I went back and forth on whether or not to post this - I didn't want to step on any toes or bring about controversy, though I'm not entirely sure my view is all that controversial. I certainly don't want to start some great disease/non-disease debate but I do have very strong views about this and when a statement was made on a blog I frequently read, I had to comment. I wanted to share my opinion with all of you about addiction the disease. I don't regard myself an expert in any sense, though I do study the addicted brain (by study, I mean I'm finishing my PhD in behavioral neuroscience focusing on the process of addiction and work with people who have studied this for years so I do base my views on what science currently has to say on the topic - for what it's worth). Ultimately, though, this is just how I feel about it. This is just my opinion on why addiction is a disease. Just a point of view to consider...
(also, sorry - this is kind of long...) (also, also, sorry if I seem overly apologetic...my mother always says I stop just short of apologizing for living)
"Addiction isn't a disease. That's just an excuse people use to keep from having to take responsibility for their actions."
It absolutely is. And that is absolutely not true.
I am absolutely willing to take responsibility for my actions. I am not using addiction as a disease to excuse any poor decision I have made. I have never done so. Do I understand why some might feel this way? Sure. And in some cases, I'm sure it's completely true. But to discount the disease of addiction on account of a few is irresponsible and incorrect. Yes, I made poor decisions and yes, I did so as an ultimate result of a condition I have. But my poor decisions were made because I was high (or drunk). I made poor decisions because I made them. That's that. Because I have a disease that did I not have, I likely would not have made those decisions doesn't make the decisions the disease's responsibility. It was a contributing factor. It created situations in my brain that were not aligned with reality. But when the day is done and all the cards are on the table, I did it. And I will never not take responsibility for that.
However, I have a disease. One may not fully be able to understand what saying addiction is a disease actually, really means. What it means is that, in the simplest terms I can find, my brain is different than a non-addict's brain. My body is different than a non-addict's body. When a substance such as alcohol enters my body, my reactions are not the same as a non-addict's. The physiological and mental processes that are kick-started are not the same. I am unable to describe and you who have not experienced it are unable to empathize the feeling that occurs when your body and mind are consumed by a pattern of thinking that is ultimately designed to kill you. In the face of all consequences - jail, death, disease, homelessness, poverty, starvation, isolation - you continue to do that which is the root of all your failings because you are unable, actually physically and mentally INCAPABLE, of not doing it (without the proper tools). You despise the very thought of it; you no longer experience pleasurable effects from it; when physical pain would be preferable; when it is no longer doing anything that is in the remotest sense positive - you have a disease.
A disease is a medical condition associated with specific symptoms. It is either caused by some external factor, such as a virus or some internal factor, such as a genetic disorder. The word "disease" is generally used to describe any condition that impairs normal function of the body and causes pain, dysfunction or death. Impairs normal function? Yes. Causes pain? Oh, absolutely. Dysfunction? Right here, sister. Death? Most definitely. Most importantly, it is TREATABLE. Addiction is a disease - it is chronic, and left to its own devices, terminal - but it is treatable. It is one of the most difficult diseases to treat and it is the ONLY disease that you have to convince people they have. I believe it can be beaten. Not cured - it is always present - but controlled.
The American Medical Association (AMA) has recognized addiction as a disease since 1956. The illness can be described - it has specific symptoms - and it is predictable and progressive. Addiction causes changes in the brain that then drive behaviors.
Our brains work differently. Our bodies do not respond as others' do to the entrance of substances. I, for example, cannot understand why anyone would have just one drink if that one drink did not get you absolutely smashed. I can recognize that it is absolutely true that some people enjoy, perhaps, the taste of a nice drink and may just enjoy one with dinner - but I cannot understand the idea that one might drink alcohol for any other reason than the express purpose of getting drunk. I know that that is true. And I know that that is how my brain is different and that abstaining from alcohol is much easier than trying to pretend as though I "get" drinking socially. Because when I take a sip of alcohol (or a hit of weed or a bump of coke), my brain says "doasmuchasyoucanasfastasyoucangethighhighhighnown ownow." And my first and best line of defense is to avoid introducing that substance altogether. Abstinence is the only option because moderation is a nonexistent concept. I can pretend and fight through it and struggle and seem successful, but it's just much easier to not start than to try to stop. And that is because my brain does not work the same way as a non-addict's. In fact, a non-addict may not even understand this idea much like I cannot understand "social drinking."
It sounds as though perhaps I believe addicts are in a sense "damned" to their addictions for the rest of their lives...that's not what I intend. I do believe addicts can live in recovery for the rest of their full, happy lives. But I believe that that takes learning how to "talk over" your deepest drives. It takes learning a new way of thinking and living. You have to learn over deeply ingrained patterns of behavior - patterns that are wired in. 12-step programs teach us that, rehab teaches us that, supportive recovering addict friends teach us that, addiction therapists teach us that, other forms of recovery that I've forgotten/unaware of teach us that. By implementing a structured treatment plan (whatever it may be) each and every day, addicts conquer their disease. By not using or drinking just for this one day, each day at a time, addicts treat their disease. By rehabilitating the mind and doing emotional and mental work to develop healthy and effective coping strategies, addicts stay sober.
Make no mistake about it - addiction is a disease. And it kills. But it doesn't have to.