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,).

No, it's a mental illness.

Addiction is not a disease. It is addiction.

It's different. It's a thing by itself, and I don't understand this obsession with trying to bend it into something it's not.

I hate people glibly declaring 'it's a disease' when they haven't lived with the absolutely fucking chaos and heartbreak it brings.

Addicts deserve empathy and support, but they do not have a disease.

I think when you say “it’s a disease” implicit in that is (a) the responsibility is on others to cure you and (b) people who choose to walk away from the chaos of addiction are somehow morally in the wrong, whilst the addict is fully entitled to do their addiction, and Centre it in the lives of everyone around them.

That’s the difficulty- I’ve never heard anyone say to an addict “No they didn’t ‘abandon’ you, stop that manipulative nonsense, they have their own lives to lead rather than being a bit part in yours. Get a grip.”

Hear hear

If someone believes they are addicted then their behaviour will reflect that belief. There are some substances - alcohol, heroin - that require medical intervention in order to be safely weaned off them, but most 'addictions' can be dealt with by the appropriate therapy, as long as the desire is there.

@feryon98 I certainly do not class drug addiction or alcoholism as diseases!! they are self inflicted!!

I agree with this, but I'm not sure it always deserves empathy and support. Empathy and support run out, when you and the health service have done everything possible to help, but is thrown back at you.

Substance abuse is surely a mental health condition- especially when it becomes habitual and neuroadaption occurs.

Addiction to anything is a mental health issue as well as causing physical symptoms. Mental health problems are not a disease.

Well, it's bloody hard to give them empathy and support. And I have got to the point of compassion fatigue. Sounds like you've lived through it too.

I think this is correct.

It may not be an adults fault they are an addict but they are responsible for their recovery.

I think disease implies they don't have to take responsibility (and most of them don't) and need to be protected from the consequences of their addiction. It is not a helpful perspective.

A symptom of a mental health condition perhaps?

A disease to me is something physical.

Addiction is an illness.

I don't know how to feel about this - my primary emotion is anger and to feel frustrated it's compared to say the multiple diseases I have where nothing I do or try stops it destroying me.

My family all have drink dependence problems. It's very difficult to experience people like this.
I could have also gone this way but was forced to take ownership and do what I could to protect my already horribly diseased body.

I notice the family members with horrible drink dependence have issues with accountability and ownership in all areas of their life. Looking at it this way, I struggle with the concept it's a disease in the same category as others where there is no choice.

I believe no one wants to be an alcoholic and it's often self medication/ trauma based. I still despite all this feel there's a choice involved. I have had to make some horrendous choices to stay alive so I do lose sympathy. And I have a very traumatic history also.

I don't think they are diseases either, but are you saying lung cancer to a smoker isn't a disease?

I think it can become a disease, but in the early stages it's a choice.
You can choose not to start smoking, everyone knows that it's addictive and causes cancer.
You can choose not to drink regularly, you can choose to cut down or stop if it's becoming a habit and again it's clear that drinking too much is harmful and addictive.

Yes, it's a disease. But it's a disease with a treatment. And that treatment is abstention. Just as a diabetic is responsible for their 'treatment' by using insulin or a Coeliac is responsible for their 'treatment' by abstaining from gluten, so is an addiction 'treated' by staying away from the substance.

The problem is that it is 10k times harder for an addict to abstain than it is for a diabetic or a Coeliac to stay 'on treatment'. But that just means they have to be more dedicated and to seek support with medications (Antabuse, Methadone, etc) and with support groups such as AA nor NA. And therapy.

The parents of one of my friends have both been sober for 40 years due to hard work and AA. My brother has been sober almost 10 the same way, along with medication. I would view a (God forbid) 'slip up' by them completely differently to an alcoholic who falls off the wagon regularly and hasn't managed sobriety for any length of time. Just as I would have little sympathy for a diabetic or Coeliac who chose not to manage their condition and then complained about being ill.

There are 'diseases' and there are 'diseases'. I would never compare an addiction to cancer, MS, or the like. But then again I wouldn't compare those to the flu or bronchitis, either.

BTW I am Coeliac and as above, my brother is an alcoholic. I admire him tremendously for his continuing to get up every morning and say "Today, I will not drink" and knowing that he will have to say this every day for the rest of his life. My 'desire' for a 'regular' food is 'mental' and easily controlled, whereas his is an overwhelming physical craving. His is the much harder choice to make.

