Language matters: ASAM updates definition of “addiction”

Language always matters to addiction medicine physician Yngvild Olsen, MD, MPH. “Whether we are talking to our patients about medical concerns—or to policymakers about terminology—we must be clear, honest and accurate.” Dr. Olsen explained that the emphasis on using correct terminology is one of the prime reasons why the American Society of Addiction Medicine (ASAM) updated its definition of “addiction” as well as clarifying how people use the term “MAT.”

Dr. Olsen commended the work of a special ASAM Task Force, which recommended that “addiction” should be viewed as a treatable medical disease that has many interrelated parts. The updated definition, she said, reflects that complexity:

“Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences. Prevention efforts and treatment approaches for addiction are generally as successful as those for other chronic diseases.”

Dr. Olsen also explained that while ASAM recognizes the widespread use of “MAT” to be defined as “medication-assisted treatment,” it is important to update the term to be defined as “medications for addiction treatment.”

“This is not about semantics,” said Dr. Olsen. “This is about highlighting the fact that treatment is not just medication, and that addiction is a highly complex medical disease. As physicians, we want to ensure that complexity is understood. This is important for the current epidemic, but also for future generations of physicians. The updated definition captures the known factors that enter into the development of a diagnosable substance use disorder in any given individual. It highlights and concisely explains the underlying brain disease of addiction and acknowledges the symptoms that form the basis for the accompanying substance use disorder diagnoses that clinicians make.”

Any change in health care-related terminology can disrupt care or policy as providers, policymakers and the public work to understand new or revised definitions. However, Dr. Olsen emphasized that ASAM’s update only underscores already needed policy change.

“Like the AMA and the AMA Opioid Task Force, ASAM is focused on promoting evidence-based care and removing all barriers to that care,” said Dr. Olsen. “This new definition doesn’t change the fact that health insurance companies and state policy need to change to support physicians and patients. It doesn’t change the fact that mental health and substance use disorder parity laws need to be enforced. It’s simply an important advancement to help us all speak and work together for our patients.”

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