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Book Challenges Binary Idea of Addiction

Dr. Jeffrey Berman, MD By February 21, 2019

Most, if not all, treatment centers that help patients with their substance use disorders, including facilities offering addiction treatment in New Jersey, take a very binary approach to the nature of addiction; either you’re an addict or you’re not. While it helps rehabs in New Jersey to identify addiction through common symptoms and behaviors, none of these are typically rated in a scale of severity. They tend to follow a pattern of assessment not unlike Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) in that all use is intolerable and constitutes a treatment ‘failure’.

AA and NA will use this definition as a large guilt factor in hopes that personal guilt of ‘failing’ will encourage people from using any substance again, despite the fact that research points to the opposite being true. In fact, without a range of measurement for addiction, a recovering alcoholic having a thimble of wine at church is considered on the same level as someone who drinks to blackout and gets into a wreck leaving a bar in 12 step programs. Most people looking at these two things will be able to discern the difference. Treatments, even clinical and research based, however, do not tend make a distinction between the two.

A new book by Paul Thomas, M.D., titled “The Addiction Spectrum”, aims to shift the conversation to create a more effective and actionable range of treatments based on severity. Most experts define addiction as disease and is indeed the working model for treatment centers. According to Dr. Thomas, there are multiple factors that constitute a problem and not everyone will experience all of them, even if they seek treatment. One of the goals of the book, as well, is to educate the public and treatment experts who currently operate on the ‘disease’/’binary’ model of treatment that with a range and severity spectrum, detecting the addiction before it gets out of control can lead to greater prevention.

The book also aims to make addiction treatment less aversive to those who might be on the spectrum but still wish to partake in use, such as a very common use of having a glass of wine before bed, for instance.  

Discovery Institute“What I’m really hoping to get across by talking about addiction as a spectrum is, again, you don’t have to hit rock bottom to change. Maybe your relationship with alcohol, food, screen-time, whatever it is, isn’t as healthy as you would want it to be. You don’t have to reach a tipping point to change it,” adds Dr. Thomas. He says not every addiction type will ‘destroy your life’, but many will have people concerned a little bit and those are the times when it’s much easier to correct a person’s behavior to avoid severe addiction, before the addiction does serious physical and emotional damage to themselves and people around them. Prevention is much less costly than repair.

If you or someone you know suffers from substance use disorder, help them find sober living in New Jersey by calling Discovery Institute at 844-478-6563.

Article Reviewed by Dr. Jeffrey Berman, MD

Dr. Jeffrey Berman, MDDr. Jeffrey Berman is a psychiatrist in Teaneck, New Jersey and is affiliated with Robert Wood Johnson University Hospital. He received his medical degree from State University of New York Upstate Medical University and has been in practice for more than 20 years. He also speaks multiple languages, including French and Hebrew.

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