Addiction a disease?

ninerbuff

Easy to get hung up on semantics. We tend to not like to label things similarly when they appear to be so different (e.g. alcoholism and leprosy are both "diseases"). Lots of research showing addictive behavior can be chemical, genetic. But the behavior looks so much like a "choice" why can't people just stop?

There is physical addiction and psychological addiction, possibly even behavioral addiction (though that might fall under psychological). Whether addiction is a disease or mental illness or psychological disorder depends on whom you ask. How it is labeled can also affect what kind of treatment an addict can get.

In 2007, Joe Biden (as senator) introduced the “Recognizing Addiction as a Disease Act” in the U.S. Senate. It didn't pass. http://www.govtrack.us/congress/bill.xpd?bill=s110-1011&tab=committees

The DSM-IV does not list addiction as a disease, but does talk about substance dependence and uses terms like "disorder." It uses a symptom-based definition.

The National Institue on Drug Abuse says addiction is a disease, and that genetics play as high a role as 50% of the risk of becoming addicted.
http://www.drugabuse.gov/Testimony/6-23-10Testimony.html

Tons of information and differing opinions about the labeling of addiction, addictive behavior, etc. Even recent debate about whether addiction should be called a 'brain disease.'
http://healthland.time.com/2011/08/16/why-the-new-definition-of-addiction-as-brain-disease-falls-short/

I've seen people have a difficult time accepting the ideas food addiction, love addiction, sex addiction. How can someone be addicted to something that is good, something that we need? Easy to see why this is hard to comprehend. But for the addict, often the pleasure from those behaviors is gone. Whether it's food, cocaine, relationships or sex, it's become a psychological and/or physical need. A sex addict having sex doesn't enjoy the act the way most people do. Likewise, a food addict doesn't enjoy a good meal the way some of us might.

And I think - for me, at least - that's the tipping point. That's where I would say the line between compulsive behavior and addiction begins - when there it is no longer a pleasure-motivated choice and more a function of need or dependency. It's where a person becomes a slave to the addiction, where choice really does begin to disolve.

There are smarter people that can articulate this stuff a lot better than I can. I do have fairly extensive experience with addiction (myself, family members, friends, working with groups, etc.) but my experience isn't science.

And whether you want to call it a disease, a condition, a mental disorder, whatever, I don't really care. However, I do sometimes get a whiff of judgment and even condemnation when people discuss this topic (whether addiction should called a disease), and I suspect much of the discussion is fueled by the opinion that calling addiction a "disease" lets the addict off the hook. Or that calling addiction a disease somehow minimizes "real" diseases in people's minds. I can understand that thinking. But I think it can be myopic.

I think the idea of accountability is a tricky one. It sounds so simple, right? If an adult makes a choice to do something he or she is accountable for that choice. But are there any shades of gray there? What about the mentally unstable?

The terms "addict" and "addiction" get overused. "I'm such a chocolate addict!" "Garfield is addicted to lasagna." If you want to get into the issue of accountability, it's probably crucial to distinguish between someone who has a substance abuse problem, or a psychological/behavioral disorder and someone who is truly an addict. Many of the definitions of addiction actually hinge on the point where a person loses control over choosing the behavior or not.


Some resources:

Drugs, Brains, and Behavior - The Science of Addiction
http://www.drugabuse.gov/scienceofaddiction/

Understanding Drug Abuse and Addiction
http://www.nida.nih.gov/Infofacts/understand.html

What Is Addiction? What Causes Addiction?
http://www.medicalnewstoday.com/info/addiction/

What Is Alcohol Or Drug Addiction? Part 1 of 3 – The Medical View
http://addictionrecoverybasics.com/what-is-alcohol-or-drug-addiction-part-1-of-3-the-medical-view/

What Is Addiction?
http://www.psychologytoday.com/basics/addiction

What is Addiction?
http://www.addictionsandrecovery.org/definition-of-addiction.htm

Definitions & Characteristics of Addiction
http://www.alcoholanddrugabuse.com/article1.html

The Genetics of Addiction - Is Addiction a Disease?
http://www.addictionsandrecovery.org/is-addiction-a-disease.htm

Addiction: A Neurological Disorder
http://www.medical-online.com/addict.htm

Treating Addiction as a Disease: The Promise of Medication-Assisted Recovery
http://www.drugabuse.gov/Testimony/6-23-10Testimony.html

Why the New Definition of Addiction, as 'Brain Disease,' Falls Short
http://healthland.time.com/2011/08/16/why-the-new-definition-of-addiction-as-brain-disease-falls-short/

You articulated just fine. And good job on the references.

foremant86

It doesn't work that way.

