Is Addiction A Disease?

Discussion in 'Off The Beaten Track' started by PeterG, Feb 6, 2014.

  1. PeterG

    PeterG Argle-Bargle-ist

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    What do you think? I've read articles that say addictions are diseases and other articles says that they are not. Some articles, the first from the National Institute on Drug Abuse:

    DrugFacts: Understanding Drug Abuse and Addiction

    And there is this article from the US National Library of Medicine National Institutes of Health. It is written by Tim Holden, MMed (Psych), Psychiatrist and assistant professor:

    Addiction is not a disease

    How the above article opens:

     
  2. cruisin

    cruisin Well-Known Member

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    I agree with the first article. Understanding that addiction is a disease does not absolve personal responsibility. A person with symptoms of physical illness has the same responsibility to seek medical help as a person with addiction or other psychiatric illness. We know that drugs can change brain chemistry. We know that there is a genetic predisposition to addiction or addictive behavior. To cavalierly toss off addiction as an illness, by using Flip Wilson's "The Devil Made Me Do It" Is completely irresponsible, in my opinion.

    There was a time when depression and other forms of psychiatric illness were not considered real illnesses. Should we go back to the dark ages and the snake pits?
     
  3. Badams

    Badams Well-Known Member

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    I believe addiction is a disease because if addiction isn't a disease, then how could there possibly be a genetic predisposition to it?
     
    Last edited: Feb 6, 2014
  4. Anita18

    Anita18 Well-Known Member

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    There was also a time where being sinful was blamed for poor people dying so young, not because they were living in their own filth in the newfangled cities. Then society discovered sanitation and public health. :p

    Addiction and other disease that involve the mind are a complicated matter. There are things you can do to help yourself - in fact, the only way you can get better is to help yourself. But the truth of the matter is, if you are affected, you can't live your life like someone who isn't affected. That's a reality.
     
  5. snoopy

    snoopy Team St. Petersburg

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    But that's the thing, addiction doesn't just involve the mind. There is a physiological component. And I think calling it a disease can help people trying to overcome an addiction because when they get the *physical* craving, they can understand it IS physical, and not just a weakness of mind or self control. It makes coping strategies more effective.
     
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  6. overedge

    overedge Well-Known Member

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    I don't think you can generalize whether addiction is or isn't a disease for all kinds of addictive substances. Some substances may cause a physiological reaction like snoopy describes, but for others, the addiction may be more psychological than physical.
     
  7. Anita18

    Anita18 Well-Known Member

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    The thing that makes addiction addiction is wonky brain chemistry. In a way, it really is all in your mind, but it doesn't mean you have conscious control over it. Brain chemistry is a very finicky thing.
     
  8. cruisin

    cruisin Well-Known Member

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    Anita is right. The "wonky" chemistry in the brain that can trigger addictive behaviors, can be the physical addiction. Seretonin, dopamine, adrenaline, endorphins, are all very powerful chemicals. Also, many psych illnesses are co-morbid with addiction. That can be due to the chemical disorder or the need to self medicate. It is fairly common for some sort of addiction to go along with OCD and bi-polar disorders. I am somewhat fortunate, in that my addiction was/is an eating disorder. I have never been much of a drinker and have never used recreational drugs (too afraid of germs :lol:). But, part of why I avoid pain meds, even when they are necessary, is because I don't trust my addictive personality. I control it. But, I never went to that place. the eating disorder is a whole other thing, it is there all of the time. It is a struggle all of the time. OCD is a horrible thing to deal with. Especially since it makes no sense. You can intellectually understand that your reaction is illogical and still have no ability to stop the terror. That is the worst part of it. That you know it makes no sense, and you can't stop it. Even SRIs can only take the edge off. You pray for something that can stop you from the obsessive thinking.
     
  9. AliasJohnDoe

    AliasJohnDoe Dornbush 2015!!!

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    I consider FSU an addiction sometimes. I've probably popped into FSU at least once a day for almost a decade (unless I was physically incapable of it).

