Relapsing disease

An addiction disorder can be defined as a chronic, relapsing disease that alters brain structure and function, thus, affecting not only the brain, but also behavior. It is characterized by “maladaptive pattern of drug use” which includes a compulsion to seek the drug and use it despite the full knowledge of the harm it causes (Frances, et al, 2005 & NIDA, 2007). The vulnerability of a person to addiction is variable and genetic make-up accounts for a 40-60% chance of becoming addicted. Those who have mental disorders are more likely to become addicted compared to the general population (NIDA, 2007).

The following behaviors are believed to be suggestive of addiction disorder: selling prescription drugs, prescription forgery, stealing or “borrowing” drugs from others, injecting oral formulations, obtaining prescription drugs from nonmedical sources, obtaining prescription drugs from multiple drug sources without informing or despite prohibition, concurrent abuse of alcohol or illicit drugs, multiple episodes of self-escalation of dose, despite warnings not to do so, multiple episodes of “prescription loss”, evidence of functional deterioration unexplained by the pain or other comorbidity, repeated resistance to changes in therapy despite clear evidence of adverse effects (Frances, et al, 2005). A good example would be alcoholism.

The addiction to alcohol can damage not only the brain but many other organs in the body, such as the liver. Since alcohol affects that part of the brain that is responsible for higher brain functions, skills in problem-solving and decision-making are affected. As to whether addiction disorder can be managed and treated, yes, it can be managed and treated, although the fact remains that it is a relapsing disease. A well-managed addiction can actually help the addict to live a normal life. But since it is the possibility of a relapse is there, treatment should involve not only medications but should also address the behavioral component of the disease. This means that management should involve changing behaviors that are already deeply ingrained.

Also, it must be kept in mind that relapses do not signify the failure of treatment; only that treatment should be evaluated then adjusted or alternate treatments sought. Research has shown that the most successful approach has been combination treatment of both medication and behavioral therapy (NIDA, 2007). The American Psychiatric Association defines a personality disorder as the inflexibility and maladaptability of personality traits that cause functional impairment or subjective stress since personality traits are ingrained patterns of “perceiving, relating to, and thinking about the environment and oneself that are exhibited in a wide range of social and personal contexts” (Weiner et al, 2003). The DSM-IV, on the other hand, defines a personality disorder by giving a general diagnostic criteria.

Criteria included: (1) that there is an enduring pattern of inner experience and behavior that deviates markedly from that which is expected of the individual’s culture and manifested in two of the following—cognition, affectivity, interpersonal functioning, and impulse control; (2) the pattern is inflexible and pervasive across a broad range of personal and social situations; (3) the pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning; (4) the pattern is stable and of long duration, and its onset can be traced back to at least adolescence or early adulthood; (5) the pattern is not a manifestation or consequence of another mental disorder; and (6) the pattern is not a physiological effect of a substance or a medical condition (Weiner et al, 2003). The American Psychiatric Association recognizes ten official personality disorders and one of the ten is the Obsessive-Compulsive Personality disorder which is characterized by a preoccupation with orderliness, perfectionism, and control. Individuals who have this personality disorder are overly rigid, stubborn, and perfectionists that it comes to a point that tasks never get done. They are sticklers to rules, morals, principles, and details that cause trouble in their personal and social lives. Other people usually see them as workaholics or control freaks (Weiner et al, 2003).

Studies have shown that personality disorders may have developed from childhood experiences, which may lead to the belief that it can then be prevented given better circumstances. On the hand, studies have also shown that individuals who exhibit a personality disorder already show signs of certain personality traits which lead to the disorder early on and these studies are supported by the other researches that indicated certain personality disorders as being heritable (Weiner et al, 2003). But, personality traits in themselves are not what make up the disorder but the way the traits give rise to an enduring pattern of living life that causes impaired function and distress.

It may be then, that given heritability and environment, the trait may be heritable but the environment and experience also play a big part in giving the final push that brings the individual in the realm of having a personality disorder .


Frances, R. , Miller, S. , and Mack, A (2005). Clinical Textbook of addictive disorders. New York and London: Guilford Press, 370-372. National Institute of Drug Abuse (2007). Drugs, Brain, and Behavior : The Science of Addiction. National Institute of Drug Abuse (NIDA) and National Institute of Health. Weiner, I. , Freedheim, D. , Stricker, G. , Schinka, J. , Widiger, T. , Velicer, W (2003). Handbook of Psychology: Clinical psychology. New York: Wiley, 8, 149-165.

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