Is Addiction A Disease? Let’s Find Out.

There are varied opinions about what addiction really is and how people should perceive it. Originally viewed as a ‘choice’, researchers are beginning to discover that addiction is indeed a disease. What should we know about substance use disorders, and how should we respond to this information? Read to learn more.

People’s relationship with addictive substances dates back to the earliest human records. Drugs were used for religious purposes, as a means to medicate, or for recreation. The pathology of substance use has been discussed as far back as the 17th century. However, our understanding of addiction is gradually evolving. The development of how we perceive addiction is helping us to refine our treatment, and find more options that work.

Addiction: Two Schools Of Thought

Is addiction a disease or choice? There are two ‘opposing’ sides about how many of us view addiction. On one end of the spectrum, addiction is considered a choice. The blame is entirely placed on the sufferer, and getting out of it should be an act of sheer will. On the opposite end, addiction is a disease–people just can’t help it and they need medical intervention to get better.

Understanding popular beliefs

What comes to mind when we hear the word “addict”? Is it someone in the streets with shabby clothes and unkempt appearance, or is it someone in the workplace–a professional walking with a white collar and a dignified posture? Addiction doesn’t spare anybody–it can affect anyone regardless of status, race, gender or social background.

However, the stereotype that addiction is a result of moral failing can’t help but remain even in our modern-day mindsets. According to a survey found in Health Day, the majority still doubt, “Is addiction really a disease?” and continue to view the condition as a choice. The common popular beliefs about substance use disorder are:

• It is a personal vice. People have the choice to take substances or not.
• Treatment for substance use disorder shouldn’t become as extensive as other medical conditions such as heart problems, stroke, or cancer.
• Those who succumb to addiction lack moral integrity, thus suffering the consequences.

The reality of addiction

Popular opinion doesn’t mean it is necessarily true. In fact, the reality of addiction is complex. We may attempt to view substance use disorders from a moral standpoint, but the truth is, it also has biological factors set in place. The ‘act’ of taking drugs or alcohol may look like a choice from the outside, but just like other mental health disorders, it is an inner struggle that cannot be helped.

A study found in the New England Journal of Medicine (NEJM) reports the different physical changes in the brain when a person suffers from addiction:

• Desensitized reward circuits of the brain causing drug or alcohol tolerance
• Increased reinforcement of addictive habits in response to stress
• Lower functioning of brain areas related to controlling inhibitions, decision-making, and self-regulation

To better decide how we should view addiction, we should base our thoughts on empirical evidence rather than riding the bandwagon of popular beliefs and stereotypes. If you are wondering, “Is drug addiction a disease?”, the studies of how addiction changes the brain can clear some of the myths that cause people to face stigma and refuse treatment.

Understanding The Source Of Stigma

The main purpose of why addiction is considered a disease is to find management strategies for people who need it the most. When we view substance use disorders as a ‘moral failure’ and a personal choice made by the sufferer, this is where the source of stigma stems from.

Just like how cancer cells modify the body and cause various ailments, addiction changes the brain that results in physical and psychological changes. However, we don’t view cancer patients as ‘bad’ because they had the disease. Therefore, we shouldn’t view substance use disorder patients as falling short–in a moral sense–just because they suffer from addictions.

The Brain Disease Model of Addiction (BDMA) is strongly supported by science, as it encompasses many factors that cannot be controlled by the individual. There are genetic, psychological, and even specific bodily components that are contributing factors to the development of addiction.

Merging What We Know

Despite the support of scientific evidence about BDMA, many are still backing the belief that addiction is a choice. With how popular media, news, and accounts of others portray substance use disorder sufferers, it is quite understandable why. The general public still seems to be unprepared to view addiction as an actual illness due to years of media influence regarding addiction.

What is the best way we can learn from this?

When you are armed with emerging scientific-based information versus old beliefs, the ideal route to take is to combine all the things you know to find ways in helping those with addictions.

