Addiction now defined as brain disorder ...
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Addiction now defined as brain disorder ...
Just released article ...
Addiction now defined as brain disorder, not behavior issue
According to the American Society of Addiction Medicine.
"Addiction is a chronic brain disorder and not simply a behavior problem involving alcohol, drugs, gambling or sex, experts contend in a new definition of addiction, one that is not solely related to problematic substance abuse.
The American Society of Addiction Medicine (ASAM) just released this new definition of addiction after a four-year process involving more than 80 experts.
"At its core, addiction isn't just a social problem or a moral problem or a criminal problem. It's a brain problem whose behaviors manifest in all these other areas," said Dr. Michael Miller, past president of ASAM who oversaw the development of the new definition. "Many behaviors driven by addiction are real problems and sometimes criminal acts. But the disease is about brains, not drugs. It's about underlying neurology, not outward actions."
The new definition also describes addiction as a primary disease, meaning that it's not the result of other causes, such as emotional or psychiatric problems. And like cardiovascular disease and diabetes, addiction is recognized as a chronic disease; so it must be treated, managed and monitored over a person's lifetime, the researchers say.
Two decades of advancements in neuroscience convinced ASAM officials that addiction should be redefined by what's going on in the brain. For instance, research has shown that addiction affects the brain's reward circuitry, such that memories of previous experiences with food, sex, alcohol and other drugs trigger cravings and more addictive behaviors. Brain circuitry that governs impulse control and judgment is also altered in the brains of addicts, resulting in the nonsensical pursuit of "rewards," such as alcohol and other drugs.
A long-standing debate has roiled over whether addicts have a choice over their behaviors, said Dr. Raju Hajela, former president of the Canadian Society of Addiction Medicine and chair of the ASAM committee on addiction's new definition.
"The disease creates distortions in thinking, feelings and perceptions, which drive people to behave in ways that are not understandable to others around them," Hajela said in a statement. "Simply put, addiction is not a choice. Addictive behaviors are a manifestation of the disease, not a cause."
Even so, Hajela pointed out, choice does play a role in getting help.
"Because there is no pill which alone can cure addiction, choosing recovery over unhealthy behaviors is necessary," Hajela said.
This "choosing recovery" is akin to people with heart disease who may not choose the underlying genetic causes of their heart problems but do need to choose to eat healthier or begin exercising, in addition to medical or surgical interventions, the researchers said.
"So, we have to stop moralizing, blaming, controlling or smirking at the person with the disease of addiction, and start creating opportunities for individuals and families to get help and providing assistance in choosing proper treatment," Miller said."
Interesting new information about how the view of addiction is changing ...
Addiction now defined as brain disorder, not behavior issue
According to the American Society of Addiction Medicine.
"Addiction is a chronic brain disorder and not simply a behavior problem involving alcohol, drugs, gambling or sex, experts contend in a new definition of addiction, one that is not solely related to problematic substance abuse.
The American Society of Addiction Medicine (ASAM) just released this new definition of addiction after a four-year process involving more than 80 experts.
"At its core, addiction isn't just a social problem or a moral problem or a criminal problem. It's a brain problem whose behaviors manifest in all these other areas," said Dr. Michael Miller, past president of ASAM who oversaw the development of the new definition. "Many behaviors driven by addiction are real problems and sometimes criminal acts. But the disease is about brains, not drugs. It's about underlying neurology, not outward actions."
The new definition also describes addiction as a primary disease, meaning that it's not the result of other causes, such as emotional or psychiatric problems. And like cardiovascular disease and diabetes, addiction is recognized as a chronic disease; so it must be treated, managed and monitored over a person's lifetime, the researchers say.
Two decades of advancements in neuroscience convinced ASAM officials that addiction should be redefined by what's going on in the brain. For instance, research has shown that addiction affects the brain's reward circuitry, such that memories of previous experiences with food, sex, alcohol and other drugs trigger cravings and more addictive behaviors. Brain circuitry that governs impulse control and judgment is also altered in the brains of addicts, resulting in the nonsensical pursuit of "rewards," such as alcohol and other drugs.
A long-standing debate has roiled over whether addicts have a choice over their behaviors, said Dr. Raju Hajela, former president of the Canadian Society of Addiction Medicine and chair of the ASAM committee on addiction's new definition.
