Addiction is a disease

[chris epic]

So SCIENCE is saying that addiction is a disease, thanks to phychologists. Frankly this is absolute rubbish. First of all, I have been an "addict" and although I have overcome alcoholism and drug abuse, I still demonstrate an "addictive personality."

I even used to buy in to the whole "disease" thing, especially with time spent in AA.

When the idea started to really get me thinking is when I heard pseudo-celebreties and others on television who were caught in a scandal involving drug or alcohol abuse saying "Wow, yeah, you know, its a disease..."

But the insinuation is very easy to see "I just can't help it, I have no control over it"

This is undoubtably a psych trick used to manipulate an audience into sympathy, justify personal choices that were unpleasing to others, or bluntly prohibiting people from taking personal responsibility for their actions.

The bottom line: in most cases, no one forced you to take that first sip or use that first dose when you were completely sober, regardless of your emotional state.

This could very easily get into a free will/determinism argument. I will be the first to admit that my genes and my environment may very well make me more likely than others to abuse substances, but that doesn't keep me out of the clear for being accountable for my mistakes- my police record and the bridges I have burned in the past attest to this.

Also, identifying addiction with disease makes it easier for the loved ones of those who use and abuse to cope with the crisis.

But what is the bottom line? Is it a disease? I dont think so.

 

[Skeptic Ginger]

Addiction is a complex problem. While no one "forces" people, one doesn't typically become an addict after using a substance once. When a threshold is crossed, that's when addiction starts. That threshold differs for people and for the substance one becomes addicted to. There also seems to be significant differences in recovery based on the substance and obviously based on the person.

Society doesn't do well with deciding what to do with addicts. Arrest them or put them in detox, we simply don't address the problem as the science suggests we should because there is this element of freedom in there. I'd love to see people sent to drug treatment with longer mandatory commitments with each relapse but it will never happen. Too many social issues get in the way.

 

[Dancing David]

I agree , addiction is a set of behaviors. However some people do seem to have a higher biological vulnerability and the effects of substances are physical and do have an impact on a physical body.

I think the main point to the disease model is to remove the 'moral' element of addiction, in that addicts are not morally inferior, they do not lack will power. They suffer from a behavioral disorder that can be very biologicaly driven.

(Including the wierder forms of non-biological addiction, like gambling. There is usualy a biological cycle in there. It is called a human body.)

 

[Dancing David]

This is undoubtably a psych trick used to manipulate an audience into sympathy, justify personal choices that were unpleasing to others, or bluntly prohibiting people from taking personal responsibility for their actions.

.

I would say that the big trick, and I will grant you there is one, is that it is to get the addicts to admit they can't control the behavior.

If an addict views it as a lack of spiritual connection then they will fail, bacause that's not the problem.(Even though AA mislead people there, religion is a coping skill not the path.)

If the addict views it as a will pwoer issue they will fail. The problem for most addicts is that they compare themselves to other people and they make value judgements like "They can use and it doesn't get out of control" and they end up trying to control thier use. The problem there is they can't control thier use, the minute they base thier recovery on use they are lost. (Although the course will vary after they dry out and have a long period of abstinenece).

Jack Trimpey and AA agree on one thing, if you are an addict you must not use, no matter what. The disease model is mainly a trick to get people to accept that. If they view it as a moral or will power issue then they will continue down the wrong path and they will keep drowning themselves in the shallow water.

 

[Dustin Kesselberg]

The idea that "addiction is a disease" buys into that whole philosophy that no one is responsible for their actions due to their genetic circumstances. The same argument is sometimes made for pedophiles, that they are genetically predisposed to sexual attraction to children and can somehow be "cured" of it. I believe it's all nonsense. Whether someone is predisposed to specific emotions or actions is another question, but whether they can or can't control their actions is what is important.

People who are addicted to alcohol or other drugs like to make up the excuse that they suffer from a "disease". Addiction is as much of a disease as is being selfish or being an *******. Addiction is people giving into their desires even though they know they should not be. I sometimes have the desire to punch people in the face when they get on my nerves, but I don't do it. Other people do punch others when they get annoyed. Those people are the same kinds of people who lack self control in other aspects of their life as well.

Are we now living in an age where there is no such thing as self-responsibility anymore? No such thing as any responsibility? I for one am sick and tired of the insanity plea and the "but it's a disease!" excuse.

 

[lionking]

I would say that the big trick, and I will grant you there is one, is that it is to get the addicts to admit they can't control the behavior.

