Pubdate: Sun, 02 Jul 2017 Source: Boston Globe (MA) Copyright: 2017 Globe Newspaper Company Contact: http://services.bostonglobe.com/news/opeds/letter.aspx?id=6340 Website: http://bostonglobe.com/ Details: http://www.mapinc.org/media/52 Author: Jeffrey Geller WE NEED CLARITY AND CONSISTENCY IN HOW WE APPROACH ADDICTION Sally Satel and Scott O. Lilienfeld do an excellent job, in "Stop calling addiction a brain disease," explaining how a unidimentional brain disease model, rather than a biopsychosocial model of addiction, birthed the opioid epidemic. The 21st century is not the first time medicine considered addiction a brain disease. In 1889 Massachusetts built the Massachusetts Hospital for Dipsomaniacs and Inebriates in Foxborough, thinking overuse of alcohol could be cured in the same fashion as insanity was being cured at the time. Today, we don't think of addictions as brain diseases in all contexts. In criminal cases, inebriation or acting under the influence of any self-administered drug hasn't the possibility of leading to exculpation as mental illness can. And from Presidents Kennedy through Obama, we've gone back and forth on entitlements and health insurance coverage for those with addictions. Not only do we need to understand what addictions are, but we also need a consistency in our application of that understanding if we are ever to have a sober solution to successive addiction epidemics. Dr. Jeffrey Geller Holden The writer is a professor of psychiatry at the University of Massachusetts Medical School. - --- MAP posted-by: Matt