    But that's a good addiction....right? ;)
     
  10. Japanfan

    Japanfan Well-Known Member

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    I think addiction can be a disease, but isn't necessarily a disease. I somewhat agree with the following:

    Most addictions serve a purpose and have a psychological dimension, although perhaps in some case it is purely physical. For example, a person with a non-addictive character could become addicted to pain killers in the course of suffering a painful injury.

    In some cases addictions become in a disease in that they take over a person's life and cause them to engage in destructive, even violent behaviours

    But in other cases people function with addictions, using substances (or processes) as a means of self-medicating and coping.

    The misuse or overuse of substances and behaviours that are potentially addictive exist on a continuum. And related to obsessive/compulsive behaviours.

    And it is important to consider that addictions extend beyond traditional drug/alcohol addictions to include work, sex, shopping, spending - even housecleaning.
     
    Last edited: Feb 6, 2014
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  11. cruisin

    cruisin Well-Known Member

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    I think that with regard to non-substance addiction it is harder to define. However, if the self-medicating/coping/behaviors become obsessive and interfere with the ability to live life, addiction is involved. Lots of people get joy from shopping. They buy a new pair of shoes or just a new lipstick and it gives them pleasure. However, when they are buying, just for the sake of buying. In serious debt, with closets full of things they don't need or use, they are in trouble.

    AliasJohnDoe, FSU is therapy for our addictions :)!
     
  12. purple skates

    purple skates Shadow dancing

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    I agree with Japanfan.

    At one point in my life I smoked. I certainly was physically addicted. The withdrawals when quitting were horrible. However, I wasn't necessarily psychologically addicted in the manner in which cruising is describing. Did I have a habit? Yes. Was my behavior repetitive and ingrained? Yes. Did it take some work on my part to change those habits? Yes. Was it caused by a disease or something outside of my control similar to asthma or cancer? Absolutely not.

    I do think that some people have more of a risk to develop addictions (especially those which are mind-altering) that is based on their internal make-up, but I don't know that addiction in and of itself is a disease.
     
  13. cruisin

    cruisin Well-Known Member

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    Do you ever feel a desire to smoke? My mother smoked for 45 years, then had to suit, because smoking caused her to have an aortic aneurism. Not a day went by that she didn't crave cigarettes. So, she controlled it, but was still addicted. You can be a clean addict.

    Maybe the problem for some is the word disease. We tend to think of disease as viral or bacterial. Maybe the word illness is better suited. But, there are physical illnesses that can be controlled by choices too. People with type 2 diabetes can almost totally control their blood sugar with diet and exercise. Yet, many eat what they want, don't exercise and wind up insulin dependent. My father was one. When he was diagnosed, they told him he would never need insulin, if he watched his weight, ate right, and exercised. He was insulin dependent within 2 years.
     
    Last edited: Feb 6, 2014
  14. purple skates

    purple skates Shadow dancing

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    Nope. Once the physical cravings were gone (I used the patch to quit, so it was what - 8 weeks?) I was pretty much done with it. I might have had a thought to two about smoking (but they were just thoughts) occasionally, but I couldn't tell you the last time I did. I've been quit for 15 years now.

    I have a problem with using the idea of disease because, to me, it removes the voluntary aspect of addiction from the equation. The other thing that bothers me is that there are some people who get so addicted to their substance that they cannot quit, and others who can quit cold turkey and never look back. Why are these two types different? If it were a disease, wouldn't everyone who is addicted have the same trouble quitting? Or is addiction more tied to mental illness, which can manifest in varying degrees in different people. I tend to think that is more correct. I often wonder if the addiction treatment industry is actually doing a disservice when they talk about giving up to a higher power and being powerless against their addiction. If my experience with nicotine (and caffeine, for that matter, which I also quit years ago) is any indication then I absolutely did have power over them.
     
