15 years ago addiction was declared as a brain disease. This was revolutionary step in the field of health science. Recognizing addiction as a disorder of the brain can impact overall health of society and social policies.
Such a presentation of the complex concept of addiction was revolutionary, as social and psychological aspects were largely considered as the most important.This new approach towards addiction translated into new scientific concepts for addiction treatment. This changed understanding and approach towards addiction forms especially alcohol dependence, which is one of the leading causes of preventable deaths in the EU and seen as a major public health hazard. News approach towards addiction treatment was based on following concepts:
- Proposing a motor rehabilitation instead of the usual cognitive control to reduce impulsive choices. Accordingly, a rehabilitation program trying to increase motor inhibition might be helpful to deal in a different way with the usual cue reactivity related to alcoholism such as being proposed a drink in a group, shopping and seeing bottles, etc.
- Using positive environmental conditions to reduce the intense and urgent desire for alcohol.Environmental conditions can dramatically influence the behavioral and neurochemical effects of drugs of abuse. On the other hand, positive conditions such as environmental enrichment can reduce the reinforcing effects of drugs and may provide protection against drug cravings.
- Starting treatment to increase the insight into the disease, facilitated by the use of anti-craving medications, rather than expecting a better insight as requirement to begin with treatment. With medications that reduce craving even in alcohol abusers, it is now possible to treat in the first place and then expect the patient to develop better insight and high motivation to achieve abstinence, rather than the other way around.
- Deep Brain Stimulation (DBS) in severe cases of alcoholism. Deep Brain Stimulation (DBS), a surgical treatment involving the implantation of a medical device in the brain, represents an interesting strategy for the treatment of severe alcoholism. DBS sends electrical impulses to specific parts of the brain and directly changes brain activity in a controlled manner; its effects are reversible. Until recently, it was not even possible to propose DBS as an intervention for a behavior disorder such as addiction. However, DBS was indeed used on a very limited number of cases, with positive outcomes.
Alcohol and drug dependence are among the most frequent mental around the world. Due to high mortality and morbidity rates associated with alcoholism, intervention at the earliest possible stage is essential. Supported by modern treatment with anti-craving medication, starting treatment to increase the insight into the disease, rather than expecting the patient to develop better insight before initiating treatment, represents a promising approach.