Recently here on Recovery Review Jason Schwartz has been posting some fairly interesting new material, as well as re-posting older material, about the idea of addiction as a disease.
The material he has shared has grown interesting enough and produced enough thoughtful conversation on various platforms, that I wanted to share a version of my very first post on Recovery Review (from 10/21/2019). It pertains to the topic. Over the next few days I might post one or two more that are relevant to this topic Jason has highlighted.
Earlier today, Bill Stauffer posted important and interesting content about the elimination of the classic diagnostic categories separating problematic use and addiction, their replacement with a simple list of criteria, and the relative uncertainties associated with the meaning (if any) concerning the number of criteria for SUD that may be met. That post can be found here.
That post reminded me of conversations I have had over the years with Norman Hoffmann concerning what Norm calls “The Big 5”.
“The Big 5”
Norm has both published, and presented at national conferences, his work concerning what he calls “The Big 5” substance use disorder (SUD) criteria from the DSM-5.
In short, Norm has examined the relative weight of each of the 11 DSM-5 SUD criteria, separately, as applied to the probability of having any one or more additional positive criteria for SUD (from data collected on thousands of consecutively incarcerated individuals).
The empirical questions and answers on The Big 5 as Norm has presented them are summarized here:
In presenting these results from his research, Norm has asked if perhaps the total constellation of The Big 5 is what is commonly called the disease of addiction. Interestingly, Norm has also noted the individual may fit mild or severe characteristics (aside from DSM scaling), based on The Big 5, and as a result he has expressed the following questions:
Overall, Norm encourages the clinician to consider the pattern of positive criteria, in addition to the mere total number of criteria present.