There’s still confusion about addiction as a disease. Old ideas persist contrary to the chronic brain disease concept. There’s a lingering idea that to call it a disease let’s people off the responsibility hook. I hear this often – “No one forced them to drink alcohol or take other drugs, so it can’t be a disease.” If we went by that logic, then diabetes wouldn’t be a disease, and you can also say that heart disease is partly due to lifestyle and what we eat. The point is not how the person started using drugs (alcohol is a drug), but what happens to the person’s brain/body when addiction occurs. The progression of addiction meets all the criteria for disease. Below is what Terry Gorski wrote about addiction as a disease:
To intelligently discuss the issue of whether or not alcoholism is a disease, we must first define the term “disease”. To do this I turned to the 24th Edition of the Stedman’s Medical Dictionary which provided the following definitions.
- A disease is a morbus, an illness, a sickness that causes an interruption, cessation, or disorder of bodily functions, systems, or organs
- A disease is an entity characterized by at least two of these criteria:
(1) a recognized etiologic agent (or agents);
(2) an identifiable group of signs and symptoms; or
(3) consistent anatomical alterations of known body systems.
To determine if alcoholism is a disease, we must see if it meets this definition.
My position is that alcoholism is a disease. This position is shared by many prestigious organizations including the World Health Organization (WHO), the American Medical Association (AMA), and the American Psychiatric Association (APA). The Congress of the United States of America formally acknowledged that Alcoholism was a disease with the passage of the Hughes Act in 1970. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) was created to promote research on the nature of this disease. A major thrust of NIAAA has been on the biomedical aspects of this disease and much progress has been made in understanding its etiology, symptoms, and treatment.
Society can debate the moral issue of using drugs, and society can hold a person responsible for taking the first drug, but society can’t ignore scientific facts, without consequences, and what we’re faced to deal with is addiction when it happens and causes legal, relationship and medical problems that cost society billions every year.
Most people aren’t moralistic about using drugs, especially alcohol. The majority starts out drinking alcohol or smoking pot or whatever because it’s acceptable in their social circles. No one starts out to be an addict. Some people are susceptible to addiction because of their brain chemistry, and it can happen to anyone. When addiction happens in a family, people usually develop a different, understanding perspective — they know how the family member was before addiction, so they understand something powerful is driving the destructive behavior. Addiction as a disease begins to make more sense. They also realize that shaming the family member only makes it worse.
It does no good to take a moralistic stance when someone is addicted, but once the person knows about addiction as a disease and that recovery is possible, then the person becomes responsible to make the changes necessary to recover long-term. Recovery is not punishment for bad, addictive behavior.
Recovery is about transformation, about rewiring the brain and thinking differently, about taking responsibility to mend what was damaged and go forward clear headed and free from addiction. Recovery is about embracing life and health, while addiction is about sickness and destructive behavior. In treatment, we teach recovering addicts that abstinence and time are their best friends. It takes time for the body and brain to heal. Treatment for 8 weeks or so is a bare beginning — it can years before the healing is complete and the desire to use drugs is gone. But, recovery does happen. Yes, responsibility comes in when a person knows that addiction is deadly yet refuses to try recovery. Like I wrote above, no one starts out to become an addict, but once it happens the person doesn’t have to slowly die from it. Addiction isn’t a choice, but recovery is.