It wasn’t that long ago that society perceived addicts and alcoholics as immoral, rather than having a chronic disease that required intensive, long-term treatment. The presumption was that people who suffered from addictions were morally and spiritually bereft and indolent, self-indulgent, impulsive, and reckless. As such, attitudes toward those with addictions were predominately punitive, resulting in many people suffering being institutionalized or incarcerated.
Fortunately, however, today most mental health and medical professionals and much the general public have come to consider addiction as a disease, making it as just as deserving of compassionate medical care as conditions such as diabetes and cancer. Unfortunately, there are still many individuals who reject the idea of addiction as a disease, declaring that those who experience it are making a deliberate choice to abuse alcohol or drugs despite being able to refrain from doing so.
Regardless of whether addiction is a disease in nature, characterized by choice, or a combination of the two, one thing is sure: research suggests that it is a chronic condition most effectively treated when approached from the disease model, rather than as a moral dilemma.
Public Perceptions of Addiction
As noted, in the past, the general perception of addicts was almost entirely negative. Anyone who engaged in addictive behavior was deemed to be a morally bankrupt person who should be condemned and penalized for their selfishness, laziness, and unwillingness to exert self-control.
After much trial and error, professionals in the medical field eventually developed a more informed understanding of how addiction operates. Despite this improved understanding we have garnered regarding addiction, a stigma continues to remain that is not insignificant.
Many unfortunate effects stem from the blame and shame that society has placed on addiction, one of which is that this stigma has discouraged alcoholics and addicts from asking for help and seeking treatment. Those who have gone to great lengths to keep their addiction concealed from loved ones may initially resist the idea of recovery. Frequently, this opposition is because they don’t want to experience the discrimination and vilification associated with being an addict.
Due to this stigmatizing perception, historically, society has been reluctant to support government initiatives to assist or help those suffering from addiction. Thus, it has only been a relatively recent development that substance abuse treatment has been widely recognized as being among the critical benefits that health insurance plans and government programs should provide.
The Disease Model of Addiction
Most informed medical and mental health providers have adopted the belief that the origins of addiction are complex, intertwined, and that genetic, neurological, social, and environmental factors are all involved. The reasoning behind addiction being approached as a disease is based on the fact that it is a chronic biological condition that tends to be persistent and can wax and wane over time. When left unaddressed, it can lead to devastating consequences, including severe health complications, permanent disability, and death.
This belief is near-identical to the traditional medical model of disease. It is classified as an abnormal condition that causes the individual to experience long-term dysfunction and suffering. Concerning addiction, this disorder is associated with a genetic or inherited predisposition that can be provoked by environmental factors, including family dynamics during upbringing and the availability of drugs or alcohol.
In a 2016 study that the New England Journal of Medicine published, the authors examined “advances in the neurobiology of addiction to clarify the link between addiction and brain function and to broaden the understanding of addiction as a brain disease.”
They identified the following associations:
- Desensitization of the brain’s reward circuits
- Increased conditioned responses associated with the substance the subject is dependent upon
- Declining function of brain regions responsible for self-regulation and decision-making abilities
Addiction and the Brain
Within the medical community, it is now generally accepted that addiction is a potentially severe brain disorder. According to the disease model, addiction is hallmarked by adversely altered brain structure and functioning. For many, it is the presence of these brain malformations that trigger alcohol or drug addiction following repeated exposure. Conversely, others without these abnormalities may not experience the same degree of dependence with similar substance use histories.
Moreover, certain hereditary or genetic traits may predispose a person to develop a physical dependence after being exposed to a gratifying stimulus, such as a psychoactive drug that produces intense feelings of reward and pleasure. It logically follows that repeated exposure to that stimulus further reinforces dependence and addiction by adversely impacting brain functions that motivate an individual to regain sobriety.
Unfortunately, this behavior will continue to occur even in the face of negative consequences, such as isolation from loved ones and the loss of vitality and well-being. The brain areas associated with self-regulation cease to function normally, so the addict will continue to engage in destructive behavior, despite the destruction that addiction has inflicted on their lives.
Once a person has developed an addiction, it is thought to be irreversible and that while the associated symptoms can effectively be treated medically, the condition itself will be lifelong. Moreover, the individual will always have the disease of addiction and face the possibility of relapse, regardless of how long they remain sober.
Choice and Accountability
The primary purpose of the disease model of addiction is to help explain an addicted person’s behavior and propose a practical solution. However, that is not to say this approach should excuse such behavior, and for some, it may be challenging to disentangle the concepts of disease and choice regarding addiction—and perhaps they should not. These are not mutually exclusive, and the problem does not have a simple answer that can explain it all.
Of course, with any controllable behavior, a certain amount of choice involved. If the addicted individually chose not to use it in the first place, the neurological traits associated with addiction would never have been activated. And if there a person is incapable of choosing, he or she could never stop using once these biological processes had taken over. But millions have.
Approaching addiction as a disease should not suggest that the person who is experiencing it is freed from dealing with its far-reaching adverse effects. No one is being given a pass in saying that addictive behavior that inflicts harm to oneself and others is okay. Addiction is a chronic and degenerative disease and may lead to the diminishing of moral values and personal integrity. The addict’s authentic identity is compromised as the compulsion to use drives them to make decisions detrimental to their own health and well-being.
As such, an addict will often experience a personal crisis characterized by shame, self-hatred, and self-condemnation. However, the truth is that the person is suffering from a grave illness that causes and perpetuates unhealthy and harmful behavior. Moreover, approaching addiction as a disease can help lessen much of the self-effacing judgment associated with it.
Treatment for Drug Addiction
Honesty and accountability are critical areas that need to be addressed on the path to long-term sobriety. For recovery to occur, individuals need to enact changes in nearly every area of their lives and address the underlying physical, spiritual, and mental factors contributing to the condition.
Persons who are battling addiction are urged to enroll in an intensive rehab program that specializes in evidence-based treatments, including counseling, behavioral therapy, psychoeducation, mindfulness therapy, and group support. Just Believe Detox and Just Believe Recovery centers employ highly-skilled addiction professionals who deliver these services to those we treat with compassion and expertise. We provide each individual with the tools, education, and support they need to abstain from substance abuse indefinitely.
We can help you conquer addiction and begin to experience the happiness you deserve! Call us today to find out how we can help you start the journey to recovery!