A Response to a Question About Addiction and Disease Model

Addiction is not simply an extension of bad habits, or else every person who drank wine would be an alcoholic and every person who tried pain killers after surgery would grow into a heroin addict. The truth is that some people are susceptible to addiction and others are not, and the only factors that can account for the individual differences in reaction to addictive substances are those that are biological in nature. Therefore, addiction is clearly a disease and should be researched and treated as such. Many sources have been presented showing that addiction is not a disease, primarily due to backlash against the Twelve Step movement or some other distaste for the underlying principle of the disease model. Yet consistently the research points to the inability of addicts to manage their addictions in ways that are compatible with cognitive-behavioral therapy and other interventions that circumvent the disease model.

According to the American Society for Addiction Medicine, "addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry." As a primary disease, addiction is not an extension of some other underlying issue. Rather, addiction can exist independently of other problems. Moreover, addiction is a chronic disease in that it can last a lifetime if left untreated and does not flare up only to suddenly subside. People who temporarily use drugs for whatever reason and then give them up are not addicts; whereas persons with the addiction disease can never truly stop using. One of the reasons why addiction is confused with behavioral dysfunction is that it resembles basic behavioral issues. Yet the difference between addiction and other bad habits is that addiction signals fundamental changes in brain structure or chemistry: the circuits of neurological activity. "Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations," (American Society for Addiction Medicine, 2011). Addiction is about the "underlying neurology," which is why it is classified officially as a disease and not as a behavioral problem ("Addiction Now Defined as a Brain Disorder, Not Behavior Problem," (2011).

It is tempting to presume that the addiction model is a hoax based on the need for funding for treatment. After all, classifying addiction as a disease warrants funding for programs and treatments. If addiction were simply classed as a bad habit, then it would be harder to secure funding. The conspiracy theory point-of-view clouds over the core facts: addiction is fundamentally different from bad habit. A professional psychologist or psychiatrist can make a diagnosis that differentiates between a person who simply uses drugs or alcohol too much but who can also stop, and a person who uses drugs or alcohol but who cannot stop due to the disease. It is politically important to recognize the disease model because addicts would otherwise lack access for treatment. As Dodes (2011) notes, the addiction model has fundamentally altered perceptions about substance abuse. No longer is there a stigma associated with the disease, but rather, the disease model enables compassion and public support. This means that persons with the disease feel more confident and capable of seeking treatment without fear of being judged or stigmatized.