Great questions. Formally, without the brain, addiction in our usual understanding would not have worked. And most of the processes responsible for the condition occur precisely in and between neurons. However, I would not put all the responsibility on our cerebrum. As well as on the substances themselves. Dozens of factors play important roles in the formation of addiction, ranging from genetic material and sensitivity to exogenous agents, ending with the social and cultural background in which we are born, formed and live. And these are just the fairly obvious and well-known variables that come to mind first.
The brain disease model of addiction holds that substance use disorders (SUDs) are chronic, relapsing brain diseases and that relapses are symptoms, and part of the expected course, of the disease. As with other diseases, SUDs are caused by multiple forces, including behavioral, environmental, and biological ones.
The general disease conception of addiction, which includes the brain disease model, is supported by all major psychiatric authorities, including the National Institute on Drug Abuse (NIDA), the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and the American Academy of Addiction Psychiatry. It is not a recent trend in thinking. As early as 1784 in the United States, Benjamin Rush discussed addiction in terms that anticipated the disease model. In 1956, the American Medical Association (AMA) affirmed that alcoholism qualified as an illness, and by 1987, the AMA officially affirmed the brain disease model of addiction. The brain disease model of addiction is a useful framework for understanding substance use disorders, but there is no shortage of controversy among the public surrounding it’s validity.
Precisely, these institutions are the ones that supported the War on Drugs and, a few years ago, considered LGBTI+ people as sick. By this I mean, on what basis do they say this?
In other words, according to them, there is irreversible damage to the dopamine D2 receptors;Drug addiction is a chronic disease characterized by compulsive and uncontrollable drug seeking and use, despite adverse consequences. For most people, the initial decision to use drugs is voluntary, but repeated drug use can lead to changes in the brain that challenge an addicted person's self-control and interfere with his or her ability to resist intense drug cravings. These brain changes can be persistent, which is why drug addiction is considered a "relapsing" disease-people in recovery from drug use disorder are at high risk for returning to drug use even if they have been drug-free for years."
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