It's not a disease. It's an addiction.

Personally I see addiction as a tendency towards cowardice, self-pity and selfishness, so more of a 'character flaw' model, but then I have experience of family members behaving in awful ways towards others while being addicts.

Calling it a 'disease' feeds into the self-pitying narrative of the addict. Woe is me, the world is against me, I can't help it because... there is ALWAYS an excuse. Yes a lot of people probably have a lot of underlying mental health issues, trauma etc... but you need to face up to those problems and deal with them in a different way. Not run away and bury your head in substances. And yes, I have experienced massive trauma in my own life and am neurodivergent too.

Yes, yes you can help it. Nobody is forcing that wine down your throat.

NO.
Addiction is addiction.
"Disease" you usually don't get by choice!

I’d say I quite closely agree with this.

My BIL is an addict, has been for years, and while I know that unfortunately in general support is not as available as it should be for those struggling with addiction, my BIL doesn’t have that excuse.

I’ve posted about him on here before, we have just in the last 2 years taken him into our home to try and help him (found drugs and empty vodka bottles under his bed and so he had to leave, I was weeks away from giving birth and that was not safe to have around a child), paid for a residential stay for him on his request which cost literally thousands of pounds and he walked out after just a few days claiming he was cured & fine (call less than 24 hours later that he was in a&e after being found passed out in a road miles away and an ambulance had been called), paid for addiction counselling again on his request as he said he wanted to get better and the waitlist for NHS was months long (attended a few sessions then again stopped going, said he didn’t need it, brought home by police a few days later off his head), arranged for a place in an abstinence house for addiction support including chasing for multiple referrals and weeks of fighting to get this place (walked out after a few days because “he’s fine”).

For lots of addicts I appreciate none of that support is available to them and so it would be incredibly difficult, but BIL has had all the help anybody and any money could possibly provide, he is choosing not to take it. That’s a choice.

People have a choice to start doing something addictive. But if they suffer from this illness then they struggle to make a choice to stop.
It's a mental illness, yes. You can have less sympathy for a smack head who hasn't got cancer than for one who has, but nobody would choose either.

I have been researching low dopamine because of Parkinson's in my family and a friend has it. I am curious about the role low dopamine has. In my reading I came across the link with addiction which made sense. Not sure exactly how it works.

Of course addiction impacts those around you but so do does a lot of mental health conditions. There are lots of physical conditions that exist because of behaviour of people e.g. people who don't manage their stress will often get physical conditions as a result.

I have a lot of addiction in my family and I see how it impacts those around but also how it impacts them. Nobody wants to do stuff that causes them harm but so many of us do. I have friends addicted to exercise, work, alcohol, food. I think our understanding of addiction isn't great but hopefully we are getting there.

I’m a psychologist who specialised in addiction for years. The disease/illness model of addiction is very much in the past. Addiction / dependency can absolutely lead to chronic disease and ill health, but in of itself it is a way of coping with life (often trauma, which comes hand in hand with addiction). Chronic addiction which starts in childhood/young adulthood is often a way of coping with overwhelming emotions, or a lack of any emotion. Often people haven’t been taught or modelled emotional regulation skills in childhood and so drugs or alcohol become a way of managing feelings - either to numb out / escape or to temporarily feel something.

Lots of people experiment with alcohol and drugs, but not everyone becomes addicted. The same with prescribed pain medication. Those who develop a dependency do so for a reason, the drug(s) serve a function in their lives, often lessening psychological pain temporarily. Of course once people become physically dependent on substances they will get very real withdrawal effects, which is why detox programmes and medications exist. Addiction can lead to disease but it is not a disease.

As a recovering alcoholic, whose parent died from alcoholism, I've never described it as a disease.
I think mine came from childhood trauma, MH issues, undiagnosed ADHD and Autism.
I appreciate people saying it's self-inflicted, as I have very little sympathy for 'old me', for the ripple effects of my alcoholism and chaos, but I understand why it became as bad as it did.
Today, coffee and chocolate are my vices.

I'm a recovering alcoholic and I struggle with being told - in AA by some people - that it's an illness or disease. I have control over whether or not to take the first drink. After that, if I drink, I accept that I am powerless and that a physical craving takes over.

That means that I work a programme of recovery to ensure, one day at a time, I don't take that first drink. Step one is the only one of the 12 steps we must adhere to 100%.