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Tuesday, August 30, 2011

ASAM - Operational Definition of Addiction - The Way Forward

The new ASAM Definition of Addiction sets the limiting parameters for what are and what are not legitimate areas of interest for anyone trying to talk about or do research on the previously non-specifically defined field of drug dependence. "Non-specific" being the operative element.  It would be naive to ignore the implications for the discussion that I am prosing for the blog on specifically the pathophysiology of alcoholism. I have recently noticed a number of references to the "ASAM Definition," without any one of them including any descriptive information.  Indeed the authors of this prodigious undertaking have been careful to include a nod to each of the various traditions that have been the subjects of LinkedIn Debates.  Here, we have the vede mecum from which we ought to discern the causes of, the natural history of, and the treatments for any a substance that fits the exclusionary criteria:

  • Inability to consistently [A]BSTAIN

  • Impairment of [B]EHAVIORAL control


  • [D]IMINISHED recognition of significant problems

  • Rather than offer comments or suggest interpretations, which would be hasty and even offensive to the brave men living and dead who struggled with this task, I would like to restrict our attention to only those parts of the 8 pages long "definition" that mention alcohol specifically. First things first. We need to relate symptoms to pathophysiology:[D]IMINISHED recognition of significant problems
    Where in the brain are these functions localized - or what is the rate controlling process?

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