What is Addiction?

Is Addiction a Disease? This has been a topic of discussion for many years now. According to the National Institute on Drug Abuse, Addiction is “a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.” Although, some experts seem to disagree.

We asked some of the Top Addiction Experts in the U.S. this question and here’s how they responded:

Edward White 

Former Addiction Counselor

Absolutely not! And this has been the get out of jail card for many in groups like AA who classify addictions a disease as opposed to a lifestyle choice.

The components of a disease are largely physical and to classify addiction as sharing the same space is to turn all that we understand about addiction on its head. People can become addicted to anything. Sex, drugs, alcohol, work, relationships, social media, you name it. If it gives pleasure in some shape or form, chances are you can be sure somebody, somewhere in the world is addicted to it.

To suggest addiction is a disease means redefining our understanding of what an addiction is and how it comes about. Over exposure to any substance or pursuit has an addictive component attached. A physical disease can come about from prolonged exposure to any type of substance abuse but does that mean addiction is a disease in that context? No, it does not. They are two completely separate issues.

Addiction is not a disease no more than disease is not an addiction. They may be inextricably linked but they need to be kept separate even though one may lead to the other. In analogous terms it’s a bit like saying if a male hangs around women long enough, he will eventually become female. That’s nonsensical. But that, in essence is what some in the medical community are suggesting.  

Lin Anderson, LMHC, M.A.

Ed.M and Aaron Sternlicht, LMHC, CASAC

Family Addiction Specialists

Addiction is defined as a disease by most addiction experts.  The National Institute on Drug Abuse defines addiction as “a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.”  Similar to diabetes, addiction is caused by behavioral, environmental and biological factors, and has a host of symptoms.  The behavioral component is the drug use itself. The environmental component is being around a setting that is prone to drug addiction such as drug use in the household.  Biological factors are genetical components, as studies indicate addiction is partially hereditary.

Specifically, addiction is a disease of the brain.  Addiction causes disruption of the brains reward system, resulting in regular life pleasures no longer bringing pleasure.  This is why many people with addictions also struggle with depression.  Furthermore, addiction causes disruption of the brains circuits involved in impulse control in the prefrontal cortex, making it more difficult for individuals with addictions to resist drugs or alcohol.  Also, individuals who have developed addictions have neurally embedded associations and memories with their addictive behaviors, resulting in minuscule things triggering them that may not even enter our conscious mind.

Alan Muskat

Development Director at SeekHeeling

Addiction is a response to the pain of unmet needs. It can bean attempt to meet a need or it can be a way to ally the pain of not meeting it.Either way, like every behavior, it’s just a strategy, and every strategy alwayshas at least one need driving it.

Every behavior has a cause, and that cause is always a need. Every strategy is a symptom of something deeper. Trying to break an addiction,then,  is like trying to break a fever: it’s“treating the symptom.” Treating the symptom is often necessary, but it’s seldom sufficient. It’s not a solution because it doesn’t deal with the underlying issue.This is why it can be misleading to think of addiction as a disease. Is it a disease to have a fever?

Between every behavior and the need behind it is a feeling. This feeling tells us whether the need is met. If you’re hungry, it probably means you need food. It usually doesn’t mean there’s something wrong with you.

Like fever, hunger isn’t the problem. The problem is what hunger points to: a lack of food. Severe hunger points to starvation. When starvation is widespread, you don’t call it an epidemic, you call it a famine.

Addiction is a disease in that it hijacks our reward system. It’s like a fever out of control, or hunger misdirected away from food. But beneath and before these complications, there are authentic needs left unmet. If we can meet those needs, addiction can be prevented and short-term treatment can become long-term cure.

If widespread addiction is the result of a famine, what is it we’re starving for? Love. Our “disease” is love sickness.

Vonnie Nealon 

Warriors Heart Clinical Director

Substance Abuse is disease that impacts the whole family – As the Clinical Director of Warriors Heart, a substance abuse treatment center located in Bandera, Texas, that specializes in PTSD for Warrior class clients (military, fire fighters, law enforcement, and all first responders), my favorite family group discusses the disease process and how it affects all family members. Many people do not know that alcoholism and addiction are devastating diseases. Addiction is defined as a disease by most medical associations, including the American Medical Association and the American Society of Addiction Medicine. Addiction is caused by a combination of behavioral, environmental and genetic factors.

