Is Addiction Really a Disease?
In some quarters, this question has been answered with a resounding “Yes.” It might surprise you the issue is still very much alive in the addiction community, especially when you bring in biologists and medical professionals who weren’t trained in that model.
A recent article by Dr. Marc Lewis in Psychology Today brings up the unresolved issues. Dr. Lewis starts from the “not a disease” side of the ledger and brings up several points on that perspective:
- You don’t “catch” addiction. Addiction is not contagious, and cannot be caught in the same way you’d contract an infection. However, there is some argument that it might be contracted through social means, or at least made worse.
- You don’t treat addiction with medications or expect a cure. It’s not that medication is unhelpful, but there certainly isn’t an anti-addiction pill that clears it up.
- You don’t “have” addiction like you "have" a cold. Addiction is deeper than that and interwoven with who we are as individuals. There doesn’t seem to be a way to abstract out just the addiction component of someone’s personality, nor can you surgically remove it or rank someone on a clear scale against anyone else.
Lewis also presents the other side of the issue and the powerful analogy with type 2 diabetes, a condition for which some people are predisposed. Type 2 diabetes is affected by behavior and is never cured nor thought of as anything other than a disease.
Perhaps the real discriminator is the idea of addiction being a character flaw with a moral dimension. This idea is falling away as addiction is seen less as a willful choice and more of an inborn propensity toward the harmful behavior. We don’t blame people for getting diabetes so much as show them ways to live and reduce the negative consequences. Diabetes isn’t a moral failing (although obesity might be thought of that way). Diabetes isn’t “evil.”
The best framing might be that addiction is a type of developmental disorder, a disease that can develop in susceptible people when exposed to an environment conducive to the condition. This doesn’t solve all the problems, but does shift the focus away from blaming addicts for moral lapses and hedonism.