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Alcohol Treatment Research: Denial in drug addiction may be explained by insight deficit
Drug abusers are often characterised as being in "denial" - not recognizing the severity of their disorder. Although "denial" is often considered to be a form of deception, emerging research suggests that it may be due to a specific brain dysfunction similar to that observed in other neuropsychiatric illnesses.
Scientists from a variety of fields presented relevant research during a symposium on "Impaired Insight into Illness in Drug Addiction" at the Society for Neuroscience annual meeting in Washington, D.C.
"The more we understand about the brain mechanisms affected by drugs of abuse and that underlie addiction, the better equipped we will be to address its complex and difficult-to-treat symptoms, including relapse triggered by exposure to cues outside of conscious awareness, and altered perceptions of internal responses and cognitive performance," said Nora D. Volkow, Director of NIDA, who will serve as a discussant at the symposium. "This knowledge will lead to the development of more responsive, integrated treatments."
Brookhaven's Goldstein explains the idea of impaired insight and how it might relate to drug addiction: "Patients suffering from mental illnesses such as schizophrenia often have compromised awareness of their own symptoms and the severity of their disorder. This compromise can exacerbate symptoms and reduce responsiveness to or compliance with treatment," she said. This "insight deficit" appears to originate from impairments in many of the same brain regions that underlie addiction symptoms - such as continued drug use despite catastrophic consequences, even when the drug is no longer pleasurable.
"It is therefore possible that these core clinical addiction symptoms - craving and compulsion and the chronic relapsing nature of addiction - may be a consequence of compromised insight," Goldstein said. Such impaired insight might help explain why drug-addicted patients often have a hard time recognizing, accepting, and/or acknowledging their own signs and symptoms of addiction, as well as the need for treatment. It could also help explain these patients' failure to comply fully with treatment regimens - and their tendency to relapse.
"Deficits in insight and interoception [sensitivity to the body's internal signals] and emotional awareness have largely been ignored in the field of addiction, despite the fact that this disorder is finally recognized as a disease of the brain, amenable to intervention and treatment," Goldstein said. "My hope is that this symposium will help bridge this gap and contribute to the design of new diagnostic tools and treatment approaches, pointing us toward more effective intervention strategies to improve prognosis in this illness."
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Alcohol Treatment Research

Poor Alcohol Regulation could cost up to 250,000 lives, doctors predict.
Poor Alcohol Regulation could cost up to 250,000 lives, doctors predict. ...more
Technology improves treatment options for drug users
The Drug and Alcohol Review has released a special issue on the use of new technologies in the treatment of drug problems. The issue highlights the use of mobil ...more
Department promoting early substance use screening process
The Wyoming Department of Health is strengthening its promotion of early screening for substance use-related health issues by reimbursing Wyoming healthcare pro ...more
Alcohol tax increases deter drinking
As leaders of many national, state and local governments debate whether to raise taxes on alcohol to boost revenues, their decisions also could influence how mu ...more
DrugScope welcomes report on 'neglected issue' of prescription and over-the-counter medication depen
DrugScope has welcomed the publication of the All Party Parliamentary Drugs Misuse Group's (APPDMG) findings from its inquiry into dependence and addiction to o ...more
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