Addiction is a disease

[Dancing David]

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.

Psychology can be a science, but that does not mean everything called psychology is science. Any more than alternative medicine is science.

Paging Mercutio, paging Mercutio.

 

[skeptifem]

I have heard AA people say its a disease, but not psychologists ????

I tried to find something on the american psychological association website about it, but they refer to it as 'substance abuse disorders" repeatedly.

 

[Dancing David]

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.

Thank you, the standard of care applies wether you have a disease like schizophrenia or a biologicaly/behavioraly intermix of behaviors like addiction.

Personal responsibility rocks!

 

[Dancing David]

So what that comparison is still bogus.

Suppose I'm a chocolate connoisseur and eat chocolate all day long. I'm subject A.

Subject B is a person that never eats chocolate.

Now you get a fMRI or PET of both of us while eating chocolate. My brain scan will be different than his, because over all the years of chocolate eating I've formed a lot more synaptic connections than subject B has related to chocolate.

So the results of that scan are meaningless. However, I've repeatedly heard so-called scientists and their lawyer cronies claim that this imaging difference proves that its a "disease process" and therefore the person cant control their own actions or behavior.

That is the nature of expert testimony, which is not related to the biological basis of human behavior. There are many alcoholics who are not 'type two' alcoholics. There are those who have less of a biological vulnerability to alcoholism.

The fact that some people in a court use something does not invalidate what the rest of the people in the world are doing.

PS The only behavior an addict has a hard time controling is thier use. They can choose to avoid use, that is what relapse prevention is all about.

 

[Dancing David]

For example, drunk drivers should IMO be given jail sentences, even for first offenses.


Now you know that that would be almost impossible for all drunk drivers to be given jail sentences, while its just considered a misdemeanor, 364 days in jail, most offenders pay a fine and go on their way. If they do a weekend in jail, they continue to drink, it doesn't change their ways.

The fact that our court system chooses to treat it that way does not excuse the behavior. They should loose thier license for the second offense, period. No excuses, if they own the car it should be impounded.


unrelated rant

Alcohol is a real problem when people drive. Assault should not be a misdemeanor either. But hell we will continue to act as though cocaine is the real problem and put millions of people in prison for that and the alcohol manufacturing and distribution system will continue to support the most lethal substance of abuse.

 

[Dancing David]

Diabetes is a result of lifestyle in some cases and not the lifestyle itself. "Alcoholism" is simply drinking too much alcohol. If someone gets cirrhosis of the liver, pancreatitis, polyneuropathy, alcoholic dementia, heart disease, increased chance of cancer, nutritional deficiencies or sexual dysfunction from drinking too much alcohol then those things can be considered diseases. But "alcoholism" itself can't. Moreover, Addiction can simply be ended by not drinking anymore.

That is why i said that the disease model is a trick, the point is you have to not drink or use. It isn't simple at first but it becomes so.

All of your studies do nothing but argue that addiction can be genetically predisposed to specific individuals. This doesn't mean it's a disease. CRIME and VIOLENCE can be genetically predisposed to specific individuals. Is crime a disease now? If it's a disease why punish violent criminals? After all they just suffer from a disease!

Predisposition is a dangerous word, i prefer vulnerability..

I belive in incarceration for those with mental illness as well.

 

[Dancing David]

So are all pathological criminals diseased? Should we then punish them?

No they are not, some have learning disorders, some have mental illness, some have ADHD and other mental illnesses, most have screwed up lives and unhealthy patterns of behavior.

And yes we should punish them.

 

[Dancing David]

Do you question whether schizophrenia is a disease as well?

No.

If somebody kills under the influence of their schizophrenic condition, should they go to jail?

Yes. Most people who murder due to psychopsis know about treatment and are avoiding it.

If somebody has any neurological condition which influences their behaviour, should they be released into society?

Judicial choice.

These are not simple questions.

The standard of care applies in most cases.



[/QUOTE]

 

[Dancing David]

They're simple questions. Is schizophrenia a disease? Yes.
Should people with schizophrenia be punished like other criminals? No.

I disagree, maybe they should be in a forensic psych unit but they should be treated just like everybody else.

Should people who have neurological conditions which influence their behavior be free to live in society? Only if the conditions influence on their behavior doesn't make them violent.

Unless they are brain damaged that is highly unlikely, and even then siezure medication will usualy control it.
The only people I know who are legaly excused from their behavior, and they can still go to jail, are those with severe autism and developmental disability. I suppose dementia as well.

 

[Dustin Kesselberg]

Mabey, does it matter? Should an alcoholic who is a drunk driver be treated differently from someone else who drives drunk?

No. Alcoholism isn't a disease.

 

[ponderingturtle]

No. Alcoholism isn't a disease.

So a predisposition towards violence should be a mitigating factor, but a predispoistion towards abuseing alcohol should not be a mitigating factor?

