Why is addiction called a disease?
The controversy on whether addiction is a disease or not has continued for a long time and is unlikely to end soon. It is one of the most popular ways of conceptualizing addiction nowadays and it is one that research has shown some very positive results in support of. However, it is worth considering why is addiction considered a disease rather than something else.
Historically, addiction used to be conceptualized from a moral perspective. It involved looking on the addict as lacking in moral fiber and having deep, intrinsic personality defects that led them to become addicted. There was a strong religious component to this idea as well. Addicts themselves were viewed with disdain, an attitude that often appears even today. However, the issue with this concept was that it did not allow for treatment or had only inhumane or ineffective treatment options. After all, there would be no point in treating someone who is lacking in morality and who is, by nature, doomed.
Thankfully, there was a shift from this paradigm, but for a very long time the moral component stayed strong. Addicts were seen as flawed human beings, so many treatments or programs were focused on shaming the individual and working solely with the issue of willpower. This approach, in general, was not effective, because it did not consider the different mechanisms of addiction and the process that real recovery necesitates.
With time and with the development of psychiatry and psychology, new and better treatments became available. More and more was discovered on addiction until the present concept of addiction as a disease was developed.
So, where did it the idea of addiction as a disease originate?
Why is addiction called a disease? Well, it has to do with the idea of mental health disorders and of physiological elements of these disorders. There is a neurobiological mechanism for addiction, involving the brain’s reward system and neurotransmitters such as dopamine. There are also changes in the brain, some of which are irrversible or at least long-lasting, that occur due to substance use and substance abuse. In short, addiction was found to have a strong neurobiological element and a mechanism for addiction that occurred in the brain.
The reward circuit of the brain releases dopamine, which makes us feel pleasure and happiness. A drug like cocaine prevents the dopamine from being reabsorbed, leading to very high dopamine levels which induce a state of euphoria. However, as time passes and the person continues to use drugs, the brain starts producing less dopamine on its own and requires the drug to feel happiness. A mechanism known as tolerance begins to act and the person’s nervous system becomes accustomed to smaller doses. The person starts taking larger doses, which does more damage and eventually may end up in a tragic outcome, such as an overdose. Different substances can affect the brain differently, but heavy use can end up in brain damage, cardio-pulmonary collapse, kidney/liver failure and so on.
So, addiction has a biological mechanism.
The person might choose to use the substance at first, but at a certain point the individual’s will power or judgment are significantly reduced due to the effects of the use.
Some studies have suggested that addiction is also genetically predisposed. This means that some individuals who consume alcohol or try a drug will not get addicted, while others have a higher likelihood of developing this disorder. A genetic component can also support the idea that addiction is a disease.
However, the element that many argue about is that addiction has a lot to do with a person’s choice and with a person’s way of thinking. Some people argue that many addicts consciously begin using substances they knew were dangerous, so can we really call it a disease?
This is the aspect in which addiction is closer to other mental disorders. While problems like depression or anxiety also have a genetic element and a chemical imbalance, emotional and cognitive aspects also play a role. Mindfulness Cognitive-Behavioral Therapy (MCBT) can be used to improve the symptoms of these issues, because they change the way a person thinks. In a way, the thought process and irrational decisions and cognitions can be linked to other mental disorders, as well as to addiction. In general, it can be said that even though addiction involves distorted thinking and decision making, often starting with poor choices, that does not mean it should be considered as a wholly different mental disorder nor that it in any way needs to be considered from a moral perspective. A person with addiction needs to receive medical and psychological help, as well as a treatment that is confidential and adequate to the person’s individual needs.
Today’s model of addiction as a disease, while strongly supported, is not without its problems and will continue to change in the future. At the moment, however, it is a model that does take into account the neurobiological elements of addiction, as well as the processes involved in this condition that make it such a dangerous problem. Specifically, the concept of addiction as a brain disease can explain why addiction occurs and why people can not overcome it without help in most cases. Looking at addiction as a disease with biological, social, emotional and psychological components, it’s possible to develop an integral treatment model that recognizes that addiction is not a choice and that it involves a problem which can not be overcome with sheer will power. The model of addiction as a disease can be used to study addiction, to understand how it appears and develops and to provide treatment, which is why it is a widely used model today.
Why is addiction called a disease? / Live Better Live Now / Houston, Texas