To think that addiction is a disease?

[feryon98]

Was having a discussion with a few coworkers about this and it seems to offend them when people claimed addiction is a disease and they said people with actual diseases don't have a choice.

Yes, addiction it's self inflicted but there are many diseases which are caused by an initial choice (e.g Eating unhealthy can cause Type II diabetes, heart disease, high blood pressure,).

I suspect it’s because whilst addiction meets the criteria for a disease, it’s also a disease with symptoms which don’t just affect the person with the disease, but have a disproportionately difficult and traumatic impact on those around them. That clouds people’s desire to understand and acknowledge what makes up addictions.

Yes, yanbu, it's a disease

Although addiction should include non physical addictions such as food, gambling, sex

You could say the same about dementia.

Unless you've seen it, i.e., been really affected by it, it can be hard to recognise it as a disease. The reason I see it as a disease is that it follows the same course each time (my experience is of alcoholism), and people have a hereditary predisposition to it.

When people say that there is a choice, they are not recognising that that choice is harder to make for people with the predisposition, than it might be for the person judging. Granted, there is a period before the disease really takes hold where perhaps a choice can be easily made and followed (assuming the potential addict has some education on the matter), but once the disease takes hold, choice is out of the addict's hands.

I'm not sure many of us would buy a man with a sex addiction telling us that he has a disease to be fair.

Alcohol use disorder is an illness. When you have friends or family members with this disease, you can swing between feelings of anger and upset toward them; it feels as though they chose it over you, or that they have a choice. It feels selfish; you feel sorry for them but also exasperated. It is complex, as substance misuse affects more people than just the user.

Addiction is an illness that causes other medical and psychological issues, it's no different to any other illness, anyone can become addicted to harmful substances including the elderly with pain medication, many people always just think of drug and alcohol users and have little understanding or sympathy until it happens to them. I've learnt never to discuss this with people.

No, I agree with you there. My post above is about substance addiction. Sex addicts, imho, are just people who can't control that particular urge.

In my opinion, the idea of addiction being a disease seems to have far more acceptance in America than in Ireland/UK where I've lived (at least when I've discussed it with people).

I think a disease is a passive thing happening to a person that they don't have control over . Where addicts have choices , the choice to get better, to seek help and to access services. A lot don't make those choices and their choice affects others. Again their aren't many diseases that impact so many people to such a degree.
It's hard to know what to call it really , I think its a symptom of wider issues , neurodiversity, mental health issues , ptsd ect ect .

It’s certainly a discussion, but I think extrapolating addiction to cover more and more things can actually lead to the attitudes OP describes. I don’t believe you can be addicted to food or sex. I believe that as mammals who are biologically programmed to procreate and to gorge on food when it’s available because that ensures we survive through the times when it’s scarce, we naturally struggle in an environment where seeking out as much sex as we can isn’t socially acceptable or compatible with our society’s construct of monogamy; and in an environment where food - particularly calorie-laden food - is always plentiful and the scarce times never come. I don’t think that being beholden to those entirely natural biological drives meets a medical criteria for an addiction.

I think it's complex. I read this interesting essay recently that might shed some light. https://www.wsj.com/health/wellness/people-say-addiction-is-a-disease-mine-wasnt-c9969d82?st=tK2Zpp&reflink=desktopwebshare_permalink

Excerpt: Addicts in recovery take a different view. They often say that if addiction is a disease, it’s like Type 2 diabetes, in which the sick person is a participant. Whereas Type 1 diabetes involves being born without the capacity to produce insulin, Type 2 diabetes involves faulty insulin metabolism typically associated with poor diet, lack of exercise and being overweight. If you start to exhibit signs of Type 2 diabetes, you can deal with it by exercising and eating better. Similarly, if you’re an addict, you can stop using and in that way put whatever obsession and craving you experience, assuming these are among your symptoms, into hibernation or remission.

I think pretty much everyone, though, recognises that dementia essentially just “happens” to people regardless of who they are, whereas there’s a perception among some people that e.g. heroin addicts do have to actively make a choice to take heroin, to continue doing so to develop an addiction, and to therefore have a choice in the trauma they put those around them through. I think both dementia and heroin addiction are diseases, but they’re not analogous.

Also: whether it's a disease or not I think everyone in addiction deserves huge empathy, even if it seems easy to "blame" them for allowing it.

This doesn't work because not all type 2 diabetes is caused by diet and weight.

I come from a family of addicts (alcohol).

I think the issue I have with the alcoholism-as-a-disease viewpoint is that so many of the addicts that I know have used it as a total abdication of all responsibility for their choices and behaviours.

While I personally do accept the concept, I think of it as most like diabetes - yes, a disease, but one where the sufferer must take ownership of their health condition and take positive steps towards recovery.

many diseases can be cured without the active participation of the patient. Addiction requires a choice to get better

calling it a disease is offensive to the people who suffer collateral damage. It means every child who gets abused by an addict parent is just a victim of a disease, not of a person who makes a choice each day not to stop.

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100 % agree. That's how I feel. It is so so hard.

I am not comfortable with calling addictions a disease. What I do think is that some people seem to have something in their make up which makes them more likely to become addicted, be it to alcohol, drugs, gambling or something else.

I agree, it's not just a cae of stopping or even getting help, the help isn't there for thousands of people. Addiction, homelessness, abuse, loss of job, there are many reasons people become reliant on substances, it seems so much easier to just blame them and tell them to get help, help from where? We don't even look after our military veterans, what hope is there for the people who have nothing.

What about a woman saying it?

It’s a disease, but one that the sufferer has a degree of control over. Same as type 2 diabetes, high cholesterol, high blood pressure, sleep apnea and some cardiovascular disease.

Many of the above can be controlled or reversed by lifestyle changes (at least in early stages), so in that sense very similar to addiction.

I am psychiatrist

From my professional perspective, yes it's a disease. But it's not in the same class as other mental illnesses. I cannot detain someone and enforce treatment on them purely for addiction, in the same way that I (potentially) could with someone with depression or psychosis.

This is a very hard thing for people to accept, particularly Coroners...

I agree with this. Also my observed experience indicates to me that many addictions are based in the individual experiencing childhood trauma and/or undiagnosed spectrum conditions - ADHD, Autism, which received unsympathetic parenting/teaching etc because at time the adults involved didn't understand, historically this was certainly true, didn't care enough or had their own issues which meant they were completely unable to change how they managed the child.

The trouble is these addictions so often destroy the health & lives of those close to them. What may look like lack of care or support is more often withdrawal in order to survive.

I think more people would, but because of social constructs around sexuality: we live in a culture which teaches us that women aren’t “supposed to” seek out sex indiscriminately and should only want to have partnered meaningful sex, so a woman who goes against that must have something wrong with her mentally; whereas our attitude towards male sexuality is very different: that men love sex, want and think about it all the time, and will have it with whoever offers it.

The recent controversy around the Only Fans actress who wanted to have and film sex with 100 men in one day is a good example of that: it’s generally believed that she must have enormous mental health and self esteem issues and possible background trauma of her own. Whereas a male actor wanting to have sex with 100 women - we’d react quite differently.