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.
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