  15. cruisin

    cruisin Well-Known Member

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    Addiction is very difficult to treat. And is different in different people. Just as some people can have cancer and never have it come back, some are not so fortunate. I'm not sure that it always is tied in with mental illness. As has been said, there are some people who get hooked on opiates from pain medication prescribed for legitimate reasons. That said, addiction is almost always tied in to some other underlying mental illness. And as I said, up three, I don't see how it takes away the voluntary aspects. With any illness, you have to fight it. Whether it is physical or mental, you have to want to get better and do what it takes to fight the illness. some people are successful, some are not. Mental illness, for the most part if chemical. Meds can usually stabilize the chemistry to some degree. But, there can be unpleasant side effects. Many people go off their meds because of those side effects and the unbalance recurs. I am usually pretty good at talking myself down from my OCD panic attics. But, there are some triggers that send me over the edge. I can't breathe, my heart is pounding, I can't concentrate. I do everything in my power to stop the obsessive thinking, but that just exacerbates the obsessive thinking. Going over and over (in my head) that I have to let go of it, can send me into a total state of panic. Sometimes it is the fear of the panic attack, itself, that creates the panic. You create rituals that you use to try and circumvent the attacks. Sometimes they work, sometimes they don't. There is a component of phobia in OCD that is devastating. I can no more stop a major panic attack than I could fly (without a plane :)). Much of the problem with these type of disorders is that people who have them are not crazy. They know that their thinking is not rational. However, most of the time, there is some element of reality in their fears. Their brains take over with this what if, what if, what if permutations of what could happen and they lose control. For instance, we all know that we should handle raw meat carefully. That we could get very sick or die from bacteria in raw meat. But, I go beyond what is necessary for prevention. I know I don't have to go that far, but, what if I missed one germ? That one germ could get onto my hands, then I touch the salad, then… You see?
     
  16. snoopy

    snoopy Team St. Petersburg

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    Lots of afflictions can affect different people to different degrees. Rheumatoid arthritis or MS can affect one person severely and another person lightly. People even learn differently. So I don’t think how one person copes with an addiction can’t be extrapolated to how everyone should cope. But yeah, people with addictions are fortunate that they can practice behavior modifications to improve their condition in ways that people with MS can’t.
     
  17. topaz

    topaz Well-Known Member

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    As I was one of the one's posting off topic comments :(

    I agree with this post. I smoked for 7 years and I still occassionally want a a cigarette especially when I see others smoking and when I drink alcohol. MY aunt smoked for over 40 years and she's abstained from smoking for 5 years and she still craves nicotine.
     
  18. cruisin

    cruisin Well-Known Member

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  19. modern_muslimah

    modern_muslimah Thinking of witty user title and coming up blank

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    My mother works in the addiction treatment industry and they don't tell clients to just give up to a higher power. NA does this, I think, but modern treatment programs definitely hold clients accountable for their behavior. The organization she works for does view addiction as a disease but they also hold clients accountable if they relapse while in treatment. For instance, they may lose the privilege of going out during the weekend or worse, be kicked out. They have to explore what made them do drugs in the first, explore what triggers cause them to use, come up with plans to stay away from those triggers, learn to keep different company and stay away from areas that can trigger a craving, learn a job skill so they can be employable and hence have less time to get in trouble or hang with the wrong people, etc. So drug treatment programs definitely believe that clients do have some power over their addiction.
     
  20. LilJen

    LilJen Well-Known Member

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    Yes, it's a disease, or an illness. It can be controlled, or not controlled, or poorly controlled, just like my MIL's diabetes. (And she exhibits a lot of addictive behaviors in her relationship to her body and food, so it's a good thing she never was interested in alcohol.) Or it can dramatically affect your life, or not, or somewhere in between. The cravings (for whatever) may be horrible and overwhelming or they may be less--there are so many factors that go into your ability to control your addiction. Brain chemistry is DEFINITELY a factor, personality, your family, external stresses all affect how you'll live with your disease.
     
  21. Gazpacho

    Gazpacho Well-Known Member

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    What is your definition of a disease? The answer to the question hinges on that.
     
  22. manhn

    manhn Well-Known Member

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    What diseases have no element of personal accountability?
     
  23. Anita18

    Anita18 Well-Known Member

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    Seriously?

    You can get an STD at birth if your mother had it and it wasn't treated.