"The disease creates distortions in thinking, feelings and perceptions, which drive people to behave in ways that are not understandable to others around them," Hajela said in a statement. "Simply put, addiction is not a choice. Addictive behaviors are a manifestation of the disease, not a cause."
Even so, Hajela pointed out, choice does play a role in getting help.
"Because there is no pill which alone can cure addiction, choosing recovery over unhealthy behaviors is necessary," Hajela said.
This "choosing recovery" is akin to people with heart disease who may not choose the underlying genetic causes of their heart problems but do need to choose to eat healthier or begin exercising, in addition to medical or surgical interventions, the researchers said.
"So, we have to stop moralizing, blaming, controlling or smirking at the person with the disease of addiction, and start creating opportunities for individuals and families to get help and providing assistance in choosing proper treatment," Miller said."
Interesting new information about how the view of addiction is changing ...
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I love neuroscience! I bought a book called The Compass of Pleasure, about the relationship between pleasure and addiction, and it's authored by a neuroscientist.
I believe the behaviors can vary from person to person, depending on the substance of choice combined with a person's character and DNA.
Along the same lines as this topic -- the criminal mind and brain:
Cosmic Log - Behaving badly? Blame the brain
I believe the behaviors can vary from person to person, depending on the substance of choice combined with a person's character and DNA.
Along the same lines as this topic -- the criminal mind and brain:
Cosmic Log - Behaving badly? Blame the brain
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the disease is about brains, not drugs. It's about underlying neurology, not outward actions.
"choosing recovery" is akin to people with heart disease who may not choose the underlying genetic causes of their heart problems but do need to choose to eat healthier or begin exercising, in addition to medical or surgical interventions, the researchers said.
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Originally Posted by lillamy 
Well, to people who live with an addict, it's the outward actions that are the problem. Brain tumor, alcoholism, stupidity -- unacceptable behavior is still unacceptable.
But thank you to the OP for this article - I do find it very interesting!!
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We can only hope in the future, instead of the high relapse rate and its immeasurable damage ... we will instead be looking at the high success rate of recovery for all those impacted by addiction, directly and indirectly.
The more science begins to understand this devasting disorder - the closer we will come to finding more effective ways to treat and manage it.
Someday soon, hopefully they will find effective ways to salvage millions damaged lives ... including those closest to “ground zero” of addiction - the families and children of alcoholics.
The more science begins to understand this devasting disorder - the closer we will come to finding more effective ways to treat and manage it.
Someday soon, hopefully they will find effective ways to salvage millions damaged lives ... including those closest to “ground zero” of addiction - the families and children of alcoholics.
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Personally I leave the medical definitions and such to the clinicians, scientists and shrinks as I am not qualified to make those calls.
I am however qualified (to Professors level I think) to decide what of the actions, behaviors and manners of addicted folks are not what I want, need or deserve.
I don't give a toss whether giving ones partner or child a belting, black eye or worse, calling them foul names or beggaring the family financially is due to inherited genes, a brain abnormality, a virus or the Bad Luck Fairy.
If their behavior is unacceptable, offensive or plain cr*ppy, then that is too bad and I am out of their way, and staying that way.
I don't need or want it in my life, and it doesn't matter why they may be that way, it is enough that they are.
I am however qualified (to Professors level I think) to decide what of the actions, behaviors and manners of addicted folks are not what I want, need or deserve.
I don't give a toss whether giving ones partner or child a belting, black eye or worse, calling them foul names or beggaring the family financially is due to inherited genes, a brain abnormality, a virus or the Bad Luck Fairy.
If their behavior is unacceptable, offensive or plain cr*ppy, then that is too bad and I am out of their way, and staying that way.
I don't need or want it in my life, and it doesn't matter why they may be that way, it is enough that they are.
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The closer we come to a widespread solution to this devastating and destructive epidemic of addiction ... the closer we will come finding real enduring changes.
This research is an affirmation to all those “normies” who might think somehow someone else is to blame for the addict’s alcoholism - just more evidence of how our behaviors do not “create” alcoholism in someone else.
It is just more proof, someone else's addiction is beyond our control ... and all we can do is protect ourselves and our children from the insanity of addiction.
It is also an affirmation for those of us on the receiving end of ongoing anger and blame from an alcoholic - confirming that ....
We didn't cause it, we can't control it, and we can't cure it - but maybe someday .. science will do, what we cannot.
