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,).

It's a tricky one. It doesn't really fit the disease definition.

Addictions always begin with a choice. Do you take another drink, do you place another bet, do you take cocaine etc.
Addiction then develops into a kind of brain damage.

The regular performing of any addictive behaviour changes the structure of the brain. It's the brain altered structure that prevents an addict from making self preservation choices. The brain literally won't let you as it demands the thing that keep the dopamine flowing and the neural pathways satisfied.

It's like a hijacking of the brain.

I'd say addiction is brain damage, rather than a disease.

Nope. It’s a choice IMO. People get clean from drugs, sober from alcohol, etc. so it’s totally possible and within anyone’s reach.
It’s an absolute insult to compare it to cancer, dementia, MND, etc.

My understanding of the disease concept for addiction is that it was designed to take some of the stigma away from addiction and make it less shameful. And to reflect that there is a biological component to vulnerability to developing an addiction. Unfortunately it can also become a way for people to say they have no responsibility for their addiction.

It's not within everyone's reach, many people cannot access addiction services and support, doctors, hospital, rehab, housing, key workers, money.

It's definitely a disease but it's also a choice.

I used to have a functioning addiction pre kids. Quit when I got pregnant. Thought about it every day for the last 10 years, the only thing that keeps me from it is loving my kids more. I dont even want to do it, I don't want that money pit back in my life. Nothing about it is good. But you crave forever. You have to make that choice every day forever. Definitely a disease

Well, I’d rather have ‘alcoholism’ as a disease than cancer, because if I were an alcoholic, I could stop drinking! Cancer isn’t going to cure itself. So no, I don’t think addictions are diseases and it’s an insult to those with more serious conditions to call them that. It’s also insulting that such a huge amount of money is spent on treating addicts who simply don’t want to get better, when that money could be spent on people with illnesses over which they have no control.

Most cancers are avoidable. Should we not treat lung cancer? And if you think the NHS should only treat the “good guys” where do you draw the line? Because why not just have it that people who aren’t skinny, don’t have a vegan diet and don’t exercise religiously shouldn’t receive healthcare treatment

But well done for the sound advice that alcoholics can just stop drinking. Nobody has ever thought that before. Summon the village elders, we have news to spread 🙄

And like o say don’t think it can’t happen to you. It could happen to any of us tomorrow

I think there are a few questions to ask around this, one being - what is a disease?
Usually the medical definition says that it has to affect the body in a physical or functional way - so it has to have an actual effect, not just be there in a latent form - and it has to be abnormal.

Obviously addiction meets the first criteria, I wonder if it meets the second however. It's not really abnormal to become addicted to a substance like crack or methamphetamines, or even weed, it's your body working quite normally when you take a substance like that. I suppose you might say the way the body changes over time as you use more, it becomes a kind of disease as it won't work normally.

But what I would say more generally is that I am not sure the disease model of addiction is the most useful way to think of it, which is to say, I am not convinced it is the best model for helping people resist or overcome addiction. I think people tend to feel disempowered by it, or treat it as an excuse. Which is a significant thing because a feature of addiction is a propensity to look desperately for excuses.

One of the things that's really interesting to me about the AA model is that it seems to walk a line, where an important element is acknowledging lack of control, but there is also a lot of emphasis on personal responsibility. It seems to me that this is similar to an addiction model but not identical, it's closer to a religious mode of thinking.

Some of these things wren't always considered diseases in themselves. They were considered risk factors for other things, like heart attacks.

I mean - presumably the doctor prescribed the drugs not as a drug pusher, but for appropriate medical reasons? Why should that be considered dodgy?

Whereas there is not any excuse for giving a minor recreational drugs illegally.

That's how most people would think of it, IMO.

Addiction is neither addiction nor an illness, its a choice.

Many will disagree and many will resonate. I believe growing up with an alcoholic father who chose it over his family influences my belief.

But when the GP refuses to prescribe more, that is when someone is likely to then seek it out through other means, which is far more dangerous. Sometimes GP’s keep people on medication for far too long, and must surely take responsibility for this.

It is why Addiction services have started prescribing diazepam etc to people who are dependent, so they don’t have to resort to street diazepam which could contain any number of substances.