If every person had the ability to say No alochol or no drugs or no food or whatever the addiction may be then there would be no such thing as addiction.

It's so easy for those of us who don't have these problems to say "just stop drinking, just stop taking drugs, just stop eating so much" because we don't understand what it's like to have your body and mind telling you that you NEED the alcohol, drugs or food.

It's like telling someone who is clinically depressed to just be happy and positive, it doesn't work that way, Their BRAIN doesn't work that way.

maab_connor

It doesn't work that way.

If every person had the ability to say No alochol or no drugs or no food or whatever the addiction may be then there would be no such thing as addiction.

It's so easy for those of us who don't have these problems to say "just stop drinking, just stop taking drugs, just stop eating so much" because we don't understand what it's like to have your body and mind telling you that you NEED the alcohol, drugs or food.

It's like telling someone who is clinically depressed to just be happy and positive, it doesn't work that way, Their BRAIN doesn't work that way.

couldn't have said it better myself.

I've been in recovery from drugs and alcohol for 12 years. "just stop" doesn't work. addictions - all of them - are like hydras, there are always two more core problems when you think you've "handled" one of them. and i'll say this too - the only way that weightloss is working for me NOW is that i finally started treating it like i treat my addictions. it's day by day and sometimes minute by minute. the big difference being, i can't choose not to eat, i can only choose to eat better.

Pangea250

No no no no no. If an alcoholic doesn't drink, the disease is most assuredly still there. If a drug addict doesn't use, the disease is still there. The alcohol and drugs are just a symptom, not the disease itself.

If a diabetic controls her blood sugar with insulin, isn't she still a diabetic? If a hemophiliac controls his bleeding by avoiding being cut, isn't he still a hemophiliac? If a person with an allergy to peanuts doesn't eat peanuts, isn't he still allergic?

If an alcoholic or drug addict simply avoids alcohol & drugs and does nothing more, they will be a miserable sot. Addiction is a disease that affects the thinking. Addictive thoughts rage through the addict who doesn't use or drink. Food is no different in that aspect. In fact, it is considered more difficult for the food addict, for one can live without drugs and alcohol, but one must eat.

Pangea250

I don't wanna sound mean but I think addiction is just people that are too weak to stop doing whatever it is that there "addicted" to. Canser is a disease,in my opinion eating,drugs,drinking ect.,isn't!

Okay. But what about the addict that DOES stop? If you feel that addiction is only for those too weak to stop, where does the addict who stops fit into your equation?

Anyone who wonders about addiction and the disease process should find (Google) Father Martin's Chalk Talks. It's nice to "think" that it isn't a disease. But if you aren't knowledgeable about it, then what you think can really be quite wrong. Insurance companies (who, btw, really really would rather not pay claims) and doctors disagree with you.

Gwen7121

Just my opinion but I've always thougth disease & disorder were just interchangeable words. Both require treatment. Sometimes with drugs, and sometimes with therapy.

My ex-husband was an alcoholic. My best friend has had issues with depression to the point of being suicidal. I don't see a difference between either illness.

With my ex, I used to think if he loved me, he would quit. Then one day, he told me something that made it click for me. He said that alcohol was the first thing he thought of when he woke up. That every second I was there, getting ready for work, he was planning the alcohol he would get the moment I was out the door. The thought/need was so intense, it was like pain. It was the most honest thing he had ever said to me.

I used to smoke. A cigarette was the first thing I wanted in the morning. If I couldn't have a cigarette, I would just about go nuts. Quitting was super hard, took multiple tries, and even now, three years, eight months and 26 days later, I still crave a cigarette. I know that I wouldn't stop with one. But I still want it.

If you've never had an addiction, you will most likely never truly understand that feeling. And I think most who have never had an addiction are fairly judgemental of those who have, regardless of the scientific studies showing that certain people are pre-disposed due to genetics, environment, etc. (Notice I said MOST, not all)

ninerbuff

Addictions can be treated with no drugs. Diseases like cancer, Systic Fibrosis, etc. require drugs to help.

kennethmgreen

Addictions can be treated with no drugs. Diseases like cancer, Systic Fibrosis, etc. require drugs to help.

