The Disease of Addiction

Ken Roy, MD, FASAM

Addiction Recovery Resources of New Orleans

River Oaks Hospital

Tulane Department of Psychiatry

www.arrno.org

kenroymd@bellsouth.net

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

NormalEuphoric

Terminal

Dopamine

Reptilian Brain Not too bright

NormalEuphoric

Terminal

i.e. Suicide

The Brain

Dominant over Higher Thought

Where our feelings live Not too bright

Your Drug of Choice Alcohol

NormalEuphoric

Terminal

ETOH

Too much

Drunk = Clumsy + Stupid

Drunk

Normal People Eric

NormalEuphoric

Terminal

ETOH

People with Addictive Disease Joe

NormalEuphoric

Terminal

ETOH

4X ConcentrationOf Dopamine

Gene

The Misunderstanding Eric (et. al.) doesn’t know this happens to Joe Joe thinks that this happens to Eric too

NormalEuphoric

Terminal

ETOH

4X ConcentrationOf Dopamine

Gene

The Natural History of Addictive Disease

NormalEuphoric

Terminal

ETOH

4X ConcentrationOf Dopamine

Gene

N

H

B

We don’t grow up!!!

Factory failure = Dopamine

The Story of Joe’s Bottom

NormalEuphoric

Terminal

ETOH

4X ConcentrationOf 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!