Session to Examine Definition of Addiction as One Disease

ASAM’s definition of addiction, as a primary chronic disease of brain reward, motivation, memory, and related circuitry, will be the focus of “Addiction is Addiction: Clinical Perspectives from Definition to Practice” from 10 to 11:30 am Sunday in Governor’s Ballroom B, Fourth Floor.



“The implications of that definition are profound because it encapsulates that addiction is one disease as opposed to ‘addictions,’ which is what a lot of people talk about,” said the session organizer, Raju Hajela, MD, MPH, FCFP, FASAM, DABAM. “Certainly in the psychiatric nomenclature, substance use disorders are identified and classified separately.

“Our definition defines the disease as a brain disease. Because of that advance, we have been able to synthesize all the research that has gone on over the previous decades that we want to share with membership and other attendees to help them understand what it is, where it came from, and how to implement it.”

One of the goals of the definition, developed through the work of ASAM’s Descriptive and Diagnostic Terminology Action Group (DDTAG), is to develop a holistic approach to care. Currently, many physicians focus on treating a substance abuse or behavior in isolation, said Dr. Hajela, President and Medical Director of Health Upwardly Mobile Inc., Calgary, Alberta, Canada.

Speakers at the session are:

  • ASAM President Stuart Gitlow, MD, MPH, MBA, DFAPA, who will highlight the development of the definition and how ASAM plans to have it more widely accepted.
  • Hajela, who will review the work of DDTAG and the need for physicians to cover the spectrum of addiction medicine, and not just one area.
  • Howard Wetsman, MD, FASAM, DABAM, who will address the growth of the idea that addiction is a unitary disease. He is Chief Medical Officer of Townsend, New Orleans, Louisiana.

“We will cover the practical aspects of the theory,” Dr. Hajela said. “We will not be going into the neurobiology, but we will reference it. The irony is that despite the fact neurobiology says addiction is all one disease, in practice people get caught up in treating opioid dependence or alcohol use disorder or cocaine use disorder. That is the problem we want to address.

“I have encountered many patients who were treated for one aspect of the disease while another aspect of the disease was left untouched. People want to try to intervene in one area and not give holistic treatment, and the other aspects of the disease get worse.”

The session also will address the challenges to more widespread acceptance of this ASAM definition of addiction, Dr. Hajela said.

“The takeaway is that we would like to have as many come as possible,” he said. “This is a very important workshop. This is truly the future of where addiction medicine will go.”