It’s not about what’s ‘dodgy’. Drugs being de-criminalised would be a solution to many of these issues.

I feel that it's a mental health issue rather than a disease.

My mother had been an addict since her teens. My father died of an overdose of heroin when I was a toddler and my subsequent step father was an addict too. Us children would be in and out of care, on the run, hiding, neglected, abused by the scum that our parents hung around with. Eventually my own mother let people abuse me for money for drugs.

The thing my parents and stepfather had in common was they were all abused as children. My stepfather terribly beaten daily by his drunk dad, my mother SA by a family member and not believed then thrown out at 14. My mother told me she was offered a way to keep warm on the streets and smoked heroin. She said it felt so safe, anything could happen to her and it didn't matter anymore because she was in this warm cocoon. All pain disappeared.

So as I grew up with the same pain my parents had suffered I knew how dangerous it would be for me to even try drugs just once. But I actually found comfort in self harm and starving myself. These were my addictions. And I only got better once I had good therapy and got support.

Over the years I've come into contact with lots of addicts. And the one thing they all had in common was mental health issues. I've never met a serious drug addict who came from a good home or had a good upbringing. Although I'm sure there are exceptions to that.

There must be a genetic aspect to alcoholism and addiction.
Lots of people are prescribed opiates such as codeine or tramadol and some get addicted and some don’t. Likewise plenty of people can have an occasional glass of wine and some people become alcoholics.
My uncle was an alcoholic and out of his 4 children, one also became an alcoholic - yet they had all suffered the same unhappy childhood that is the consequence of an alcoholic parent.

You hear ‘oh so-and-so became an alcoholic because he lost his job and his wife left him’. There’s every chance that he lost his job and his wife left him because of his drinking rather than vice versa.

Im a recovering alcoholic in the worst period i couldn't stop it was like an ocd to drink, like a possessed woman i would watch myself drinking and wishing i wasnt crying that im drinking again yet unable to stop. Im convinced my brain that binge eats and drinks or my body is actually different to others who never get fat or alcoholic we process inner snd outer world differently. Nobody sane would have behaved like i did. To self harm with addiction clearly shows something not right in our head.

So sorry for what you've been through @Showerflowers

Amazing that you have made it through to the other side.

You are amazing! ❤

I totally agree with you.
There can be an element of choice..
But having met alcoholics I just think that I could never do that. Because I just don't like alcohol enough. When I've spoken to people who've had struggles with alcohol, the things they say about how it feels to drink have no resonance to me.
Yet I have struggled with another type of substance abuse...
I think it's not actually a choice how your body reacts to substances. Some people will become addicted to things very fast.. and there's an element of that that's completely beyind their control.
For example regarding the alcoholics. The people I know who've been successful in tackling their issues have done so by becoming completely sober. However the people I know who haven't have kept relapsing because they thought "I'm on top of it now, I can just drink normally" and then spiralled back into chaos. The people who went totally sober identified that things were beyond their control.. that it's a disease and they will not EVER be able to make good choices regarding alcohol.. so the choice left to them is to choose to cut it out of their life entirely.
So yes there's an element of choice as they've put the work in to remain sober.. but there's also strong factors beyond their control that they've had to accept and work around.

Thank you @trythisforsize x

You can make your point without being a dick, you know.
Consider that some of these replies are from people who grew up surrounded by addiction and carry it with them today. Show some compassion.

I grew up surrounded by addiction. That doesn’t stop me recognising that it’s a disease not a weakness

It's a choice. I'm married to an alcoholic. He can go all day without drinking and doesn't have a physical dependency - functions well in his job - but then need to drink 4 pints and 2/3 bottles of wine, on his own in the dark. He's had every offer of help. He has managed times of going sober but he can't say no if people are drinking around him. It's incredibly sad and frustrating. And I feel trapped.

It's a choice in the way non-addicted people could just not eat for 4 days straight-a choice but a very hard one to make. I also don't think that addicts don't love their family or choose their addiction over it.

There is a lot of selfishness in addiction.

It takes hard work and discipline to stop being addicted.

My experience of most addicts is that the achievement is not worth the effort.

They also give themselves a pass nowadays because of this approach of inherited disease.

I have huge admiration for anyone who stops.

Disorder, yes. Disease, no

Ex addicted partner agrees.