And therein lies the biggest contribution to prejudice with addiction and addicts, IMO. The problem with that logic is that you are judging a disease by its treatment and not by its symptoms. Only the general public does that. Very few, if any, scientific, medical or gov organizations will do this. Addiction and diseases are defined by their symptoms.

ninerbuff

And therein lies the biggest contribution to prejudice with addiction and addicts, IMO. The problem with that logic is that you are judging a disease by its treatment and not by its symptoms. Only the general public does that. Very few, if any, scientific, medical or gov organizations will do this. Addiction and diseases are defined by their symptoms.

Again, my opinion is addiction is a disorder just like those that are deemed mental disorders. I'm not prejudicial about seeking treatment nor using medical means to assist, I just don't believe that addiction is on the same level as a disease like cancer.

livnlite

There is a difference .. at least as far as I understand it ...

Wikipedia says it best:
Historically, addiction has been defined as physical and psychological dependence on psychoactive substances (for example alcohol, tobacco, heroin and other drugs) which cross the blood-brain barrier once ingested, temporarily altering the chemical milieu of the brain.

A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs.[1] It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune diseases. In humans, "disease" is often used more broadly to refer to any condition that causes pain, dysfunction, distress, social problems, and/or death to the person afflicted, or similar problems for those in contact with the person.

Pangea250

There is a difference .. at least as far as I understand it ...

Wikipedia says it best:
Historically, addiction has been defined as physical and psychological dependence on psychoactive substances (for example alcohol, tobacco, heroin and other drugs) which cross the blood-brain barrier once ingested, temporarily altering the chemical milieu of the brain.

A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs.[1] It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune diseases. In humans, "disease" is often used more broadly to refer to any condition that causes pain, dysfunction, distress, social problems, and/or death to the person afflicted, or similar problems for those in contact with the person.

First, just a mention that Wikipedia is merely...well, Wikipedia. It's a collection of writings by laypeople that may or may not be correct. Just sayin'.

But reading the definition of disease as Wikipedia lists it, yes, that is addiction. I don't understand how that can be read and NOT construed to be a disease. Addiction is:
An abnormal condition
With specific symptoms and signs
Caused by both external factors and internal factors
Causes pain, dysfunction, distress social problem and death

What part of that paragraph ISN'T addiction?

kennethmgreen

And therein lies the biggest contribution to prejudice with addiction and addicts, IMO. The problem with that logic is that you are judging a disease by its treatment and not by its symptoms. Only the general public does that. Very few, if any, scientific, medical or gov organizations will do this. Addiction and diseases are defined by their symptoms.

Again, my opinion is addiction is a disorder just like those that are deemed mental disorders. I'm not prejudicial about seeking treatment nor using medical means to assist, I just don't believe that addiction is on the same level as a disease like cancer.

I can respect your opinion that addiction is a disorder. In fact, as I stated earlier, I don't really care if you call it a disease, disorder, mental condition, whatever. But I don't agree with your supporting logic. To say X is not Y because X is not on the same level as Y is not really a good argument in this context.

I believe the discussion is about whether addiction is a disease, right? If you want to make a case that addiction is not a disease, then you need to define what "disease" is and why "addiction" does not meet that definition. Conversely, if you want to argue that addiction is a disease, then you need to define what "disease" is and why "addiction" fits that definition. Right?

Saying that addiction isn't as bad as cancer, so it must not be disease is a little like saying turquoise isn't blue because it's not as dark as navy.

You can't really argue addiction is not a disease by saying addiction is less than cancer. Inflammatory Bowel Disease is a disease. IBD is not fatal. It's not on the same level as cancer. But it is still a disease.

Again, if you want to call addiction a disorder, that's fine. I just don't like the cancer comparison argument.

McKayMachina

This gets so hotly debated because people equate the word "disease" with some kind of excuse. I, personally, don't think "disease" is the appropriate word for addiction. But, regardless of what you want to call it, the thing that incenses people is that people seem to call it a disease, throw their hands up and act like since they have a "disease," there's nothing they can do about it and resign all responsibility. That's what's upsetting.

Source: I'm a linguaphilic pedant who has managed to quit smoking AND over-eating.

sinclare

It's like telling someone who is clinically depressed to just be happy and positive, it doesn't work that way, Their BRAIN doesn't work that way.

couldn't have said it better myself.