Why?

 

[Dustin Kesselberg]

So a predisposition towards violence should be a mitigating factor, but a predispoistion towards abuseing alcohol should not be a mitigating factor?

Why?

I never said a predisposition towards violence should be a mitigating factor.

 

[Earthborn]

Do all pathological criminals have diseases?

Yes, by definition. "Pathology" means "disease".

 

[Dustin Kesselberg]

Yes, by definition. "Pathology" means "disease".

The word I meant to use is 'persistent'.

 

[Earthborn]

The way I see it (coming from a predisposed addict), is by asking the biological question: how does this genetic disposition benefit someone? If there are benefits, how can it be a disease?

That's not a useful way of looking at it, because many things you have no trouble recognising as diseases also have benefits. Whether some genetic predisposition becomes a disease or a benefit depends on the circumstances.

An example: dark skinned people have the benefit of being better protected against sunlight. If they move to a place with less sunlight, they run the risk of serious vitamin D deficiency. Vitamin D deficiency is a disease, even though the genetic predisposition to a high risk to it benefits millions of people worldwide.

 

[Twilek]

I looked at my psychology textbooks I've kept over the years. It's not defined as a disease after all. If someone really wants me to, I'll take pictures of the pages; there is some good information within the book.

Way too much for me to type out however.

That reminded me, I believe I've encountered that as well. I have a friend who is a psychiatrist and when I read about this in his books it said basically that you should treat the patient as if it is a disease. Meaning, if you tell someone they are sick and lay out a treatment plan for them, they will respond to the advice more positively than telling them the only way to stop being addicted is to just start saying "no". Obviously I'm paraphrasing, but the way it was worded in the book made a lot of sense.

 

[TellyKNeasuss]

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.

About 15 years ago, I was one of the "guinea pigs" for a prototype alcohol abuse prevention program at a university that I was a grad student at. Their finding was that the percentage of cases in which only 1 of a pair of identical was an alcoholic was statistically equal to the percentage of cases in which only 1 of a pair of fraternal twins was an alcoholic.

 

[chris epic]

That's not a useful way of looking at it, because many things you have no trouble recognising as diseases also have benefits. Whether some genetic predisposition becomes a disease or a benefit depends on the circumstances.

An example: dark skinned people have the benefit of being better protected against sunlight. If they move to a place with less sunlight, they run the risk of serious vitamin D deficiency. Vitamin D deficiency is a disease, even though the genetic predisposition to a high risk to it benefits millions of people worldwide.

Thats a good point, but I don't see how that justifies addiction as a disease. And it's rather screwey logic when using it with the addiction problem.

 

[chris epic]

You simply stopped using and overcame your addiction and then decided to do something constructive. You didn't "replace" your addiction for meth with an addiction for education.

Dustin, you dont have a clue buddy I said compulsion, not addiction- it was my compuslive behavior that contributed to my addictions, it is my compulsive behavior that threw me into a thousand constuctive, non-substance replacements. If you honestly think you can draw any conclusions on my life by reading a few of my posts, you're sadly mistaken

 

[Skeptic Ginger]

Why punish them if they can't control their actions? If they have a disease then they aren't responsible for their actions. How can you punish them?

How does having a disease = being unable to control it?

This is the crux of the matter. When the medical community views a problem such as addiction using a disease modal, an incorrect assumption is made by many people that disease means "can't stop yourself". That isn't what the disease model means. If I have a disease, there are many things about it I can control and some I cannot.

The point of using the disease model is it results in avenues of investigation that lead to solutions. Using the premise addiction is a personal failure generally results in a cycle of perpetuating the problem.

At the same time, if research into addiction and other sociopathic behaviors does uncover evidence the behavior is not controllable, then isn't it better to know that than to just keep letting people out of jail after a crime, using the false premise they have the ability to control their behavior?

Some sociopathic disease exists which still leaves the person with a brain defect but they do have control over their behavior. Just as someone with rheumatoid arthritis must live with the unpleasant consequences of their disease, a person with a sociopathic disease may suffer severe emotional consequences controlling their disease. It might mean a pedophile must restrict his movements and cannot be around children ever. But without recognition of the disease factors in that pathological condition, we simply expect that person to control themselves or go to jail. I expect them to control themselves or go to jail as well but medical research may give that person better tools with which to control the behavior. And where research discovers how to detect the dangerous pedophile from the responsible one, we will also have the tools to mandate incarceration in a treatment facility.

Same with determining through research rather than through social stigma who can and who cannot control their addiction. If meth addicts suffer brain damage which disables their ability to recover, then they need long term inpatient treatment. Alcoholics very often need antidepressant medication.

The point is, medical research can sort out fact from moral judgment and with that provide better tools to stop sociopathic behavior before crimes are committed rather than merely providing the revolving prison door and a lot of harmed bystanders.