By Maia Szalavitz
02/15/12

The DSM V—the next edition of psychiatry’s diagnostic bible—will redefine addiction in ways likely to have long-lasting, real-world consequences. As I explored in my column last week, psychiatrists are eliminating the seriously problematic terms “Substance Abuse” and “Substance Dependence” and placing all related conditions into a single new category: “Substance Use and Addictive Disorders.”

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Indeed, research shows that some people who meet the full criteria for alcoholism or addiction can return to controlled use—though this proportion decreases as severity of the problem increases. The data also shows that a large proportion of people who would currently be diagnosed as “substance dependent” recover without any type of treatment or self-help involvement at all.

In short, no one can predict which college drunk will go on to skid row—and which one will become President.

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Even now, however, a great deal of treatment energy and time is currently aimed at trying to get people in recovery to admit that they have “the disease of addiction” and to label themselves as “addicts” or “alcoholics” in therapy groups. Counselors and other staff press clients to confess to a greater and greater problem severity, due to the pervasive suspicion that most people with addiction lie about how much they use. (This continues to be done in the face of research showing that doing so does not benefit recovery—if anything, “confronting denial” is linked with more relapse, not less.)

This push to adopt an addict identity happens even in adolescent treatment— despite the fact that most teens in treatment do not meet criteria for being addicted (some don’t even meet criteria for drug abuse!). Indeed, the vast majority are, not surprisingly, nondaily binge users of booze and pot. Nonetheless, at ever-younger ages, these kids are being pressured to view themselves primarily as addicts and alcoholics and to admit to having a chronic, lifelong illness with a 90% chance of relapse. Very little research has been done on the effects of this “treatment”—but given what we know about the fluidity of adolescent identity, it certainly has the potential to do significant harm.

For one, it can be a self-fulfilling prophecy—and I’ve spoken with quite a few people who have gone into adolescent treatment as marijuana users and emerged as cocaine or prescription drug misusers, in part because they felt that they were “already addicts anyway.” Second, since research cannot predict which teens will outgrow their problems and which will have a chronic course, does it really make sense to have them all embrace a stigmatized identity centered around a disease?

The Complete Article-
http://www.thefix.com/content/addiction-definition-phony-epidemic-DSMV8765