This research is an affirmation to all those “normies” who might think somehow someone else is to blame for the addict’s alcoholism - just more evidence of how our behaviors do not “create” alcoholism in someone else.
It is just more proof, someone else's addiction is beyond our control ... and all we can do is protect ourselves and our children from the insanity of addiction.
It is also an affirmation for those of us on the receiving end of ongoing anger and blame from an alcoholic - confirming that ....
We didn't cause it, we can't control it, and we can't cure it - but maybe someday .. science will do, what we cannot.
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Right on Lillamy and JadMack, I agree with you both. I just cannot buy into that article. When a adult man or woman chooses to get bombed on there ass everyday, and destroy lives on a daily basis, I surrender.
They may get to choose their actions and consequences, but they sure as hell don't get to choose mine. And I cannot be empathetic to someone who is unwilling to help themselves. My mom used to say "God helps those who help themselves" I finally understand that now. Miss you mom!
They may get to choose their actions and consequences, but they sure as hell don't get to choose mine. And I cannot be empathetic to someone who is unwilling to help themselves. My mom used to say "God helps those who help themselves" I finally understand that now. Miss you mom!
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This article addresses the origins of addiction and does not excuse or condone the harmful behaviors of an addict. It appears this article is being misinterpreted by some posters from what is really being stated.
If you read the article carefully, it never states that we should excuse the behavior of the addict - which is how some are interpreting it. It simply states that people don’t choose to have the disorder of addiction. However, it indicates that choosing recovery over unhealthy behavior is necessary. See quote below.
"Because there is no pill which alone can cure addiction, choosing recovery over unhealthy behaviors is necessary," Hajela said.
This "choosing recovery" is akin to people with heart disease who may not choose the underlying genetic causes of their heart problems but do need to choose to eat healthier or begin exercising, in addition to medical or surgical interventions, the researchers said.”
The article definitely states someone with this disorder should seek recovery and treatment of these destructive, harmful behaviors - like anyone with any other disorder or illness should. And it certainly does not condone the damaging behaviors of addiction.
This research is dealing more with explaining the origins and cause of the addiction - rather than telling us we should excuse the associated behaviors - which it never does.
With time and further effort, these types of research may soon provide resources for actually changing addiction's course - perhaps even ending its powerful hold that destroys so many lives.
If you read the article carefully, it never states that we should excuse the behavior of the addict - which is how some are interpreting it. It simply states that people don’t choose to have the disorder of addiction. However, it indicates that choosing recovery over unhealthy behavior is necessary. See quote below.
"Because there is no pill which alone can cure addiction, choosing recovery over unhealthy behaviors is necessary," Hajela said.
This "choosing recovery" is akin to people with heart disease who may not choose the underlying genetic causes of their heart problems but do need to choose to eat healthier or begin exercising, in addition to medical or surgical interventions, the researchers said.”
The article definitely states someone with this disorder should seek recovery and treatment of these destructive, harmful behaviors - like anyone with any other disorder or illness should. And it certainly does not condone the damaging behaviors of addiction.
This research is dealing more with explaining the origins and cause of the addiction - rather than telling us we should excuse the associated behaviors - which it never does.
With time and further effort, these types of research may soon provide resources for actually changing addiction's course - perhaps even ending its powerful hold that destroys so many lives.
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Originally Posted by marie1960
Right on Lillamy and JadMack, I agree with you both. I just cannot buy into that article. When a adult man or woman chooses to get bombed on there ass everyday, and destroy lives on a daily basis, I surrender.
They may get to choose their actions and consequences, but they sure as hell don't get to choose mine. And I cannot be empathetic to someone who is unwilling to help themselves. My mom used to say "God helps those who help themselves" I finally understand that now. Miss you mom!
They may get to choose their actions and consequences, but they sure as hell don't get to choose mine. And I cannot be empathetic to someone who is unwilling to help themselves. My mom used to say "God helps those who help themselves" I finally understand that now. Miss you mom!
But here, Marie1960, Lillamy and JadMack remind me how naïve my daughter truly is an why we have the second A in AA. Thanks for the clarification.
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Stuart -- there's no need to be snarky. If my AXH had behaved the same way he did because he had a brain tumor, or diabetes, or cancer, his behavior would have been just as inexcusable.
I am thrilled if science discovers neurological and fixable reasons behind addiction. Because addictions are hell. For the addicts and their families. You want to hang out here and learn what hell it is for the families, you are more than welcome. And best of luck with your recovery.
