AA has been arguing for decades that addiction is a disease and a recent poll shows that a slim majority of Americans now believe that addiction is a disease that requires treatment. Despite the popular acceptance that addiction is a disease, there are some experts who argue the designation isn’t apt and say it even makes recovery more difficult.
The disease model of addiction has some obvious advantages. Perhaps the biggest advantage is that it’s far superior to the notion of addiction as a moral failing. It’s far more compassionate and productive to treat people with substance use disorders rather than punish them. No one is arguing for a return to temperance style thinking about demon rum and so on. Treating addiction as a disease also holds out hope of a medical solution. If the cause of addiction is physiological, perhaps the solution can be too. And, in fact, medications have played an important role in treating addiction and related conditions.
The downside of the disease model, critics argue, is that it isn’t very accurate. Although there are some genetic indicators that correlate with addiction, there’s no actual physiological abnormality that leads to addiction. In fact, in a way, physical dependence and craving a strongly reinforced stimulus are indications that your brain is doing exactly what it’s supposed to do. Your brain is supposed to adapt to a change in chemicals; it’s supposed to try to repeat pleasurable behaviors. Just as traumatic experiences can make you avoid similar situations in the future, extremely positive drug experiences make you seek more drugs in the future.
People opposed to the disease model say people with substance use disorders need to relearn certain behaviors around potentially addictive substances. They say that labeling addiction a disease creates a fixed mindset, making it harder to relearn these behaviors.
Addiction is complicated. It involves genes, trauma, motivation, opportunity, learned behavior, triggers, physical dependence, and social connection. Only some of these factors are relevant to diseases. It would be strange, for example, to say someone could overcome diabetes with the right combination of social support and motivation but both of these make a big difference in addiction. Certainly, there are aspects of addiction that can benefit from medical intervention, but perhaps we should be wary of letting medicine own the problem completely. Before-and-after brain scans of people struggling with addiction are striking, but they only show part of the picture.
The disease model does seem to work for some people. To think of addiction as a disease that makes you vulnerable to drugs and alcohol is a great incentive to abstain. There is little downside to abstaining from drugs and alcohol completely. However, there is also value in attacking addiction from many angles, including the possibility that you can learn more control over your behavior. Studies have shown that people who believe they can change and grow are far more likely to exert themselves to that end, while people who don’t believe they can change and grow are more concerned about avoiding failure.
Located in downtown Midland, The Springboard Center’s mission is to offer programs and services to treat alcohol and drug addiction treatment using an evidence based curriculum, 12 step programs, diet, nutrition, exercise, emotional, mental and spiritual development for a long recovery. For more information, please call us at 432-620-0255 as we are open 24 hours a day, 7 days a week.
