The Definition of Addiction by Dr Margaret McCann

Dr Margaret McCann, Co-Founder of Castle Craig Hospital and Smarmore Castle and former Medical Director and CEO of Castle Craig, writes to explain her definition of addiction.


The Definition of Addiction – by Dr Margaret McCann, Co-Founder of Castle Craig Hospital

The view I have taken for many years is that addiction is a complex illness involving many factors.

These factors include:

  • the effects of the drug itself;
  • the response of the brain to the drug – with resultant neurochemical and biological changes after prolonged exposure;
  • the hereditary and genetic makeup of the individual – there is strong evidence that genetic factors predispose an individual to addiction and increase the person’s vulnerability;
  • psychological factors;
  • and socio-cultural factors. 

In order to simplify the message, I think of a triangle where the three points are:

  • the substance (alcohol/drugs);
  • the person (biology, psychology)
  • and the environment (price; availability, peer influences, education, occupation).

In this way, according to a previous definition, addiction is a biopsychosocial disease. I think there is no doubt that it also has a spiritual dimension (dishonesty, selfishness, the moral and spiritual consequences of the lifestyle).

Understanding addiction as a disease is not a cop-out for taking responsibility for one’s recovery. In fact because it is a chronic progressive and potentially fatal condition it is all the more necessary that the individual take full responsibility.

Alcoholics Anonymous itself has always spoken of an illness but there is a greater understanding now of how the brain’s reward centres and neural circuits are hijacked by long exposure to significant drug levels.

For further reading on this subject I recommend the American Society of Addiction Medicine’s definition of addiction. 

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