I've been in recovery from drugs and alcohol for 12 years. "just stop" doesn't work. addictions - all of them - are like hydras, there are always two more core problems when you think you've "handled" one of them. and i'll say this too - the only way that weightloss is working for me NOW is that i finally started treating it like i treat my addictions. it's day by day and sometimes minute by minute. the big difference being, i can't choose not to eat, i can only choose to eat better.

this.

I think it is both...it starts out as an emotional thing ( ie, overeating ) but then some people develop the physical addiction. They are no longer dependant, but physically addicted. To whatever substance. People do Coke. They drink. They eat. They do meth. Really, lots of options out there.

Not one-fits-all solution.

My sister kept on drinking and was in denial... She Died.

Complex, confusing topic. But very important. Thanks for posting.

Dragongrl

I don't wanna sound mean but I think addiction is just people that are too weak to stop doing whatever it is that there "addicted" to. Canser is a disease,in my opinion eating,drugs,drinking ect.,isn't!

I'm assuming you've never been addicted to anything then, right? You've never had any kind of compulsions? How nice of you to pass judgement on countless people when you haven't the slightest idea of what you are talking about.

In responce to the OP I think that addiction is more like a disorder rather than a disease. And here is my logic. Diseases kill people. Yes, being addicted to smoking or alcohol can LEAD to a disease that may kill you. Addiction is more of a behavioral, physical, psychological thing. And sometimes it's really hard, if not impossible, to changed the way a person's brain is wired.

kennethmgreen

In responce to the OP I think that addiction is more like a disorder rather than a disease. And here is my logic. Diseases kill people.

Forget spelling and grammar. Your logic is flawed.

Google search "nonlethal diseases". First two results:

List of Nonlethal Infectious Diseases
http://www.livestrong.com/article/139195-list-nonlethal-infectious-diseases/

Non-Deadly Genetic Diseases
http://www.livestrong.com/article/74445-nondeadly-genetic-diseases/

zeeeb

You bring up a good point.... though..... when you say that "if a person doesn't eat, there is no disease," how do you feel about Alcoholism? Is it a disease? But yet, "If a person doesn't drink, there is no disease."


Note: I'm really NOT trying to be a smart *kitten*. I'm just curious to the response. Thanks!

i tend to agree with this.

i guess it's the same as all the addiction / obsessive / lack of control type illnesses / diseases / disorders

drug addiction
alcohol addiction
bulemia
annoerxia
obsessive compulsive disorders

all of these can be excused away by, well if she just ate something, she wouldn't be annorexic, if she just stopped washing her hand 20 times an hour, she would be ok, if she just stopped eating so much, she wouldn't be fat, if she just stopped smoking crack, she would be fine....

so, yes, it is an addiction, just like any addiction, but worse than drugs and alcohol, because you have to eat everyday, you don't have to drink booze or take crack, you can't go cold turkey off of it, or you'll get sick and eventually die. it is a mental disease, not a physical thing like cancer, but it ruins lifes just like any addiction, mental disorder.

nikirushka

Food addiction is just not possible - to my mind at least, addiction is to do with something that we don't *need* but which the body is convinced we do.

Each and every one of us *needs* food - without it we die. It's a necessity, not an addiction. We don't *need* sugar though, so he could be suffering sugar addiction - that is very real (scientifically confirmed as such). Likewise we don't *need* nicotine, alcohol, heroin etc.

myofibril

I don't consider food addiction a disease because if the person doesn't eat there's no disease. I consider any addiction a disorder and not a disease.

Your thoughts?

MOST substance based addictions fall more towards classification as a disorder than disease in my opinion. I think it is not a mere coincidence that ICD-10 categorises them under mental / behavioural disorders. Having said that some addictions do exhibit traits that tend to push them more towards a disease classification so there are no hard and fast rules here. As such it is open for debate.

I think disorder has less social stigma to it than disease so for the addicted maybe a more sympathetic title. Having said that disease seems to imply that the addicted person has in fact no control over their actions and may make the ordinary member of the public less critical of the addicted person. No control = no choice = more understandable. If choice is implicit it makes the addicted person seem feckless. They could stop what they are doing but they simply choose not to do the things that make them healthy.

Interesting subject which necessitates rational debate. Not like dumbass grammar arguments...

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