    Cancers when you're of a young age. My friend died of pancreatic cancer at 31 and he had absolutely no risks. No family history, he wasn't overweight (quite the opposite), didn't have diabetes, didn't drink excessively, whatever. He didn't have any risks, and he developed it anyway.



    People can react to genetic predispositions in different ways. I have weak teeth. Instead of throwing up my hands and saying, "Well, there's nothing I can do about this so I might as well relegate myself to having a mouth full of crowns at 35," I bought a Sonicare. I floss. I cut up my apples and I'm very careful when biting into things. I've made a choice - I do not live like someone who has strong teeth and get away with things like chomping into an apple or breaking things open with my teeth.

    That's a really minor example, but I think acknowledging that something like addiction is partly out of your control can set realistic expectations for yourself. Realistic expectations means that you have a fighting chance of reaching those goals. Like, some recovering alcoholics can't say no to alcohol when it's in front of them. If they are aware of that, they can take that aspect out of the equation by turning down any social events where there will be alcohol. Yes, it's a choice, but it's also an acknowledgement that their addiction is out of their control in certain situations, so they're simply going to avoid those situations to get a handle on it.

    But YMMV with each person. As I said, brain chemistry is a finicky thing.
     
  24. Skittl1321

    Skittl1321 Well-Known Member

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    There are a pretty large number that are based on genetic mutations.
    What do people do to get Thalsemmia? (Probably spelled that wrong.) MS? ALS? CP?
    Are you accountable for being exposed to TB or meningitis? Leukemia isn't usually something you could prevent getting.
     
  25. snoopy

    snoopy Team St. Petersburg

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    I think mahn may have meant what disease does not require you to manage it. Someone with juvenile diabetes didn't cause their disease but they are responsible for managing it - taking meds, etc. Pretty much any disease puts additional burdens of responsibility on the bearer. Not so much in the cause but in the response to the disease.
     
  26. cruisin

    cruisin Well-Known Member

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    But, isn't that so with addiction? What do you imagine is the % of people who try pot, cocaine, alcohol, other drugs? The % is that 20% to 30% will become addicted. So, the person who is predisposed to addiction tries a drug, like anyone else and ….
     
    Last edited: Feb 7, 2014
  27. susan6

    susan6 Well-Known Member

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    That brings up a "chicken or egg" question. I realized at a pretty young age that my family tree indicated that I was a genetic time bomb; a whole lot of addicts and other signs of serotonin imbalance in my relatives. So I decided to steer clear of addictive substances completely. (Not trivial when you attend some well-known "party schools". "What do you mean you don't drink?!?") Never triggered my genetic predisposition, never became addicted to anything. So....do I have a disease?
     
  28. purple skates

    purple skates Shadow dancing

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    That's good to hear.
     
  29. Anita18

    Anita18 Well-Known Member

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    I'd say that's a genetic predisposition that didn't progress to disease-state. You prevented yourself from getting addicted to anything, so you're not an addict.

    I have strong family history of osteoporosis, and I check off pretty much all the risk boxes. I'm taking calcium and I'm weightlifting to prevent it. I will not know until I am 50 if my efforts will be fruitful, but it's similar to your situation. I don't have osteoporosis, not technically. But I will if I don't do anything.
     
  30. cruisin

    cruisin Well-Known Member

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    Susan6, I would agree with Anita. But some, who are genetically prone to addiction, are not as aware as you. Or they don't believe it will happen to them. Or, they could accidentally become addicted, via pain meds for an injury or surgery. I have an addictive personality, and have gone there with my eating disorder. I could, very easily have gotten hooked on Percodan, with the amounts I've been given for oral surgeries. But, I chose not to take them. So, while I have an addiction, I chose not to allow a substance addiction. Even though I am not active (in my ED), I still consider myself as having an ED.

    Anita, my family has a strong history of osteoporosis, as well. At this point, I have osteopina. I also take and eat calcium, walk 3 miles a day, and do weight lifting. That helps, but I did a lot of damage in all of those years of horrible eating/starving myself. And being 5' 10" and having very small bones doesn't help either.