Is Drug Addiction a Disease? Evidence and Expert Views

Introduction

The question of whether drug addiction should be considered a disease has generated significant debate among medical professionals, policymakers, and the public. This paper argues that drug addiction should be classified as a disease, drawing on research from leading experts and major public health institutions.

Alan I. Leshner, Director of the National Institute on Drug Abuse (NIDA), describes a pattern familiar to many: an individual who first experiments with an addictive drug such as cocaine — intending to try it only once — "enjoys the drug's euphoric effect so much that in ensuing weeks and months he uses it again — and again. But in due time, he decides he really should quit. He knows that despite the incomparable short-term high he gets from using cocaine, the long-term consequences of its use are perilous. So he vows to stop using it. His brain, however, has a different agenda. It now demands cocaine." (Leshner, 2007) No matter how hard the individual tries at that point, many are unable to resist using the drug again, consuming it beyond their own control in a compulsive and addictive manner.

Drug Addiction as a Disease

According to the National Institute on Drug Abuse (NIDA), many factors are involved in drug addiction. Drug addiction "shares many features with other chronic illnesses, including a tendency to run in families (heritability), and an onset and course that is influenced by environmental conditions and behavior, and the ability to respond to appropriate treatment, which may include long-term lifestyle modification." (NIDA, 2007)

These factors span biological, genetic, and environmental domains. Just as with other chronic illnesses, no single factor fully explains why one individual develops an addiction while another does not. The interplay of hereditary susceptibility, environment, and personal behavior all contribute to the development and progression of drug addiction.

The Public Debate Over Addiction

Alan I. Leshner, writing in a 2001 article entitled "Drug Addiction: A Brain Disease," observes that "for many years, curbing illegal drug use has become one of the most contentious and complicated public-policy issues in this country. Everyone has an opinion. One side insists that we must control supply, the other that we must reduce demand. People see addiction as either a crime, a disease, or a failure of will. None of this bumper-sticker analysis moves us forward." (Leshner, 2001)

Leshner argues that the "brain-based view of addiction" has been controversial "in part because some people wrongly think that it somehow absolves addicts of responsibility for their own behavior." (Leshner, 2001) The source of this controversy, he explains, is the mistaken belief that "biological and behavioral explanations are alternative or competing ways to understand this phenomenon, when in fact they are integrated and inseparable parts of the picture." (Leshner, 2001)

For those who have this brain disease, it cannot be said that they are "simply victims of their own genetics and brain chemistry," because while some people are predisposed to be more susceptible to addiction, "genes do not doom one to become an addict." (Leshner, 2001) This is because drug addiction begins "with the voluntary behavior of drug use." (Leshner, 2001) Furthermore, Leshner notes that the drug addict "can and must participate in and take some significant responsibility for their own recovery. This brain disease does not erase self-control, but it does significantly erode one's ability to exert control over his or her behavior." (Leshner, 2001)

The Interim and Final Reports of the Joint Committee of the American Bar Association and the American Medical Association on Narcotic Drugs, published under the title Drug Addiction: Crime or Disease?, offers an authoritative definition from the World Health Organization:

"Drug addiction is a state of periodic and chronic intoxication detrimental to the individual and to society, produced by the repeated consumption of a drug (natural or synthetic). Its characteristics include: (1) an overpowering desire or need (compulsion) to continue taking the drug and to obtain it by any means; (2) a tendency to increase the dose; and (3) a psychological and sometimes physical dependence on the effects of the drug." (Ploscowe, n.d.)

Conclusion

This paper has demonstrated, according to the relevant experts, that drug addiction is a disease and not simply a choice made by an individual to become addicted to drugs. Drug addiction, much like other diseases, often develops gradually, with the individual unaware that they are becoming addicted. Drug addiction has been understood as a disease for many decades, just as alcoholism is recognized as a disease to which some individuals are genetically predisposed and which can be influenced by environmental factors.

However, drug addiction — like alcohol addiction — begins with the voluntary use of the substance to which one becomes addicted. Just as in treating and recovering from alcohol dependence, the individual who is addicted to drugs must take responsibility for their own recovery and must exert effort to regain control over their life. The disease classification does not eliminate personal agency; rather, it provides a more accurate and compassionate framework for understanding addiction and for designing effective treatment and public policy responses.

References

Leshner, Alan I. (2007). Oops: How Casual Drug Use Leads to Addiction. National Institute on Drug Abuse. Retrieved from http://www.nida.nih.gov/Published_Articles/Oops.html

Ploscowe, Morris (n.d.). Drug Addiction, Crime or Disease? Interim and Final Reports of the Joint Committee of the American Bar Association and the American Medical Association on Narcotic Drugs. Schaffer Library of Drug Policy. Retrieved from http://www.druglibrary.org/SCHAFFER/library/studies/dacd/appendixa_3.htm

Addiction or Chronic Disease (2005). National Institute on Drug Abuse. Retrieved from http://www.nida.nih.gov/about/welcome/aboutdrugabuse/chronicdisease/

Leshner, Alan I. (2001). Drug Addiction, a Brain Disease. Issue 106, 11 July 2001. Retrieved from

Drug Abuse: A Preventable Behavior, Drug Addiction: A Treatable Disease. (1997). HealthWise, July 1997. Retrieved from http://www.nih.gov/news/HealthWise/Jul97/story4.htm

Drugs, Brains, and Behavior — The Science of Addiction (2007). National Institute on Drug Abuse. Retrieved from http://www.drugabuse.gov/scienceofaddiction/

The Disease Concept (2007). Alcohol and Drug Treatment Referrals. Retrieved from http://www.alcohol-drug-treatment.net/disease_concept.html