I am thrilled if science discovers neurological and fixable reasons behind addiction. Because addictions are hell. For the addicts and their families. You want to hang out here and learn what hell it is for the families, you are more than welcome. And best of luck with your recovery.
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I had to read this article several times to determine the point of it. I still don't see anything new or of real value. A very wordy article not saying much. Research is being done on alcoholism more than in the last 20 years, and the jury is still out on much of it, but this particular article reads as though there has been a new finding. In order for research to be validated, multiple studies must be done over time following the same protocal and determine exactly the same results. That is not the case here. Same with the research done recently regarding a gene that was isolated suggesting alcoholism is predisposed. As one Dr. commented, show me 10 more studies such as this one and maybe I will pay attention.
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When I first discovered my daughter's addiction, it was all the doctors and diagnostics that helped me begin to understand it was something physiological in nature. I learned her addictive nature came from her father and I.
Eventually I came to understand that my obsessive nature was a symptom of my own addictive personality. I was addicted to her, her addiction, and I'm still obsessed with learning about addiction, among other subjects. I still had to do the hard work of changing my responses to her behavior, but the knowledge I gained made it so much easier to find compassion and acceptance of not only who she is, but all my loved ones and especially myself.
I had spent my entire life beating myself up for innate traits I cannot change. It's because of science AND working a recovery program that I've found better coping skills. The knowledge that science gives us may not make any difference for some, but for me it's made all the difference.
I no longer feel shame when my brain gets stuck on stupid. I'm aware of exactly what's going on inside my brain and know how to stop, reset it. That's just how my brain works and not only do I accept it, I like it now. I like me
Eventually I came to understand that my obsessive nature was a symptom of my own addictive personality. I was addicted to her, her addiction, and I'm still obsessed with learning about addiction, among other subjects. I still had to do the hard work of changing my responses to her behavior, but the knowledge I gained made it so much easier to find compassion and acceptance of not only who she is, but all my loved ones and especially myself.
I had spent my entire life beating myself up for innate traits I cannot change. It's because of science AND working a recovery program that I've found better coping skills. The knowledge that science gives us may not make any difference for some, but for me it's made all the difference.
I no longer feel shame when my brain gets stuck on stupid. I'm aware of exactly what's going on inside my brain and know how to stop, reset it. That's just how my brain works and not only do I accept it, I like it now. I like me
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Addiction is such a baffling disease to the outsider. I wanted to better understand why, to quote Anvil, addicts do some of the "stupid sh*t" to get the drugs, booze. I particularly wanted to understand MY addict, b/c she keeps going back to something she KNOWS is unhealthy and illegal.
I checked into some of the brain based research and it was quite interesting. i don't quite have enough letters after my name to understand it fully, but the whole relapse cycle and using despite serious adverse consequences can (partially) be explained by the neurotransmitters and how disrupted things get when you add chemicals that shouldn't be there. What stuck out for me is the addict's inability to feel pleasure w/o their drug. Its temporary, but how miserable is it for someone in early recovery to not only be overloaded with feelings they're used to numbing out, aches and pains they never noticed before b/c they were physically numbed, and to boot they can't really feel any joy. Makes recovery sound like a blast! No wonder so many relapse.
It gave me new respect for those (including my AGF) who have made the choice for sobriety. Part of recovery is allowing the body to repair and rewire those lost connections, but that takes time (a lot more than 30 days, certainly more than a 4 day detox). I'll get off my scientific soapbox now, but I find brain stuff interesting and cool.
I checked into some of the brain based research and it was quite interesting. i don't quite have enough letters after my name to understand it fully, but the whole relapse cycle and using despite serious adverse consequences can (partially) be explained by the neurotransmitters and how disrupted things get when you add chemicals that shouldn't be there. What stuck out for me is the addict's inability to feel pleasure w/o their drug. Its temporary, but how miserable is it for someone in early recovery to not only be overloaded with feelings they're used to numbing out, aches and pains they never noticed before b/c they were physically numbed, and to boot they can't really feel any joy. Makes recovery sound like a blast! No wonder so many relapse.
It gave me new respect for those (including my AGF) who have made the choice for sobriety. Part of recovery is allowing the body to repair and rewire those lost connections, but that takes time (a lot more than 30 days, certainly more than a 4 day detox). I'll get off my scientific soapbox now, but I find brain stuff interesting and cool.
