Is Addiction a Disease?
Perhaps the most widely accepted addiction model today is the Disease Model, where addiction is defined as a disease involving biological and genetic factors. Scientific research now shows evidence of neurobiological processes that occur in the brain of addicts when using mood-altering substances. Addiction is seen as a chronic brain illness marked by compulsive drug seeking and use despite harmful consequences.
The use of most addictive substances, including alcohol, heroin/opiates, methamphetamine, marijuana, etc. floods the brain with a neurotransmitter called dopamine. This causes structural changes to the brain, leading to compulsive behavior and progressive loss of control over substance use. This process alters the pleasure circuit of the brain, creating an artificially high sense of reward. Because of this surge of dopamine, the brain assigns a much greater value to the drug, often seeing it as more essential than food or sex.
The area of the brain controlling judgment, reason, decision making, memory, and behavioral control becomes compromised. Values, morality, and integrity are disregarded. In that state, the craving and compulsion for the substance often override the pain and memory of past negative consequences or the fear of future consequences; whether loss of family, relationships, jobs, finances, freedom, esteem or health. This phenomenon of craving helps explain why the addict can act in such seemingly thoughtless, careless, even reckless ways.
What About Choice, Responsibility, and Accountability?
As previously discussed, the addiction disease model helps EXPLAIN the addict’s behavior. This does not EXCUSE the behavior. For some, it can be challenging to reconcile disease and choice.
Indeed, there is a choice involved. If the addict never chose to use it in the first place, the neurobiological forces would never have been put into effect. And if there were no capacity to choose, an addict would never be able to stop once the physiological processes had taken control. Clearly, choices need to be made; the choice to stop using, and the healthy choices to do the necessary recovery work.
There are incredible benefits that come with viewing addiction through the lens of disease.
Will Power Alone Is Not Enough. Most Need Help to Achieve Sobriety
Considering addiction as a disease does not absolve the addict from dealing with consequences. It is a degenerative disease, causing decay of values, morality, and integrity. The addict’s true identity also deteriorates as the compulsion drives them to make choices that violate themselves and others. It’s a process that’s difficult for addicts to reconcile. They will often see themselves as “bad”, rather than “sick”. This crisis creates a deep sense of shame, self-loathing, and self-condemnation. In reality, the addict deals with a sickness that manifests in destructive behavior. Understanding and accepting addiction as a disease does not excuse this behavior, but can serve to alleviate the destructive self-judgment which accompanies addiction.
Principles of honesty, personal responsibility, and accountability are crucial steps on the path to recovery. Most addicts and their families need help with this process. A professional diagnosis of addiction brings greater responsibility. For recovery to occur, the addict needs to make changes in virtually every area of their life, addressing the physical, emotional, spiritual, and psychological causes of the disease. Have hope! Full recovery is possible. With proper help, many are on this path and have realized happiness and freedom. While there is no cure for addiction, this is a disease where you can CHOOSE REMISSION.
Frequently Asked Questions About the Disease Model of Addiction
The concept of classifying addiction as a disease emerged in the early 1900s. By 1956, the American Medical Association (AMA) labeled alcoholism as an illness. By 1987, the AMA and other organizations recognized as authorities in the field had officially classed addiction as a disease.
Substance addiction disease is a chronic disorder, often involving remission and relapse. The disease is recognizable by the characteristic compulsion to seek the addictive drug and continuing frequent use even knowing the serious consequences. The disease causes long-term changes in the human brain and is defined as a combined brain disorder and mental illness.
Substance Use Disorders (SUDs) are categorized as disabilities. Alcohol or drug addictions that can be diagnosed are recognized as disabilities under these US Congressional legislative acts:
- Rehabilitation Act (Section 504)
- Americans with Disabilities Act (ADA)
- Affordable Care Act (Section 1557)
Substance addiction is a chronic disease with various contributors, including biological, environmental, psychological, and social factors. All these influence the development and perpetuation of the disorder. Genetics account for around 50% of addiction risk factors.
Medical science research has linked a type of infectious RNA virus called human endogenous retrovirus-K HML-2, or HK2, to substance addiction. The infectious agent integrates with a dopamine-regulating gene. This genetic integration is more often identified in people with the disease of addiction and is associated with substance-use disorders.