Whether a person is genetically or bio-chemically predisposed to addiction or alcoholism is a controversy that has been debated for years within the scientific community. One school of thought advocates the Disease Concept, which embraces the notion that addiction is an inherited disease, and that the individual is permanently ill at a genetic level, even with those experiencing long periods of sobriety.

Another philosophy argues that addiction is a dual problem consisting of a physical and mental dependency on chemicals, compounded by a pre-existing mental disorder (i.e. clinical depression, bipolar disorder, or some other mental illness), and that the mental disorder needs to be treated first as the primary cause of the addiction. This treatment philosophy is commonly referred to as Dual Diagnosis. A third philosophy subscribes to the idea that chemical dependency leads to "chemical imbalances" in the neurological system, which would be a substance induced imbalance.

The fact remains that there is scientific research to support all of these concepts, but that none of these theories are absolute.

The concept of drug addiction/dependence is being refined in light of new research on blood concentrations, receptor sites, brain chemistry and withdrawal syndromes. All mind-altering drugs, including alcohol, marijuana, heroin, other opiates, methamphetamine and cocaine, can produce addiction or dependence, develop intolerance, and induce a withdrawal syndrome after cessation of chronic use.

Putting all this together, persons dependent on drugs or alcohol may have any or all of the following problems at the time they enter treatment:

• Induced chemical imbalance
• Genetic chemical imbalance
• Social and psychological problems
• Inhibited life and/or coping skills

On the assumption that one or more of these factors may be present, it is easy to see why different treatments work for some persons but not others. In summary, it is now believed that severe chemical imbalances exist in persons who continuously relapse despite treatment and that the origins of those chemical imbalances may be chemically induced, genetic, or social and psychological.

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