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if classifying alcoholism as a brain disorder helps take away some of the stigma, for addicts and families/friends, that can only be a good thing in terms of accepting there's a problem and seeking help.
I am prone to clinical depression, the best way of beating this for me, is a combination of talking therapies, medication and good self-care. I react very well to low doses of particular SSRIs, I have been talking to my doc today about how given the number of bouts I have had when not on the medication (extending back into my childhood, although undiagnosed at the time), it is recommended that I stay on it for at least 2 years this time. It is likely that I have a slightly abnormal brain chemistry given how well the low dose SSRIs stabilise and enable me to function within normal emotional ranges, (one's that don't see me descending into a prolonged abnormal state of mind). Some people view depression as a sign of weakness or laziness or that it is a self-pitying moral/character defect that if I tried harder I should just be able to get over, pull my socks up, that life is no harder for me than for them.
feels similar to how some people (including me in the past) view alcoholism. It also feels similar in that everyone gets sad, and that's normal and fine, so they don't always understand how different clincial depression is, and why I can't just snap out of it, just like lots of people can drink a few drinks, and then can't understand why an alcoholic can't just do that and then control it. I have a responsibility to myself and my children to do everything I can to keep that depression at bay, to use those resources available to me and to work hard at it, living with an untreated chronic depressive parent is as damaging as living with an alcoholic parent. If that means I am in therapy and take medication and have to practice rigourous self-care for the rest of my life, like a diabetic, then that's what it takes, and I do it. Being ashamed that I have to do this, wouldn't/doesn't help me pursue the help I need. But it is my responsibility and choice to ensure I do, however tempting it might be sometimes to give into that black hole, and just let it swallow me up.
There is ample proof that addicts have different brain structures than non-addicts, which is a fairly blunt instrument level to see changes, it's less clear whether the big changes that can be easily seen with modern technology are caused by or exascerbated by or there before the DOC is introduced to the system, in all cases.
All of that is irrelevant though to the choices that we make about the extent we share our lives with others. When I initially thought about addiction as a disease, I resisted it becasue I felt that if someone was ill, you had to stick by them no matter what their behaviour. That is my issue, something I was taught, but I don't have to stick by someone if their behaviour is unnacceptable to me, and I don't have to blame them for that behaviour in order to make the decision to remove myself from their sphere of influence OK.
(I still don't think it is the same as cancer which it is often compared to, but it feels similar to depression - something I am prone to that I could let take me down permanently if I don't do everything necessary to avoid that, and something that can wreak havoc on those who love me if I spiral down, I don't think that there's anything particularly special about addiction, it isn't the only disease that tells you you haven't got it, or filters the world-view of the person with it, or leads to unnacceptable behaviour, the difference appears to be that we don't treat it like any other psychiatric/brain disorder, at the very sharp end you can section and force treatment on a person who is so depressed that they are a danger to themselves and others but drinking so much that you are a danger to your self and others is handled differently).
I am prone to clinical depression, the best way of beating this for me, is a combination of talking therapies, medication and good self-care. I react very well to low doses of particular SSRIs, I have been talking to my doc today about how given the number of bouts I have had when not on the medication (extending back into my childhood, although undiagnosed at the time), it is recommended that I stay on it for at least 2 years this time. It is likely that I have a slightly abnormal brain chemistry given how well the low dose SSRIs stabilise and enable me to function within normal emotional ranges, (one's that don't see me descending into a prolonged abnormal state of mind). Some people view depression as a sign of weakness or laziness or that it is a self-pitying moral/character defect that if I tried harder I should just be able to get over, pull my socks up, that life is no harder for me than for them.
feels similar to how some people (including me in the past) view alcoholism. It also feels similar in that everyone gets sad, and that's normal and fine, so they don't always understand how different clincial depression is, and why I can't just snap out of it, just like lots of people can drink a few drinks, and then can't understand why an alcoholic can't just do that and then control it. I have a responsibility to myself and my children to do everything I can to keep that depression at bay, to use those resources available to me and to work hard at it, living with an untreated chronic depressive parent is as damaging as living with an alcoholic parent. If that means I am in therapy and take medication and have to practice rigourous self-care for the rest of my life, like a diabetic, then that's what it takes, and I do it. Being ashamed that I have to do this, wouldn't/doesn't help me pursue the help I need. But it is my responsibility and choice to ensure I do, however tempting it might be sometimes to give into that black hole, and just let it swallow me up.
