Is Addiction a Disease or a Choice?

Still, about 25-50% of people with a substance use problem develop a severe, chronic disorder. For them, addiction is a disease that requires intensive treatments and continuing aftercare, monitoring and family or peer support to manage their recovery. As Heyman outlines, the current costs of drug abuse are enormous, including costs of enforcement and lost productivity, as well as incarceration, which has increased 10-fold since 1980. Importantly, he reminds us that drug abuse is a behavioral, or psychiatric, disorder.

The American Society of Addiction Medicine (ASAM) recommends that PHPs provide 20 hours of programming per week, while intensive outpatient treatment programs provide 9 hours per week. Another key difference between a PHP and an intensive outpatient program (IOP) is the amount of time the person spends in the program. The American Society of Addiction Medicine (ASAM) also suggests that PHPs provide 20 hours of programming per week, while IOPs provide 9 hours per week.

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First, the fact that addiction is a brain disease does not mean the patient is a hapless victim with no responsibilities. Addiction begins with the decision to use drugs, and the patient must be actively involved in his or her own treatment for it to work. But we do need to Top 5 Questions to Ask Yourself When Choosing Sober House rise above the moral outrage that the addict became ill as a result of his or her own behavior and deal with the brain disease once it is there. Addiction is the result of continued substance abuse among those who are genetically predisposed to the disease of addiction.

What may be less appreciated among scientists is that its impact in the real world of addiction treatment has remained more limited, with large numbers of patients still not receiving evidence-based treatments. The view that substance addiction is a brain disease, although widely accepted in the neuroscience community, has become subject to acerbic criticism in recent years. We acknowledge that some of these criticisms have merit, but assert that the foundational premise that addiction has a neurobiological basis is fundamentally sound. We also emphasize that denying that addiction is a brain disease is a harmful standpoint since it contributes to reducing access to healthcare and treatment, the consequences of which are catastrophic.

Frequently Asked Questions

Like any chronic disease, addiction is a constant struggle that requires monitoring and care in treating but also compassion and understanding. Disease is determined by a number of varying factors from psychological, behavioral, environmental, and genetic. It can affect anyone for any number of reasons and similarly can occur in any of the body’s major organs. In the end, disease prevents an organ from functioning to complete its job in the body. The term has become one of the most loaded and stigmatized words in medical science. Most people who engage in substance use do not develop addiction, and many young people tend to reduce their use once they take on more adult responsibilities.

• After all, let us not forget that addiction is a condition that affects thousands, if not millions, of individuals worldwide.
• In this article, we intend to provide information to help eliminate the stigma around addiction.
• From a conceptual standpoint, however, a chronic relapsing course is neither necessary nor implied in a view that addiction is a brain disease.

Most addicted people will tell you that they have tried and tried again to stop drugging or drinking – but they just can’t. The forgoing remarks are important, because they help us to recognize that the insistence that addiction is a brain disease is merely one way we can avoid both the crass moralism of those who blame addicts and a facile relativism about disorders. Apparent counterexamples to this account are, I claim, only apparent. It is certainly possible to alter the environment of sufferers such that they do not suffer any impairment. That fact entails that if such alterations are sufficiently cheap, peanut allergy is not a disease. This seems to be contrary to standard medical usage (ICD-10, for instance, has an appropriate category for peanut allergy).

Addiction changes the brain

In the addiction field, compulsive drug use typically refers to inflexible, drug-centered behavior in which substance use is insensitive to adverse consequences [100]. Although this phenomenon is not necessarily present in every patient, it reflects important symptoms of clinical addiction, and is captured by several DSM-5 criteria for SUD [101]. While these behaviors do show similarities with the compulsions of OCD, there are also important differences. For example, “compulsive” substance use is not necessarily accompanied by a conscious desire to withhold the behavior, nor is addictive behavior consistently impervious to change.

Addiction may be a normative failing but if these accounts are correct it is not a normative failing rather than a naturalistically explicable disorder. Rather, it is a normative failing because of the kind of naturalistically explicable disorder it is. Experience with addiction treatment must surely make us even more dubious about the theory that addiction is a disease.

Other neuroadaptations characteristic of addiction are more plausible candidates for an agency-impairing pathology. Dysfunctions in mechanisms involved in self-control can be expected to impair agency under a range of conditions. However, in many environments and for many individuals, the defect is not so significant as to entail an impairment of agency or rationality.

• Other neuroadaptations characteristic of addiction are more plausible candidates for an agency-impairing pathology.
• All by itself, this fact shows that the neuropsychological dysfunction underlying addiction is not sufficient for disease.
• If left untreated, the person’s body, relationships, and even life could be in danger.

Through these discoveries, I learned terms and concepts like trauma and resiliency. When I assessed myself on the Adverse Childhood Experiences (ACEs) scale, my high score indicated a direct connection with addiction. I also learned that trauma affects brain chemistry in a similar way as substances. Further, trauma contributes to mental illness, with individuals often demonstrating symptoms of depression and anxiety and self-medicating with alcohol and other drugs. Because of this, neurobiology is a critical level of analysis for understanding addiction, although certainly not the only one. It is recognized throughout modern medicine that a host of biological and non-biological factors give rise to disease; understanding the biological pathophysiology is critical for understanding etiology and informing treatment.

Kolmac Integrated Behavioral Health Centers is a network of intensive outpatient (IOP) addiction treatment centers in Maryland, Pennsylvania, northern Virginia, and Washington, DC. One of the dangerous aspects of denying addiction as a disease is the continued stigma that this attitude brings upon those who are suffering. People who are not able to “will” their way out of their addiction are often blamed and shamed for their disorder, causing them to feel worthless or broken. Treating people with substance use disorders this way is immoral since it would be appalling to treat someone negatively just because they have heart disease, diabetes type 2, or cancer.