Is addiction a disease?
Though more than 40 million Americans have addiction, very few understand the disease and how it should be treated. As a result, there is a lot of misinformation. In our ongoing blog series Addiction Myths, CASAColumbia’s experts will debunk the most common misconceptions about this complicated disease.
Addiction is often considered a moral failing because using an addictive drug is seen as a personal choice. Many think, “No one is forcing you to use that drug, so why not just stop?” As with most chronic diseases, personal choice is only one element involved in developing the disease. Other factors such as genetics, biology, culture and environment are critical in understanding and addressing the condition.
For example in most cases, addiction starts in the teen years while the brain is still developing and more vulnerable to the effects of addictive substances. Use of drugs during this time is heavily influenced by family, friends and media messages. The mixed messages teens receive from these sources combined with slowly developing decision making skills, judgment, and identity do not allow them to make informed choices that are in the best interest of their long-term health.
Although the community of medical experts considers addiction a disease, the public often has strong opinions that it is not because an individual “chooses” to put something in his/her body that causes the problem. Is addiction the only disease where that is the case? Let’s look at the disease model of high blood pressure. This disease develops as a result of several components—salt intake being one of them, as well as genetic influences and other work and lifestyle choices. Eating salt is a personal choice, yet no one would contend that this single factor was solely responsible for a person developing this disease. Addiction should be viewed the same way; though personal choices contributes to developing the disease, it is only one part of a complex problem. All diseases involve choices for the patient about how he/she wants to manage or not manage his/her health problem. Blaming people for their problems never helps them get better.
Here are the facts: Addiction is complex brain disease that affects reward, motivation and memory. Addiction alters these brain circuits, affecting the way a person makes a decision about what behaviors are a priority. To an outsider, pursuing addictive substances or behaviors seems completely irrational, especially when the negative consequences are so clear. However, the brain of the addicted person has been changed by the disease, causing him or her to pursue illogical behaviors despite the consequences.
Memory and learning are also affected by addiction. Certain stimuli such as a neighborhood bar, a certain drug-using friend or negative emotions become deeply rooted in a person’s memory, often triggering cravings. This largely affects why relapse is so common among those suffering from addiction and is why it is so important that it is treated as a long-term chronic disease.
Viewing addiction as a moral failing keeps many people from accessing treatment in the first place and undermines the need for long-term medical treatment for those with chronic severe forms of addiction. Though addiction is not a matter of personal responsibility, getting medical treatment is. Because of the impairment in self-care and self-perception that comes with addiction, those with this disease very often need significant help from others (family, friends, healthcare providers, employers, criminal justice or child protection staff) to see that they have a problem and to get the treatment they need to stay alive and begin recovery.
For information about addiction, click here.
If you or someone you know has addiction, download our step-by-step guide to find quality addiction treatment.
Margaret Raskob, MPH
Margaret Raskob is a freelance blogger.