Is Drug Addiction a Disease?

¶ … drug abuse continues to be a major cause of concern in America. In fact, statistics from the most recent National Survey on Drug Use and Health conducted by the Substance Abuse and Mental Health Services Administration show that by 2012, an estimated 20 million Americans above the age of 12 were using illicit drugs or abusing psychotherapeutic medication (National Institute on Drug Abuse, NIDA, 2015). While this encompasses people of every ethnicity, geographic region, racial identity, education level, and socio economic background, many Americans view it as a major health problem particularly because it is directly linked to majority of the nation's health problems, such as cancer, HIV / AIDS and heart disease. Social problems such as child abuse, drunk driving, violence, and stress are also related to drug addiction and according to NIDA (2015), it takes a tremendous toll on the society at many levels and costs the nation more than $484 billion each year.

Compared to 30 years ago, when medical and scientific communities knew very little about addiction, today, these communities, along with other organizations and agencies, have began to acknowledge addiction not as a lack of willpower and discipline, but as a chronic and progressive brain disease. Some, however, are reluctant to describe substance abuse as a disease and they assert that if drug addiction is considered a disease, the responsibility is taken away from the drug addict, which is largely to blame for its increasing prevalence. So, is drug addiction a brain disease? This text evaluates whether drug addiction should indeed be classified as a disease that requires medicine, or it merely arises from individual choices that are influenced by improper behavior.

Drug addiction as a disease

According to NIDA (2015), drug addiction is a chronic and progressive brain disease that affects the functionality of the limbic system and cerebral cortex; which in turn results in the individual abusing a drug regardless of the harmful and often devastating consequences. Different parts of the brain are responsible for coordination, and since drugs are chemicals, they tap into the brain's communicative system and interfere with the nerve cells' ability to receive, send, and process information. NIDA (2007) explains that drugs like heroin and marijuana have chemical structures similar to those of natural transmitters and they can activate the neurons. Dopamine, a neurotransmitter in the brain that regulates emotion, motivation, movement and cognition is also affected. Once it is regulated by drugs, it produces euphoric effects that drug users seek, which leads to addiction.

The celebral cortex, also referred to as gray matter, is the part of the brain that is involved in reasoning and critical thinking. It is, therefore, responsible for a person's self-control and makes individuals act in a socially acceptable and civilized manner. Based on this knowledge, Morales and his colleagues (2015) sought to find out the role the dysfunction of the mesocorticolimbic system plays in an individual's addiction to methamphetamine. After 31 methamphetamine users and 37 control participants were studied, it was established that craving for methamphetamine was negatively related to gray matter volume, and confirmed that drugs increase vulnerability to gray matter deficiencies, which ultimately led to cravings and addictions.

Long-term drug abuse affects the brain's ability to remember, learn, and control behavior. Repeated overuse will make an individual sensitive to environmental conditions that are associated with the drug, which leads to obsessive seekings, compulsive cravings, and overuse. Moreover, NIDA (2007) claims that over time, dopamine's impact on a drug user's brain becomes low, making them feel depressed, hence they have to run back to the drug for pleasure. Moal and Koob (2006) conducted research aimed at finding out the main symptoms of addiction and the role played by stress and life events. They concluded that drug misuse is often accompanied by cormobid psychopathological conditions and classified addiction as a chronic relapsing disease.

Drug addiction as a choice

Back in the mid 1990s, scientists needed funding from politicians and companies to treat patients that were suffering from different drug addictions. They therefore came up with the 'addiction as a brain disease' rhetoric in an attempt to portray the patients as helpless victims in dire need of medical treatment (Satel, 2007). The truth, however, is that while patients with diseases such as cancer have neither control over the symptoms, nor the ability to stop the abnormal psychological functioning that creates them, drug users can choose to halt the symptoms. Despite the fact that the brain has changed, drug addicts can still choose to change their behavior.

Addiction is neither self acquired, nor is it hereditary, contagious or degenerative like other diseases. True diseases become worse if they are not treated, while drug addiction only requires stopping a behavior (Holden, 2012). For instance, a patient with cancer will not be cured if left in an empty room. A patient with schizophrenia will also not become better even when alone. However, if an alcoholic stays in a room with no alcohol for a long time, their alcoholism will subside. The fact remains that people are able to change certain behaviors without medication or surgery even when some aspects of their brain has changed.

While it remains undisputed that drugs affect the functioning of the brain, Holden (2012) asserts that these changes are not necessarily abnormal, and hence, they do not prove that addiction is a disease. Satel (2007) also claims that brain scans are not able to distinguish between impulses that can be resisted and those that cannot, which makes it inaccurate to conclude that addiction is a disease that arises from uncontrollable impulses.

Terming addiction as a disease erodes the individual's responsibility and accountability for their actions (Holden, 2012). Some drug users, in fact, are able to acknowledge that they are heading down a dangerous path and they are able to seek treatment and reform. The judgment part of the brain is not rendered completely dysfunctional because in the most troubled phases of their lives, drug users will become self-aware and attempt to fix their problems (Satel, 2007). To claim drug addiction, therefore, is to make them fully reliant on medication and to remove any form of personal responsibility.

Conclusion

In light of the views of presented by both sides of the argument, I posit that drug addiction is not a disease, it is a choice. Using drugs repeatedly changes the brain structure in fundamental ways. However, the changes are not abnormal because neurons in functional systems are able to change according to experience, and unlike diseases like cancer, treatment entails stopping certain behavior. Although labeling addiction as a disease was originally meant to rehabilitate the perception of addicts as criminals and portray them as victims, it has led to the increased prevalence of drug abuse in America because it eliminates individual responsibility and fails to identify bad choices that should be corrected.