For many individuals, beginning the conversation with the facts concerning it being a medical disorder may make the conversation easier for loved ones to understand. When confronting or talking to someone who you believe may have a chemical dependency disorder, it is best to be direct and discuss their behaviors that may have caused you to become concerned about them. It is important to try to get them to acknowledge their chemical use and the signs of addiction that you are seeing. Let them know that any anger you may be feeling is not directed toward them, and is in fact directed toward the disease itself.  Let your loved one know that you love and value them and are simply angry with the disease itself. It is also important to express your love and support for them.

Jo Burnett

Master NL Ppractitioner specialising in addiction and habit change

No, addiction is not a disease. Unlike other categorical diseases, there is no infection, no pathological biological process and no biological degenerative condition.

The description of someone with addictive behaviors as diseased is driven by a positive intention to help them feel better about themselves. Instead of beating themselves up over their behavior and feeling like a failure, they get to feel a sense of relief that they’re not really in control, the disease is in control. It also means there is less judgment from society.

The downside to this approach is precisely that it takes power and control away from the person with the addictive behaviors. It becomes part of the person’s identity that they have a disease, that they are an addict. Believing that you are diseased can mean that you are always fighting for recovery and never being fully recovered. This kind of internal and unconscious belief-system is demotivating at best and self-sabotaging at worst.

A more helpful approach to dealing with addictive behaviors is to describe the problem as an “unhealthy relationship” with the substance or habit involved. If I have an unhealthy relationship with alcohol, for example,I can change that relationship. If I have compulsive, habitual or unhelpful behaviors around gambling, I can change those behaviors.

Often, people with unhealthy, addictive and compulsive behaviors have low self-esteem and a poor relationship with themselves. A more helpful way to tackle the problem successfully is to help them to reclaim their power, think about themselves positively instead of as diseased and to build a healthier relationship with themselves.

Lindsay Cooke, LMHC

Private Practice

Addiction is considered a disease as it is chronic, progressive and if left untreated it can be fatal. Addiction is a long term condition that progresses over time and without proper treatment it can lead to death.  Oftentimes, people believe that addicts have a choice in stopping but there is a obsessive compulsive component to their behaviors; an addict struggles to stop after introducing the substance – drugs or alcohol – into their system.  Addicts typically fail to process consequences in the same way that the average person does. They don’t have the ability to think through their actions and place a larger value on drugs than anything else in their life. People can confuse ‘heavy users’ with addicts however; the main difference is that consequences will cause the ‘heavy user’ to cease use wherein the addict will minimize or rationalize these consequences.  The reason it is important to understand that addiction is a disease is for proper treatment.  If one believes that an addict can ‘just stop’ it can not only lead to frustration within the addict but also with those around them.  

Mark D Rego, MD

Assistant Clinical Professor of Psychiatry

Yale University School of Medicine

Addiction has characteristics of a disease, but in another sense does not. On the positive side it is easily inherited, so genetics play a strong role. Also the behaviors which define addiction are so consistent it is hard to imagine it does not have a biological cause. I have known addicts who would give a limb to stop craving their drug.

But addiction is also different. There is a role for will power. At some point people often decide to stop using and they stick with it. There is nothing we can do to precipitate this, but we can strengthen it when it happens.

Addiction is different from anything else we treat in psychiatry. It is not clear to me that we really know what is broken yet.

MALLORY NEUBERGER, MS, CRRA

Author of Sober.House (My Story)

As a sober coach, certified counselor, and founder/executive director of two women’s sober houses in Delray Beach, Florida,  The Frog Pad, I can confirm that addiction is a disease which is in the medical books. One in every ten people are suffering from addiction, and for much of my life, I was one of them. When I learned that addiction is a disease, I was no longer willing to die with my shameful secret because the stigma went away. This is something that anyone suffering in silence must understand in order to escape the debilitating disease and live life to their fullest potential.

Having grown up with an alcoholic mother, I was led to believe that she was a weak woman who refused to stop drinking. My family swept her drinking under the rug and refused to discuss it. When I crossed into addiction, I was ashamed and full of guilt. I was living a double life and hiding my addiction from everyoneI loved. Unfortunately, there is a tremendous amount of misconception in the world, so addicts are often shunned and looked down upon in a way that a people suffering from diabetes or cancer are not.

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