Why Addiction Is A Disease

by Victoria B., posted in Addictions

Addiction = Disease

Even though addiction was officially classified as a disease by the American Medical Association in 1987 there is still a debate today about whether this classification is correct. Opponents of the disease model of addiction claim that addiction cannot be a disease because it is brought about because of choices that the addict makes. If they did not make the choice to abuse substances than addiction would not have occurred. They believe that to declare addiction a disease is to make excuses for addicts where excuses should not be made. Yet many of these arguments seem to be driven by emotions and anger towards the addict that you don’t really see with other diseases.

For instance, if someone ate poorly for years and developed heart disease because of this I would find it very hard to believe that there would be arguments that their heart disease isn’t a disease because it was created due to choices on their part. Yet that is where we find ourselves in regards to treating addiction as a disease. Unlike other chronic diseases, addiction faces a special type of stigma. Rather than engage in opinions, though, let’s take a look at the evidence for the disease model of addiction and the evidence against it.

Evidence That Addiction Is A Disease

Addiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain. They change its structure and how it works. This idea that drug usage changes the brain is the crux of the evidence for addiction being a disease. These changes in the brain represent an abnormality that causes the behaviors that we consider to be an addiction.

The National Institute on Drug Abuse says that this change in the functioning of the brain means that addiction is like many other diseases in that it disrupts the normal functioning of an organ. In addiction’s case, the organ being disrupted is the brain and the disruptive behavior is the compulsive drug seeking that occurs in someone who suffers from addiction.

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This idea of compulsivity is another major point in the evidence that addiction is a disease and also one that is contested by opponents of this theory. Some people believe that addiction is a choice. It is a choice to continue to abuse drugs and that this choice is made over other healthier choices because of a fundamental character flaw in the addicted person. This line of thought means that the addict is a bad person and not a sick person and so addiction cannot be a disease right? Wrong. The initial choice to use is many times an actual choice, but in someone who has the disease of addiction subsequent choices to use are not choices but compulsions. Similar to someone who suffers from Obsessive Compulsive Disorder and has to perform rituals against their will, the addict does not have an actual choice in whether or not they are going to use again until help is sought.

Drug addiction is also similar to other chronic diseases in that it usually runs in the family, meaning there is some sort of genetic component to the disease. Just having the genetic predisposition is often times not enough, though, just as with someone who has a genetic predisposition to heart disease may not suffer from this disease unless the correct environmental factors are present. The same goes for addiction and someone who’s parent is an addict may not suffer from addiction themselves because they did not have the right environmental factors to trigger the disease.

The evidence that addiction is a disease is fairly substantial but given the emotionally charged nature of the illness and the complex social and biological factors that go into its makeup, unequivocally coming to the conclusion that addiction is a disease is not that simple.

Evidence That Addiction Is Not A Disease

The strongest argument that addiction is not a disease rests on the same information that proponents of the disease model of addiction use to prove their point- the change in the brain. Those who do not believe that addiction is a disease say that the change that occurs in the brain of those who have an addiction does not represent an abnormality or malfunctioning brain, but is rather what occurs when someone does something a lot. They say that when we practice doing something over and over again, as drug addicts do with drugs, those neuronal pathways strengthen and this is not evidence of a malfunctioning brain, but rather a functioning brain that has learned something.

They also say that this means that addiction is not compulsive because the change in the brain that is supposed to represent compulsivity is not abnormal. The website The Clean Slate makes the argument that someone who continuously plays the piano will have the same sort of changes to the brain that a person who continuously uses drugs has, but does this mean that the piano virtuous is incapable of stopping playing? They believe, as most other people would agree, that the piano player can stop playing whenever they want and that it is their choice as to whether they will continue to play. They also state that there is no evidence that drug abuse is involuntary and that in many studies it is just taken for granted as fact without any scientific backing.

The conclusion of sorts…

Without isolating the specific gene or exactly what constitutes the biological difference between someone who suffers from addiction and someone who is just a heavy user, putting this debate to rest will be almost impossible. The idea of addiction usually constitutes a strong response from people and depending on their own background and experience with this illness, how they feel about drug addicts will differ. Classifying addiction as a disease has allowed for many drug addicts to get the medical attention they needed and has also raised awareness for this illness in the general public. We have a long way to go in our understanding of addictive behaviors and as with all growth having voices for and against is important to innovation and breakthrough.

Rose Lockinger
Stodzy Internet Marketing.

Rose Lockinger is a passionate member of the recovery community. A rebel who found her cause, she uses blogging and social media to raise the awareness about the disease of addiction. She has visited all over North and South America. Single mom to two beautiful children she has learned parenting is without a doubt the most rewarding job in the world. Currently the Outreach Director at Stodzy Internet Marketing.

You can find me on LinkedIn, Facebook, & Instagram

20 thoughts on “Why Addiction Is A Disease”

  1. When they start putting obese people in jail for overeating, I’ll start worrying about whether or not my alcoholism is an excuse or a disease. As they say, let the whirling dervishes whirl.

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  2. Very well written post presenting both sides of the debate. No matter which view is held we must find a way to slay this dragon! Thank you for sharing.

