The Disease of Addiction: The Theory and the Argument Against It

The idea of addiction being a disease has been around since the year 1784 when Dr. Benjamin Rush of Philadelphia first explored this possibility. It seems that since that first mention of addiction being a disease there have been those on the other side of the issue that have disagreed. Those on the other side of the addiction as a disease argument consider addiction to be a moral issue of a weak willed person.

All The Characteristics Of A Disease

There are certain characteristics that make a disease a disease. In 1956 the American Medical Association agreed that addiction does exhibit enough characteristics to be considered a disease. The characteristics included are:

The illness can be described - obsessive thoughts, leading to compulsive behavior, leading to physical addiction
The course of the illness is predictable and progressive - the course of the addiction usually brings the addicts to similar mindsets: 1. obsession, 2. negative consequences, 3. lack of control, 4. denial.
The addiction is primary - it is not just a symptom of some other underlying disorder
It is permanent - There is no cure for addiction, only treatment which results in the addict being in a remission
it is terminal - if left untreated addiction can go on to cause insanity and death

The Other Side Of The Argument

Those who do not agree with the "disease model of addiction" call their theory the life-process model of addiction. This life-process model of addiction also has certain characteristics. These characteristics point to the fact that the addict has a weak will and that through repair of personal relationships and a personal strength of will they can overcome their addiction.

So basically, those who are addicted to a substance continue to use because they have no will-power at all and they have no real desire to stop their destructive behavior.

A Disease Of The Brain

More commonly than not when addiction is classified as a disease, it is thought to be a disease of the brain caused by chemical changes brought on by repeated use of a substance. There has been much research done on this area of addiction. In brain scans you can see the difference between healthy non-addicted brains and those of addicts.

My feeling however, is that the "addiction is a disease of the brain" theory goes beyond the chemical changes that take place in an addicts brain. It begins with the addicts addictive thinking pattern which they have possessed prior to them ever taking the first drink or drug.

It is this addictive thinking that I believe to be the actual disease of the brain. The addictive thought system is made up of four basic beliefs:

Low self-image
Guilt based on the past, Fear based on the future
Negative belief about self
Addictive behavior

Obviously that is just a basic outline of the characteristics that addictive thinking entails but you can see how addictive behavior can be driven due to this thinking pattern. This thinking pattern can begin at a very early age of life, long before being introduced to any mood-altering substances. It is my opinion that this is where the disease aspect comes into play.

Addicts Have A Choice

Any addict would agree that will-power does come into play in terms of their recovery. There is a saying in addition recovery "Today I have a choice". This saying points to the fact that while we are in recovery, trying to heal our addictive thinking patterns, we can make that choice not to take that first drink, or drug, or whatever it is we do compulsively.

It is that first drink, drug, or other behavior that we do have control over...after that an addict becomes out of control. They cannot turn off the switch once it is turned on. This is the disease of addiction at play.