If an addict views it as a lack of spiritual connection then they will fail, bacause that's not the problem.(Even though AA mislead people there, religion is a coping skill not the path.)

If the addict views it as a will pwoer issue they will fail. The problem for most addicts is that they compare themselves to other people and they make value judgements like "They can use and it doesn't get out of control" and they end up trying to control thier use. The problem there is they can't control thier use, the minute they base thier recovery on use they are lost. (Although the course will vary after they dry out and have a long period of abstinenece).

Jack Trimpey and AA agree on one thing, if you are an addict you must not use, no matter what. The disease model is mainly a trick to get people to accept that. If they view it as a moral or will power issue then they will continue down the wrong path and they will keep drowning themselves in the shallow water.

I believe that "addiction is a disease" is a cop out. I speak as someone with an alcohol problem currently under control. I have heard researchers say that abstinence from alcohol for a period of more than 12 months can lead to control of the addiction, but I haven't been dry for 12 months yet so cannot say.

Gambling is an equally serious addiction, but what could be the biological basis for this? If something is a disease, surely there must be some biological basis. Or am I wrong on this???

 

[Soapy Sam]

I feel the word is used too widely and comprises several rather different problems.

I'm an oxygen addict. Can't live without the stuff. Tried. Couldn't go two minutes.

Is this a disease? It's unquestionably biological. Extreme discomfort is experienced by removal of the substance. Prolonged withdrawal results in death.
Sounds disease-ish to me.

Alcoholism may have an element of this, because some folk do lack the enzymes to safely metabolise the stuff. In their case, there seems to be a parallel.

But there are also, obviously, differences.

It's clear alcoholics recover only when they take responsibility for their own behaviour. That doesn't sound like disease to me. It sounds like exerting the will.

If viewing a behaviour as an illness makes it easy to treat / cure / alleviate, well, call it an illness by all means.
But if that's not the case, I'd prefer to call it behaviour and tackle it from that angle.
Words are tools, not straitjackets.

 

[lionking]

I feel the word is used too widely and comprises several rather different problems.

I'm an oxygen addict. Can't live without the stuff. Tried. Couldn't go two minutes.

Is this a disease? It's unquestionably biological. Extreme discomfort is experienced by removal of the substance. Prolonged withdrawal results in death.
Sounds disease-ish to me.

Alcoholism may have an element of this, because some folk do lack the enzymes to safely metabolise the stuff. In their case, there seems to be a parallel.

But there are also, obviously, differences.

It's clear alcoholics recover only when they take responsibility for their own behaviour. That doesn't sound like disease to me. It sounds like exerting the will.

If viewing a behaviour as an illness makes it easy to treat / cure / alleviate, well, call it an illness by all means.
But if that's not the case, I'd prefer to call it behaviour and tackle it from that angle.
Words are tools, not straitjackets.

Well said Soapy. A clear view on a complex subject.

 

[ponderingturtle]

The first thing is that disease is not a very well defined word in common use. What of these are diseases and what are not

Influenza
Cancer
Allergies
ADD
Addiction
Schizophrenia

Also there is the point that people feel compulsions at different intensities, so what is a minor act of will for one person is much harder for someone else, so the first might view the second as weak, but they are not resisting the same urge.

It is sort of like is obesity a disease or a personal failing? Well it can be either one. Some people are physically incapable of being a normal weight, others are psychologically addicted to food(and for the alcoholics here, imagine if you had to drink just a little every day), others just don't care.

So until we get a well defined definition of disease, we can not address addictions relationship to disease.

 

[Solus]

It's called disease because the person is more prone to that undesirable behavior. It makes them vulnerable to abuse of the action be it gambling or alcohol. It requires some special steps to address the problem. I agree just saying I have disease, I can't get better and this is the way I am is no good. Leave it to the media to distort everything.

It's a disease the sense that it's heredity also.

 

[ponderingturtle]

It's called disease because the person is more prone to that undesirable behavior. It makes them vulnerable to abuse of the action be it gambling or alcohol. It requires some special steps to address the problem. I agree just saying I have disease, I can't get better and this is the way I am is no good. Leave it to the media to distort everything.

It's a disease the sense that it's heredity also.

So everything on my list is a disease then.

 

[Solus]

So everything on my list is a disease then.

Sorry, not feeling well enough right now to look into my old books check what psychology defines as a disease. Doesn't matter what you think it should be called if that's what it's called. Someone in a more feisty mood might come on though, and address this with a good source. I'll just use a really junk source: http://en.wikipedia.org/wiki/Disease

There you go.