There is ample proof that addicts have different brain structures than non-addicts, which is a fairly blunt instrument level to see changes, it's less clear whether the big changes that can be easily seen with modern technology are caused by or exascerbated by or there before the DOC is introduced to the system, in all cases.
All of that is irrelevant though to the choices that we make about the extent we share our lives with others. When I initially thought about addiction as a disease, I resisted it becasue I felt that if someone was ill, you had to stick by them no matter what their behaviour. That is my issue, something I was taught, but I don't have to stick by someone if their behaviour is unnacceptable to me, and I don't have to blame them for that behaviour in order to make the decision to remove myself from their sphere of influence OK.
(I still don't think it is the same as cancer which it is often compared to, but it feels similar to depression - something I am prone to that I could let take me down permanently if I don't do everything necessary to avoid that, and something that can wreak havoc on those who love me if I spiral down, I don't think that there's anything particularly special about addiction, it isn't the only disease that tells you you haven't got it, or filters the world-view of the person with it, or leads to unnacceptable behaviour, the difference appears to be that we don't treat it like any other psychiatric/brain disorder, at the very sharp end you can section and force treatment on a person who is so depressed that they are a danger to themselves and others but drinking so much that you are a danger to your self and others is handled differently).
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I have no problem with this extra defining description of addiction. I have always believed there was most likely a genetic predisposition to alcoholism, and possibly a brain problem as well. Lord knows that no-one who had past experience with the disasters and hell of alcoholism, perhaps suffered abuse as a child because of it, would merrily head for the bottle or bar themselves unless there was some sort of compulsion.
I however, refuse anymore to be involved in any way in the future with addiction of whatever form, as I have had enough misery from it already. I accepted unacceptable behavior from A's because they were under the influence of alcohol, not because I enjoyed the experience of suffering.
Now I can feel concern, affection even, for someone active in addiction WITHOUT joining them in the insanity of life in a bottle.
As I said in an earlier post ((( "If their behavior is unacceptable, offensive or plain cr*ppy, then that is too bad and I am out of their way, and staying that way. I don't need or want it in my life, and it doesn't matter why they may be that way, it is enough that they are.")))
I have learned some hard lessons after 47 years with 2 very active alcoholics, and the financial, physical and emotional trauma of those years.
I have prayed for more knowledge and searching for answers about addiction, and for some wonderful breakthrough that may make rehab more effective and help A's stay sober. God willing, it will one day happen.
I however, refuse anymore to be involved in any way in the future with addiction of whatever form, as I have had enough misery from it already. I accepted unacceptable behavior from A's because they were under the influence of alcohol, not because I enjoyed the experience of suffering.
Now I can feel concern, affection even, for someone active in addiction WITHOUT joining them in the insanity of life in a bottle.
As I said in an earlier post ((( "If their behavior is unacceptable, offensive or plain cr*ppy, then that is too bad and I am out of their way, and staying that way. I don't need or want it in my life, and it doesn't matter why they may be that way, it is enough that they are.")))
I have learned some hard lessons after 47 years with 2 very active alcoholics, and the financial, physical and emotional trauma of those years.
I have prayed for more knowledge and searching for answers about addiction, and for some wonderful breakthrough that may make rehab more effective and help A's stay sober. God willing, it will one day happen.
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It seems there have always been progressive, sweeping theories that spark major change - and there are flies in the ointment, the devil in the details - that some people get hung up on because of their personal experiece. Macro vs. micro view. I think this definition is closer to the truth than anything that proceeds it, and if used as the method of treatment will greatly reduce the pain and suffering of our loved ones. They don't have to understand every detail as long as we have a fellowship that is based on identification - we get it since we've been there and have been as baffled as they are!
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After reading Ceridwen's post, I was also reminded of a conclusion I reached early on - ANY brain or mental disorder will not (at this point) be considered akin to cancer. Physical and mental ailments are perceived differently. Anything brain-related becomes trickier and more confusing because of the brain's complexity - not only of the addict, but of the person assessing the addict's problem! That's the miracle of a spiritual element to recovery - we don't have to dissect the details. In 12-Step history, and in my own - self-knowledge. other people's opinions, fear, consequences - none of it can conquer addiction anyway. I wouldn't be here if it could!
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