Ignoring common opinion that addiction is a choice also isn’t beneficial. When we don’t acknowledge that many people think this way, it does not give us the opportunity to educate others. If you are suffering from substance use disorder, have a loved one who is, or an advocate for addiction treatment, developing a well-rounded understanding of this condition can help you make a positive impact.

By explaining how people haphazardly judge those with addictions, and what science really says, we can convince ourselves–and others as well, to get the treatment needed.

Addiction As A Disease: Why And How

Starting addiction treatment is just the beginning of a journey, but many do not realize how the road to recovery can be painstakingly long. Loved ones may lose patience, and substance use disorder sufferers may quit attempts to recover after some relapse.

However, understanding why is addiction a disease can also help those on the brink of giving up–to try just one more time.

Why is drug addiction considered a disease?

• Addiction is caused by environmental and biological factors. Genetic factors contribute to almost half of the reason why some people end up abusing substances and others don’t.
• Substance use disorders present physiological and psychological complications. Untreated addictions don’t just cause ‘cravings’ that can be controlled by choice, they can also pose long-term effects on one’s physical and mental health.
• The chemical changes in the brain are long-lasting. A person who has moderate to severe substance use disorders may go through chemical changes in the brain that leave them vulnerable to triggers. Chronic stress is one well-known trigger for addiction. These are often causes for relapse, which is the biological reason why some find it extremely difficult to quit altogether.
• Addiction is a chronic condition. Substance use disorder is a condition that can be managed, but it is not an illness with a one-stop cure. Many patients require long-term rehabilitation, aftercare, and constant monitoring, just like other chronic health diseases.

It can help us to understand how addiction is a disease within the lens of treatment.

How is addiction a disease?

• The effects of drug withdrawal must be medically supervised. It is not advisable for people to quit alcohol or drug use abruptly. For example, sudden withdrawal can cause death in people suffering from opiate abuse. Persistent vomiting and diarrhea may cause dehydration and heart failure.
• Other medications may be necessary to ‘flush out’ addictions. Similar to other diseases requiring medications, drug abuse patients may need antagonist drugs in order to remove the effects of addiction in the body. This can help taper off the effects of withdrawal.
• Effective treatments are comparable to those for mental health disorders. Patients with dual diagnosis conditions (such as addictions and mental health problems) often benefit from management plans with psychotherapies, counseling, and lifestyle changes. If these evidence-based treatments for mental illnesses are also effective in the angle of addiction, this suggests that substance use disorder is a brain pathology rather than an ‘act of will’.

Treatment For Addiction

Understanding the whole context of how and why addiction is a disease allows us to create a checklist of things that should be addressed during substance use disorder treatment.

The biological factors that surround addiction can be managed through medical supervision and drug detox. By treating the chemical component that affects the brain, it is easier to eliminate dependency on drugs and alcohol. The psychological issues that plague the sufferer can be addressed through research-backed psychotherapies and counseling. These strategies help in identifying triggers and past trauma while devising effective plans to fight the urge to take substances.

The social context of addiction may be addressed through family therapy and support groups. These settings eliminate thoughts of being stigmatized as well as educate family members on how to help in recovery.

Spreading Awareness: Help Break The Stigma

If you have been initially wondering, “Is drug addiction a disease or a choice?”–it should be clear to you by now that addiction is indeed a disease. By spreading awareness on how addiction can affect the brain and the body as a whole, we can help individuals break free from the stigma and get the treatment they deserve.

• NCBI – Historical and Cultural Aspects of Man’s Relationship With Addictive Drugs
• Health Day – Drug Addiction Seen As ‘Moral Failing’, Survey Finds
• NEJM – Neurobiologic Advances from the Brain Disease Model of Addiction
• NIDA – Addiction Science
• Dianova – Stigmatization of People With Addictive Disorders
• NCBI – Chronic Stress, Drug Use, and Vulnerability to Addiction
• Wiley Online Library – Yes, People Can Die From Opiate Withdrawal