always chronic?
Is there a way to cure addiction even if it isn’t available now, the way that it is imagined that pancreas transplant would be a cure for some diabetes patients even though it isn’t widely available now.