For most of the twentieth century, medical professionals, as well as the general public, understood addiction as a moral disorder. Addicts were judged as people who could not control their impulses or who made bad choices. 12 Step support groups like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) became the dominant treatment approach.
Now addiction specialists — physicians, psychiatrists, neurologists, toxicology researchers and other professionals — describe addiction as complex biomedical, psychological, social, and spiritual disorder. Thus, managing addictive disease successfully requires a comprehensive, team approach, which might deliver medication, psychological therapy, and integrated primary and specialty care, as well as participation in 12 Step and other peer support groups.
The American Society of Addiction Medicine, founded in 1983, fosters interdisciplinary study and has developed clinical standards of care for addiction treatment. ASAM publishes formal definitions at its Website.
According to ASAM, “Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry.” That definition leaves room not only for substance use disorders but also for behavioral (or “process”) addictions such as compulsions in gambling, sexual activity, and eating.