This was decided long before I was born and probably before you were.

 

[Dymanic]

So SCIENCE is saying that addiction is a disease, thanks to phychologists.

Wait... psychology is a SCIENCE?

 

[ponderingturtle]

Sorry, not feeling well enough right now to look into my old books check what psychology defines as a disease. Doesn't matter what you think it should be called if that's what it's called. Someone in a more feisty mood might come on though, and address this with a good source. I'll just use a really junk source: http://en.wikipedia.org/wiki/Disease

There you go.

This was decided long before I was born and probably before you were.

So oddly enough I think from the way you are defining disease a car accident counts.

 

[Twilek]

I had this argument with someone a while ago. He went so far in the defense of the "it's a disease" statement that he suggested that, because some people are pre-disposed genetically to have alcoholism, they could therefore be said to be alcoholics even if they never have a drink. Needless to say, I found that a bit absurd.

 

[yersinia29]

Psychology is mostly quackery and non-scientific, but psychiatry is not that much better.

The problem is that the brain is incredibly hard to study, much different than a heart or a lung. We know nohting about how the brain works, so as a result we stumble in defining disease vs behavior for all these psychological issues.

And I'm so freaking sick of people using MRIs and CT scans to "prove" that something is a disease. Yes, your brain lights up differently when you drink alcohol vs when you are sober. So what. Your brain also lights up differently when you eat chocolate vs eating bread, does that mean eating chocoloate is a pathological process? Of course not.

Your brain lights up differently for every single thing you do. When you are doing laundry, your brain lights up very differently than when you are sleeping. So lets please drop the sensationalistic crap with brain imaging "proving" anything at all.

 

[Pup]

Of course people jump on the bandwagon of "it's a disease so it's not my fault" or "it's a lack of willpower so it's all your fault," to further whatever agenda they want.

But I think there are a lot of conditions which, like addiction, are a mixture of disease and voluntary behavior. We just don't usually think of them in those terms.

To take a really basic example, say a person has a disease in a joint that makes normal movement painful but possible. There's no doubt they have something physically different than other people, that causes restricted movement in everyday life. But there's also no doubt that in theory, if offered say $1000 to move the joint through its full range of motion without showing any outward signs of pain, they could do so, through sheer willpower.

So I watch a video of them winning the $1000, not realizing what I'm seeing, and conclude I'm watching a person free from disease, who can move like anyone else. What I'm not aware of is the amount of willpower it's taking them to do it.

When I find out the truth, I think, if they can move normally, why don't they just do it all the time? The symptoms of their disease would disappear if they just had more willpower.

And that's literally true.

But it's also true that to move normally would require them to expend way more effort than the average person. If they can't muster up that willpower, then what? Should they do it anyway, because life isn't fair, sucks to be them, but there's no excuse to be a weakling? Or is it okay for them to fail, because the disease makes it so hard?

No simple answer.

 

[UserGoogol]

And I'm so freaking sick of people using MRIs and CT scans to "prove" that something is a disease. Yes, your brain lights up differently when you drink alcohol vs when you are sober. So what. Your brain also lights up differently when you eat chocolate vs eating bread, does that mean eating chocoloate is a pathological process? Of course not.

Eating chocolate is a biological process. The way I see it, a disease is simply a bad biological process. The act of eating chocolate is merely not very harmful, so it's not a disease. The mind is biological, so whatever the mind does that is bad is a disease. If you're a jerk, (and coincidentally, there is sometimes a link between alcoholism and jerk-like behavior) then that's a sort of mild mental illness you have.

I think the problem is that people put free will on a pedestal that it really doesn't deserve to be on. People don't really like to admit that willpower is simply another part of the brain, so when people find out that something is caused by some sort of problem with the brain, they feel that free will is simply out of the picture. This really isn't the case.

There are two ways to solve a brain problem, from the inside through will power, or from the outside through medical treatment. It so happens that alcoholism is a problem where dealing with the problem from the inside is extremely necessary. But it still seems valid to call it a disease.

 

[Skeptic Ginger]

The idea that "addiction is a disease" buys into that whole philosophy that no one is responsible for their actions due to their genetic circumstances.

Not necessarily. I can have the disease of diabetes and choose to take care of myself or not. Having the disease is not an excuse to ignore its consequences.

The same argument is sometimes made for pedophiles, that they are genetically predisposed to sexual attraction to children and can somehow be "cured" of it. I believe it's all nonsense. Whether someone is predisposed to specific emotions or actions is another question, but whether they can or can't control their actions is what is important.

