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The Addiction Argument | Disease or Compulsion?

For decades, addiction has been widely accepted as a disease, but there are different schools of thought as to what addiction is and how it fits into the medical world: addiction is a disease of the brain, addiction is a compulsion, or addiction is a matter of choice.  

Addiction has been recognized as a primary disease since the mid 50s, and back then, society was less tolerant of people with addiction than it is now. Addicts were viewed as having deficiencies in character, lacking in ordinary discipline and morality, self centered and callous. In general, addicts were considered to be worse than “normal” people. When the idea that addiction was a disease surfaced, that meant that people with addictions weren’t bad, they were sick. In an instant, perceptions of addiction changed. People were less discriminatory of of addicts, and addicts became less critical of themselves.

The concept that addiction is a disease was embraced, and while it continues to engage widespread support, opponents of the disease model believe this particular concept encourages willingness to overlook the behavioral aspect of addiction, and also impedes the exploration or acceptance of new findings regarding the nature of addiction.

Opponents say that addiction has very little in common with diseases; such as there is no pathological process. If addiction is a disease, you must contract it, seek treatment, and if the treatment works, you are then cured from the disease. 

But it may not be so black and white. Consider type 2 diabetes. You don’t catch it, but it is a developmental disorder that occurs when people make bad lifestyle choices, similar to addiction. Researchers aren’t searching for a cure for diabetes, physicians are treating diabetes. A cure is often found with dramatic lifestyle changes, better choices...sounds like how an addict finds refuge from their ailment, no?

As the National Institute of Drug Abuse website states, evaluations of brain scans that compare addicts to non addicts usually conclude that the “images from addicted individuals show physical changes in areas of the brain that are critical for judgment, decision making, learning and memory, and behavior control.” It goes on to state that “Scientists believe that these changes alter the way the brain works and may help explain the compulsive and destructive behaviors of an addicted person.”

So addiction changes the way the brain works just like diabetes changes the way the pancreas works. So, type 2 diabetes is a disease and addiction is not?

Why are we arguing again? 


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