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  3. I think the matter lies in that we have stigma on mental health and illness. All addiction is a mental health challenge – whether you prefer to call it illness, or dis-ease in the mind. At first, you speak about it in terms of the mind, but when you talk about how drugs change the brain, you bring it into the physical illness realm. However, addictive behavior has to do with more than the imbibing of alcohol or the intake of drugs. It has to do with gambling, eating, debting, money and more – anything you can overuse to sustain an altered mood, there goes addiction. So what happens to those brains? Mental dis-ease is already happening in an addict’s mind. It doesn’t begin with the imbibing, snorting, injecting, or the compulsivity that sustains those activities. It begins far before all of those and those are the products of the addiction.

    So if we want to be clear about whether or not it’s a disease, I believe, we have to stop beginning where the addiction finds its outlet and begin where the addiction creates itself. That’s when we’ll begin to agree with the dis-ease of it and begin to heal it in ways that we’ve never imagined possible.

    Thank you for posting this. It gave me new ways to think of this subject. I appreciate the information on this site.

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  4. This is a great post, thanks for sharing all this information. I found the explanation given in the documentary ‘Pleasure Unwoven’ by Dr Keven McCauley really interesting and helpful. He explains it as a disease that damages the functioning of the choice mechanisms within the brain. He uses clear and simple explanations of what’s happening from a neuroscience point of view in a way that the lay person can understand.

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  5. Addiction, a disease in which the sick person’s actions directly impact those around them. This isn’t necessarily true of say a cancer patient or someone with heart disease in part due to obesity. This is true of mental illness as well. As a compassionate person you can rationalize someone’s actions saying they are sick but when they – lie, cheat, steal or mentally abuse you repeatedly, well it’s just different than say diabetes. I say this as a person in long term recovery (30+ years) and as the daughter of a mentally ill parent (alcoholism + mental illness). For me one of the greatest struggles in life has been balancing compassion for my parent with my own self preservation.

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    1. Thanks for chiming in Bryce. I am impressed with your long-term sobriety and appreciate your comments. It sounds like you know much about the subject. The “balancing of compassion” is something that is very difficult.

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  7. It’s worth mentioning that alcoholism (just another addiction) was recognized as a disease by the AMA 60 years ago, in1956.

    The medical community has “gotten it” for a long time (see Dr Silkwood). It’s the morals and ethics community who are behind the times – – as they usually are.

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  8. I have been thinking about this subject a lot lately. While I haven’t formed my option yet, it bothers me that it may have to do with getting money from insurance companies. If addiction wasn’t classified as a disease, insurance companies would not pay for a treatment. Some of the research prior to 1956 is flawed.

    If I would have never consumed alcohol would I be addicted? If I had developed good coping skills would I used alcohol, food, sex or gambling ect. to escape my problems? These are all questions I am struggling with. I had 9 years of sobriety prior to being in combat in Iraq. When I returned I drank again. Was it because I had a disease of I wanted to escape the terrible things I saw? (I now have 2 years sobriety.)

    Anyway thanks for writing this. It gives me more to think about. I will be blogging about this subject in the future myself after I read more on this subject.

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  9. I am an addict and have been in recovery for the last thirty odd years. I started off by thinking that addiction was a disease which was very useful as it took the blame out of it, although I was, of course, left with the responsibility.
    I like Gabor Mate’s ideas on addiction that, although there seems to be an inherent trait, a genetic component if you will, a large factor is early upbringing and particularly the part that attachment plays in brain development.
    I have written a bit about addiction on my own blog at http://www.diveforyourmemory.com and about my personal traits which, I believe were a huge factor in my becoming an addict.
    I liked your thoughts on the topic.
    Take care

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      1. I’m hoping for another 30 or so, a day at a time. That will only make me 97! By the way, I’m still not sure about following and followers but I had an email to say you were following my blog at http://www.kevinmarshall99.com whereas I blog at http://www.diveforyourmemory.com. the other address is my main account and I don’t put anything on it. Does this make sense.
        Intend to follow your blog. It’s full of interesting articles. Stuff to think about.
        Take care

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  11. I would imagine that if the piano player stopped playing, he would go down a long painful path of despair. I would think his/her playing would be something that exercised healthy functioning of spirituality in the frontal cortex, while drugs shut off the frontal cortex because the mid-brain takes over in attempt to “maintain survival.”

    I also believe something like developing such a passion for playing the piano (or any form of art/creation) can aid in the recovering of a once drug addicted body mind and spirit, to restore health.

    Playing piano is an act of creation while doing drugs is an act of destruction. I personally believe the two of them cannot be compared with each other, unless we are talking about “The intensity of the degree of having the urge to live is equal to the intensity of the degree to having the urge to destruct” in which case they would relate to each other, but serve completely different functions that sit on different sides of the mirror. Also, if this were the case, because we are talking about destruction and creation, the destructive behavior further inhibits a person’s ability to step out of the dark hole they are creating because of its very nature, while the person playing piano would be doing something that by its very nature, can be equated with the creative force of life…and would have no need to stop playing as they are not killing themselves through the piano. I think it would behoove the piano player to never stop playing. Rock on Beethoven.

    Dr. Kevin McCauley has a video on Youtube, Is Addiction Really a Disease? I just wrote an short article about it on my blog. You might find it interesting. He makes an irrefutable case, using brain science, about why addiction is a disease. It’s helped me come around a corner I may otherwise, never have been able to. If I wouldn’t have seen his video, I would have been trying to make cases about how I had control of my drug use because Picasso could have stopped painting if he really had wanted to, in which case, I would not be typing these words right now.

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