The Disease of Addiction Ken Roy, MD, FASAM Addiction Recovery Resources of New Orleans River Oaks Hospital Tulane Department of Psychiatry

Disease Identifiable set of symptoms Predictable Course Common Cause

Symptoms Compulsion Loss of control Continued use in the face of adverse consequences

Course Chronic Progressively more devastating Ultimately affects all major aspects of life Usually associated with what we die from Primarily a disease of relationships Based on dishonesty in the form of Denial

Dishonest Relationships Beginning with self and Spirit Moving to problems in the relationship with those with whom we SHOULD be intimate Involving ever widening circles of people In the context of repeated intoxication Resulting in CHAOS and Soap Opera lives

Genetic disorder Experience Twin Studies Adoption Studies One disease

Model Make molecular biology understandable Simplified language Animal studies – one system Difference over time Different research Stability over time Difference between addicts and “normal” people

The Brain Two brains – “Reptilian” and Higher Thought

Reptilian Brain Stronger than/Dominant over Higher Thought i.e. Cannibalism

Reptilian Brain Where Our feelings live Normal Euphoric Terminal Dopamine

Reptilian Brain Not too bright Normal Euphoric Terminal i.e. Suicide

The Brain Dominant over Higher Thought Where our feelings live Not too bright

Your Drug of Choice Alcohol Normal Euphoric Terminal ETOH Too much Drunk = Clumsy + Stupid Drunk

Normal People Eric Normal Euphoric Terminal ETOH

People with Addictive Disease Joe Normal Euphoric Terminal ETOH 4X Concentration Of Dopamine Gene

The Misunderstanding Eric (et. al.) doesn’t know this happens to Joe Joe thinks that this happens to Eric too Normal Euphoric Terminal ETOH 4X Concentration Of Dopamine Gene

The Natural History of Addictive Disease Normal Euphoric Terminal ETOH 4X Concentration Of Dopamine Gene N H B We don’t grow up!!! Factory failure = Dopamine

The Story of Joe’s Bottom Normal Euphoric Terminal ETOH 4X Concentration Of Dopamine Gene N H B Denial

Is Addiction a Disease? Does anyone remember the day they decided to have a denial system? Does anyone remember deciding that “When I grow up I’m going to be an alcoholic?” Or, “A drug addict?” Are there any “bad” people in the room; any toss-outs or throw-aways?

Addiction is a Disease!