The latest version of modern medicine puts a high emphasis on scientific scrutiny and proven treatments, the disease model of addiction. This means that measurable outcomes and visible, testable ideas are valued more than “common sense” solutions. In this picture, the disease model of addiction meets many of the criteria.
Thinking of addiction as an illness, rather than a character flaw or a moral failing means scientists can look for underlying biological and psychological factors. The search is augmented by advances in medical imaging and DNA techniques. We now have images of the differences between an addicted brain and a non-addicted brain. We also have some hints at just what genetic factors come into play.
A strict disease model of addiction suffers from granularity. In other words, while there are pictures of the biology behind addiction, these aren’t fine-grained and specific. Rather, they are too foggy to make the kind of predictions that would completely validate a disease model of addiction. In scientific circles, it’s the ability to predict who will or will not become addicted that proves the point.
The hope, of course, is to understand addiction as a disease process well enough to intervene. This may or may not be possible. Certainly, although much is known about cancer and diabetes, it is still not possible to keep them from arising. None of this means advances in treatment haven't come by illuminating the sites where drugs bind or how the brain changes with substance abuse. It only means that to win against competing models, the disease model of addiction has to produce an answer.
Critics argue that the disease model of addiction suffers in being too narrow. At times it seems like a willingness to ignore much in the hope of finding a pill that will “cure” addiction. They point out that addiction is clearly not just a genetic vulnerability, but has social and psychological elements. Furthermore, it may be that addiction is too complex and too much a matter of individual traits to pin down under one clear category.
Meanwhile, the search for clear causes that can be “fixed” continues. On the positive side, shifting addiction into a disease model of addiction helps dispel the shame that often comes with being identified as an addict. After all, if it is a disease, it’s not due to being a bad person or immoral. That’s a step in the right direction.
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