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Is Addiction Really a Disease?

There is an argument that addiction is not a disease “because people have recovered without treatment.” Everyone is different. People with mild addictions may recover with very little or no treatment, but people with more severe forms of addiction may need intensive treatment along with a lifelong treatment plan that continuously evolves. Contact an expert with Master Center for Addiction Medicine to figure out a plan that works for you.

However, only in recent times have addiction experts been able to back the so-called “disease concept” with scientific data and extensive brain research. To that extent, my claim that addiction is not a brain disease may seem to change nothing, compared to the situation that would prevail were the scientists’ claim that it is a brain disease to be accepted. Though the overlap between the two accounts is important, there are some important differences. The person we call an addict always monitors their rate of consumption in relation to relevant circumstances. For example, even in the most desperate, chronic cases, alcoholics never drink all the alcohol they can.

Addiction as a Chronic Disease

Evidently, a classification concerning the capacities of addicts, such as impulsivity, may be highly useful in certain fields dealing with addicts. Criminal justice systems, for example, may benefit from such a distinction, which may aid the correct legal approach of addicted offenders. While some are hesitant to call addiction a disease because addicts seem to have choices, and the ability to “just say no,” Grant and Massey both agree that willpower is seldom enough to prevent or stop repeated substance use. Numerous family and twin adoption studies have confirmed that genetics plays a powerful role in determining who is at risk to become addicted. The genetic risk for the various drug addictions has been estimated to range from 40 percent to 60 percent for alcohol, and other common drugs of abuse. Genetic studies have been interpreted to support the hypothesis that multiple genes contribute to this risk rather than a single recessive or dominant gene.

is addiction a disease debate

Once addiction occurs, the patient’s brain has literally been rewired to believe it needs the abused substance in order to function properly. Surgeon General Vivek Murthy released a report acknowledging that addiction is a legitimate medical condition that deserves treatment. The surgeon general indicated that America needs to change the way it discusses addiction and make an effort to promote treatment and recovery, naming addiction one of the top public health concerns that face the nation. He also demonstrated support for the disease model of addiction, explaining that repeated drug misuse changes the circuits within the brain. Unfortunately, the view of addiction as a moral failure or not as a disease can have harmful consequences for those seeking treatment. One study found that rejecting the disease model of addiction leads to more negative attitudes toward those with addictions, which could have a detrimental effect on treatment.

Addiction changes the brain

Hazardous (risky) substance use refers to quantitative levels of consumption that increase an individual’s risk for adverse health consequences. Clinically, alcohol consumption that exceeds guidelines for moderate drinking has been used to prompt brief interventions or referral for specialist care [112]. More recently, a reduction in these quantitative levels has been validated as treatment endpoints [113]. Many are coming to see addiction as a learned pattern of thinking and acting – a pattern that can be unlearned. As a neuroscientist, I recognise that the brain changes with addiction, but I see those changes as an expression of ongoing plasticity in an organ designed to change with strong emotions and repeated experiences.

Is drug addiction genetic?

More than half of the differences in how likely people are to develop substance use problems stem from DNA differences, though it varies a little bit by substance. Research suggests alcohol addiction is about 50 percent heritable, while addiction to other drugs is as much as 70 percent heritable.

The good news is that even the most severe, chronic form of SUD can be manageable, usually with long-term treatment and continued recovery supports. The American Medical Association (AMA) classified alcoholism as a disease in 1956 and included addiction as a disease in 1987. For example, take someone who has received a diagnosis of skin cancer from too much sun exposure.

Is Drug Addiction a Disease?

In effect, the dopaminergic system responds to drugs with the signal that consumption is better than expected. The addict cannot learn the reward value of the drug, because the system for reward value learning is dysfunctional. On every occasion the drug is consumed, the dopaminergic system reports that the drug is more rewarding than expected. The result is pathological learning; the system treats the drug as of ever increasing value.

How do you classify something as an addiction?

Addiction is defined as not having control over doing, taking or using something to the point where it could be harmful to you.

It is not the presence of these neurotransmitters but their outcomes that can cause long-term addictive behavior. Beyond making the case for a view of addiction as a brain disease, perhaps the more important question is when a specific level of analysis is most sober house useful. For understanding the biology of addiction and designing biological interventions, a neurobiological view is almost certainly the most appropriate level of analysis, in particular when informed by an understanding of the behavioral manifestations.

At Footprints to Recovery, we believe in high quality and personalized treatment for each recovering individual. Our dedicated addiction specialists will support you from the moment you walk through our doors through aftercare planning. No matter what you’re going through, there is potential for a better tomorrow. It is crucial to continue with a treatment program long enough to emerge with confidence regarding your newly learned skills and tools for long-term sobriety. Depending on the treatment program, the exact components of treatment will vary.

is addiction a disease debate

Indeed, with regard to some addictions some individuals who satisfy the dysfunction condition suffer no impairment despite continuing to take the drug. Whether this is true will vary depending on the drug, the consumption method, and (importantly) the ability of the agent to access the drug safely and reliably. More controversially, some individuals addicted to benzodiazepines or to nicotine delivered by “e-cigarette” may suffer no impairment of rationality, of agency or of the capacity to pursue a worthwhile life. Even some heroin addicts, with the resources to obtain heroin from safe sources, may not suffer harms significant enough to plausibly constitute an impairment of their agency or their ability to pursue a good life. For alcohol addiction, meta-analysis of twin and adoption studies has estimated heritability at ~50%, while estimates for opioid addiction are even higher [44, 45]. Genetic risk factors are to a large extent shared across substances [46].

Cognitive control, attention or motivational bias, and negative emotional states are seen as major complications resulting from said brain changes [15, 16]. As a result, the behaviour of addicted individuals is considered compromised and disordered in those aspects. Besides generalized neural consequences from repeated substance use that may explain why the addicted population can experience certain dysfunctions, the BDM also explains the role of individual differences in acquiring and maintaining addiction [10]. Proponents of the BDM believe that the interaction between environmental factors and a genetic vulnerability may provide an explanation for this discrepancy [10]. In recent years, the conceptualization of addiction as a brain disease has come under increasing criticism. When first put forward, the brain disease view was mainly an attempt to articulate an effective response to prevailing nonscientific, moralizing, and stigmatizing attitudes to addiction.

  • In dismissing the relevance of genetic risk for addiction, Hall writes that “a large number of alleles are involved in the genetic susceptibility to addiction and individually these alleles might very weakly predict a risk of addiction”.
  • The ambiguous relationships among these terms contribute to misunderstandings and disagreements.
  • The first step of inpatient rehabilitation is generally the detox process.
  • The treatment of drug effects, at the patient’s request, is well within the domain of medicine, what passes as evidence for the theory that addiction is a disease is merely clinical folklore.
  • When untreated, it can often cause other physical and mental health issues.

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