According to the National Institute on Drug Abuse, addiction is a disease of the brain. This may seem like it is fact but many qualified researchers dispute it. It seems that there are arguments for and against the disease model. Unfortunately, this is where the differences get murky. Those that consider it a disease have very valid reasons but the people who do not consider it a disease do as well. The major medical communities agree that addiction is a disease because it shares a lot in common with many diseases but is sharing something with a disease make it the same? The most recent arguments against the addiction as a brain disease theory center on the fact that addiction is a choice that people make.
What Makes Addiction a Disease?
There are many reasons why people believe that addiction is a disease. Addiction shares many characteristics with common chronic conditions. Some of these similar characteristics are:
- both diseases and addiction are chronic,
- both diseases and addiction require treatment most often some form of medical treatment,
- some diseases and some addictions are genetic,
- both can be traced to environment or behavior,
- many diseases and addictions have similar relapse rates, and
- some say no one chooses a disease or addiction.
These are just a few of the basic reasons why many researchers consider addiction a disease rather than a bad habit that needs changing. Each person is different when it comes to both disease and addiction, how their body responds to the disorder and treatment. Both disease and addiction require treatment of some kind, even if it is just treatment of symptoms. The fact that the addiction, any addition, changes the brain and causes the body to physically need to substance to function does make it seem like a disease. These physical changes are sometimes permanent.
According to the National Library of Medicine, Frontiers in Psychiatry’s article “Addiction: Choice or Compulsion,” the compulsive aspect of the addiction is what makes it a disease. A compulsion is the inability to stop behaving in a certain way. The driving need for the addict to engage in the addiction behavior could be classified as a disease in this case.
What Makes Addiction a Choice?
Opponents of this theory argue that the compulsion is started by choice rather than a medical issue. Even though the scientific community generally accepts that addiction is a disease, there are still many who do not. Instead, they believe that addiction is a choice. In this model, the addict chooses to use the drug knowing that addiction is a very real possibility. Most people who are addicted to a drug or behavior know how they got that way. They knew that at least the possibility of addiction existed before they tried the drug or the behavior.
The people who argue addiction is a choice point out studies done where former addicts go back to using only moderate amounts after the addictive behavior is pointed out. This happens frequently in the case of chronic pain patients who become addicted to the opiates they use for treatment. They also point out that you cannot make the choice to quit a disease. Once you have diabetes, no amount of conscious effort stops you from having the disease. In the case of addiction, people manage to abstain without any treatment or medical intervention.
Studies done of the disease model of addiction do not take into account the ability of the human mind to evolve and change. When these models are tested in independent studies, they do not hold up reliably. This points to addiction being a choice. The main challenge to the view of addiction as a disease is the fact that people choose to quit. You cannot choose to stop being a diabetic or cancer. You can however choose to be an addict and you can choose to quit as well. It might be difficult to do but it is possible to just stop.
The Semantics of Addiction
Perhaps it is time to call addiction a disorder rather than a disease. To many the thought that addiction has a medical reason is reaching. They condemn the “it’s not my fault it’s the disease, I’m sick,” mentality. Some of the more outspoken objections call the disease model of addiction an excuse. There are a variety of recovery programs that build their services on the fact that addicts cannot help themselves. The addiction drives them to their behavior through a medical flaw rather than a choice they made. This seems escapist to more than one proponent of the choice model of addiction.
The idea of addiction being a disease or a choice may not matter. What the disorder you call a problem does not change the fundamentals of the problem. Some people choose to treat addiction medically as a disease and some choose to think of it as a choice, albeit a bad one. Regardless of what you call it, the results are the same. It is a dangerous unhealthy condition. No matter what the addiction control is necessary to recover.
One thing that researchers on either side of the argument fail to consider is that addiction is often a symptom of a more severe problem. A large percentage of addicts have a mental or physical disorder that causes them to feed their addiction.
When dealing with addiction it is important to note that there are very legitimate theories that challenge the current medical brain disease explanation. Regardless of whether any addiction is a disease or a choice, the need for treatment, help recovering, and lifestyle changes remain the same.