The Disease Model of Addiction – It wasn’t too long ago that society perceived addicts and alcoholics as bad people, rather than having a chronic health condition that required intensive treatment. The presumption was that individuals who suffered from addictions were morally bereft, lacked any relationship with a higher power, and were generally lazy, self-indulgent, and reckless. As such, attitudes toward people with addictions were primarily punitive, resulting in many of them being incarcerated in some way.
Fortunately, however, today many experts and the general public come to consider addiction a disease, making it as just as deserving of medical care as diseases such as diabetes and cancer. Unfortunately, there are still many people who reject the idea of addiction as a disease, declaring that addiction is merely a deliberate choice to abuse alcohol or drugs despite the consequences.
Regardless of whether addiction is inherently a disease or a product of choice, one thing is certain: studies suggest that addiction is most effectively treated when it is approached from the disease model, rather than as a moral problem.
Public Perceptions of Addiction
As noted above, in the past the perception of addicts was extremely negative, and anyone who engaged in addictive behavior was inherently a bad person who should be vilified or penalized for their selfishness, indolence, and unwillingness to practice self-control.
After much trial and error, people in the medical field and, to a lesser extent, law enforcement would attain a more informed understanding of how addiction works. Despite this more enlightened understanding we have concerning addiction, perceptions are still quite stigmatizing.
There are a few unfortunate effects that have resulted from the blame and shame that society has assigned to addiction, one of which is that this stigma discourages addicts and alcoholics from seeking treatment. Those who have tried to keep their addiction hidden from loved ones will resist the recovery process. This opposition is most often because they don’t want to endure the discrimination and finger-pointing that is associated with being an addict.
Also, due to this stigmatic perception, society has historically been reluctant to support government initiatives aimed at assisting or supporting those suffering from addiction. For this reason, it has only been a relatively recent development that substance abuse treatment was deemed to be among the essential benefits that health insurance plans and government health programs should provide.
The Disease Model of Addiction
Medical and mental health professionals now widely believe that the origins of addiction are complex and that genetic, neurological, and environmental factors are all involved. The logic behind the classification of addiction as a disease is based on the fact that addiction is a progressively chronic chemical or biological issue that, when left untreated, can result in devastating consequences including permanent disability and death.
This belief is parallel to the traditional medical model of disease that describes a disease as an abnormal condition that causes the person to experience a long-term dysfunction and/or suffering. For addiction, this atypical condition is associated with a genetic/inherited predisposition, which can be provoked by environmental factors, such as family dynamics during upbringing and the availability of drugs or alcohol, illegal or otherwise.
In 2016, in a study published in the New England Journal of Medicine, the authors reviewed “recent advances in the neurobiology of addiction to clarify the link between addiction and brain function and to broaden the understanding of addiction as a brain disease.”
They identified the following three associations:
- Desensitization of the reward circuits in the brain
- Increased conditioned responses associated with the substance an individual is dependent on
- Declining function of brain regions that aid in decision-making and self-regulation
Addiction and the Brain
Within the medical and mental health community, it is now generally accepted that addiction is a disorder of the brain. According to the disease model, addiction is marked by altered brain structure and functioning. For some, it is the presence of these brain abnormalities that trigger alcohol or drug addiction after exposure. Conversely, others without these abnormalities may not encounter the same level of dependence with similar substance exposure.
Moreover, certain hereditary traits may predispose someone to develop a physiological dependence after they are exposed to a rewarding stimulus, such as a psychoactive substance that produces intense feelings of pleasure. It follows that repeated exposure to that stimulus further reinforces dependence by negatively impacting brain functions integral in motivating an individual to regain sobriety.
Unfortunately, this behavior continues to occur even in the face of extremely negative consequences, such as isolation from family and friends, loss of employment, and overall loss of vitality and well-being. The areas of the brain associated with self-regulation stop functioning correctly, so an addict will continue to engage in destructive behavior, despite the devastation that addiction has brought to their lives.
Once an individual has developed an addiction, it is generally considered to be irreversible. Formal treatment can be sought to achieve abstinence, but the person will always carry the disease of addiction and the possibility of relapse with them, no matter how long they remain sober.
A Word on Choice and Accountability
The purpose of the disease model of addiction is to help explain an addict’s behavior. These facts, however, do not excuse that behavior, and for some, it can be challenging to reconcile the concepts of disease and choice regarding addiction.
But, of course, there is a certain amount of choice involved. If the addicted person chose to not use in the first place, neurobiological characteristics associated with addiction would never have been instigated. And if there were no ability to choose, an addict or alcoholic would never be able to stop once these physiological processes had taken over.
Approaching addiction as a disease does not mean that the addict is exempt from dealing with its far-reaching adverse consequences. Addiction is a chronic degenerative disease and may result in the diminishing of moral values and integrity. The addict’s authentic identity is also weakened as the compulsion to use compels them to make choices that violate themselves or others.
As such, they will often perceive themselves as “bad” rather than “sick” – a personal crisis that is characterized by a profound sense of shame, self-hatred, and self-condemnation. The truth, however, is that the addict is suffering from an illness that causes and perpetuates unhealthy and negative behavior. Understanding and acknowledging addiction as a disease does not justify this behavior, but can help to mitigate much of the self-destructive judgment that is associated with addiction.
Treatment for Drug Addiction
The reestablishment of honesty and accountability are critical steps on the path to recovery. For recovery to occur, the individuals will need to make changes in virtually every area of their life, and address the underlying physical, emotional, and spiritual factors that contribute to the disease.
Addiction can be a truly devastating condition that adversely impacts the health and well-being of those who suffer. Persons struggling with addiction are urged to enroll in a rehab program that specializes in evidence-based treatments, including counseling, behavioral therapy, and group support.
Harmony Treatment and Wellness employs compassionate addiction professionals who deliver these services to clients with care and expertise. We provide clients with the tools, education, and support they need to prevent relapse and maintain abstinence indefinitely.
We can help you reclaim your life and experience the happiness and harmony you deserve! Contact us today to find out how we can help you forge your path to recovery!