Is addiction a disease? According to the definitions used by most medical associations, yes, and a chronic one at that. However, medical lexicon is surprisingly fluid–and remarkably biased–making addiction’s classification such a challenging endeavor. This article breaks down the terminology, how those terms have evolved, and how these concepts fit with one another in the disease model of addiction.
What Is A Disease?
Disease is a broad term that can include disorders, syndromes, infections, and disabilities. According to the Oxford dictionary, it is defined as “A disorder of structure or function in a human, animal, or plant, especially one that produces specific signs or symptoms or that affects a specific location and is not simply a direct result of physical injury.”
The formal definition of which can and has changed many times before. In fact, even the current dictionary definition varies depending on which source you use. Why does this matter? These differences highlight a crucial flaw in trying to compartmentalize the multi-faceted beast that is addiction: that health, wellness, illness, and disease are all subjective.
The Trouble with Defining Disease
Our ability to classify, categorize, and define anything is limited to the lens of human perception–not even the sciences are immune from it. Even medical terminology is influenced by societal norms, moral values, political ideologies, and the limitation on the knowledge available at the time. Whether we realize it or not, these biases color our perception, including those towards drug abuse and addiction.
The concept of “disease,” and by extension, “health”, is just as susceptible to changes as tastes in fashion or food preferences are. Take for example osteoporosis, a degenerative bone disease. Prior to 1994, the World Health Organization thought this to be an unavoidable part of growing older. Now, it’s considered a deviation from health, an abnormality, with distinct causes. As our understanding of our bodies and minds change, so will our definitions.
Making A Case: The Disease Model of Addiction
However, technical definitions are not the only things that can determine whether addiction is a disease or not. Shifts in approach and thinking are regarded as case models and can influence how a condition is viewed by society, how it’s treated, and of course, how it’s labeled. In the case of drug abuse and addiction, several have been developed over the course of history.
A Brief History of Models Towards Drug Use & Addiction
In the 18th and 19th centuries, there was the moral model. Addiction was seen as a sin, a moral weakness caused by faulty character. Instead of treatment, actions were punitive and individuals were met with a considerable social stigma.
The psycho-dynamic model is a theory that originated with Sigmund Freud in the early 20th century. It attributed drug abuse to a lack of coping mechanisms and unconscious motivations. In this, addiction is an attempt to self-regulate and deal with stress. This model is still often incorporated in current addiction therapy and counseling.
The social learning model introduced the concept that addiction had a behavioral component as much as a chemical one. It distinguished between dependence and compulsion and recognized that addiction can be a sliding scale of severity.
What Is the Disease Model of Addiction?
The disease model of addiction argues that the cause or “origin” of addiction is internal to the individual and, being a disease, cannot be controlled. It likens addiction to that of heart disease, diabetes, and even cancer. Like these debilitating and chronic conditions, addiction can cause a host of issues that prevent the body from functioning as normal. Additionally, genes can play a role and cause someone to be predisposed to developing the condition, even if it’s not present at birth.
This model was adopted by Alcoholics Anonymous and was highly influential in how this organization approached alcoholism. The 12-Step model is widely known as countless other organizations modeled themselves after this approach. This is one of the main reasons why the disease model of addiction is still one of the main models used.
Shortcomings of the Disease Model
One of the main arguments against the disease model is that it removes the individual from having to take responsibility for their actions. Although research has shown that there can be a genetic, and even a hereditary, component to substance abuse and addiction, it still does not account for this condition in its entirety. One critic points out that most addicted individuals quit their addiction at some point, something that is not possible with that of heart disease, diabetes, or cancer.
The lack of agency that the disease model purports doesn’t just lack scientific evidence, but this attitude can actually be harmful in itself. This view is comparatively fatalistic, implying that addiction cannot be controlled; it is inherent and can only be managed through complete abstinence (a key component of the AA approach).
Addiction Is A Disease, Not An Excuse
Trying to pin down whether addiction is a disease is helpful in the scope of public health, where such labeling can positively influence legislation, healthcare benefits, and social acceptance. In terms of the individual, it can influence how someone might view their condition. Gene Heyman perhaps said it best, that addiction is a “disorder of choice”.
It’s without question that addiction can be difficult to manage once it has onset. However, individuals do have a choice of how they face it. Even chronic diseases like diabetes can have actions taken to make them more manageable. Even if efforts don’t completely cure the disease, they can go a long way towards giving the individual a better quality of life. Remember, no matter how addiction is labeled, you always have a choice.
If you’re ready to choose a better life that’s addiction-free, you can make the first step by contacting an addiction treatment facility today.