People who are addicted to alcohol or other drugs like to make up the excuse that they suffer from a "disease". Addiction is as much of a disease as is being selfish or being an *******. Addiction is people giving into their desires even though they know they should not be. I sometimes have the desire to punch people in the face when they get on my nerves, but I don't do it. Other people do punch others when they get annoyed. Those people are the same kinds of people who lack self control in other aspects of their life as well.

This reflects a very naive understanding of genetically determined behavior. That includes genetically predisposed behaviors which then may or may not be triggered or need to be triggered in order to be acted out.

We know that male identical twins raised apart have higher correlation of alcoholism than fraternal twins raised apart. And for some reason this does not appear in female twins raised apart.

I have an un-neutered male and female dog. The female is in heat. There is no way you can watch that male dog whine night and day and literally stop eating for a couple of the worst days and not recognize this is biologically determined behavior. They also have some pretty strong hunting behaviors no one taught them such as sniffing out underground moles and digging like crazy, sometimes successfully catching them.

Pigs have addictive behaviors when you offer them the choice of certain drugs or food. Some animals will starve to death choosing drugs over food.

You can find a wealth of Addiction Research at Brookhaven including the following studies:

Gene Therapy Reduces Drinking in Rats with Genetic Predisposition to “Alcoholism”
Finding confirms earlier result using better model for human alcohol abuse

Methamphetamine Delivers ‘One-Two’ Punch to the Brain Mechanism may knock out brain’s ability to “just say no.”

Researchers Document Brain Damage, Reduction in Motor and Cognitive Function from Methamphetamine Abuse; "Speed" Shows More Neurotoxic Effects Than Heroin, Cocaine, or Alcohol

MAPPING THE ROOT OF COCAINE CRAVING: SURPRISING FINDINGS ON DRUG'S EFFECT IN BRAIN REGIONS

Here are some more studies just to give you an idea, you can use the scientific process to reach a better understanding of the complexity of addiction rather than a judgmental moralistic knee jerk reaction.

Mouse Models for Addictions

Decades ago, researchers first tested laboratory strains of rats and mice for specific addiction traits, such as high preference for certain drugs or alcohol. Since individuals within a laboratory strain are virtually identical, they all have the same addiction profile. But researchers discovered that individuals from different strains had vastly different addiction profiles. This was one of the earliest clues that addiction has a genetic component.

Addiction research in a simple animal model: the nematode Caenorhabditis elegans.

The Neurobiology of Addiction Research Center (NARC)

Genetic determinants of alcohol addiction.

Substance Abuse Among Women: Familial Factors and Comorbidity (pdf file)

Are we now living in an age where there is no such thing as self-responsibility anymore? No such thing as any responsibility? I for one am sick and tired of the insanity plea and the "but it's a disease!" excuse.

See previous comments and perhaps consider dismounting from your moral high horse.

 

[Skeptic Ginger]

I believe that "addiction is a disease" is a cop out....

It's only a cop out if you consider having a disease is an excuse to ignore it. Declaring addiction a moral failure provides nothing in the way of prevention or treatment. Labeling addiction a disease does not mean as a disease the person is exempt from responsibility for their behavior. Would you exempt an epileptic from responsibility who chose to drive despite not having their seizures under control?

Wasting time on matters of blame and disgust merely detract from where we should be spending time, that is conducting research for cures and treatment, as well as educating young people about triggers and thresholds instead of telling them stupid things like marijuana is a gateway drug. Drug abuse education should be evaluated for its effectiveness and we need to be willing to let go of the methods which fail. Preventing addiction is easier than treating it.

What we could do better is define the aspects of addiction which are disease and those which are the results of behavior the disease affects but for which we still hold the addict responsible. For example, drunk drivers should IMO be given jail sentences, even for first offenses. Second offenses should result in mandatory treatment for alcoholism because we know from research people with 2 DUIs are almost all alcoholics. There can be some exceptions but even then, you are probably looking at an addict that just hasn't crossed the threshold yet, triggering the disease.

If you only look at the personal responsibility, you get a person who is in all likelihood, going to re-offend when released from jail. If you only look at the illness, you get a person who's addiction does indeed result in harm to others and you don't hold the person accountable. Both aspects of addiction need to be addressed. Unfortunately we tend to only address the behavior and fail to require mandatory treatment. Yet we know from research, the addiction affects judgment. It's an unscientific approach.