Addiction is characterized by brain changes that lead to compulsive drug-seeking behaviors despite the problems the drug use causes. But is addiction a disease? The medical community has widely accepted the Disease Theory of Alcoholism since it was embraced after World War II, but is the theory still sound?
How is Addiction a Disease?
Part of what makes addiction a disease is that it can be systematically observed, diagnosed, understood, treated and prevented. Like other diseases, including diabetes and heart disease, addiction is chronic, which means that it can reoccur if someone uses again after a period of recovery. Also, like diabetes and heart disease, which are often caused by a range of unhealthy lifestyle choices, choice is no longer a factor once the disease develops. Whether an addiction – or diabetes or heart disease – develops depends on a number of factors, including genetics, biology, culture, and environment.
According to the National Council on Alcoholism and Drug Dependence, addiction is diagnosed as a disease based on four symptoms:
- Developing tolerance, which means that you need increasingly larger doses to get the desired effects.
- The onset of withdrawal symptoms when you stop using drugs or alcohol.
- A loss of control over the amount you use and the frequency of using.
- Continuing to use drugs or alcohol even though doing so is causing problems in your life, including relationship, legal, financial, or health issues.
These symptoms are all the result of changes in the physical structures and chemical functions of the brain, and indeed, the disease theory is based in neuroscience.
The Addicted Brain
To answer the question, “Is addiction a disease?“, it’s important to understand how addiction affects the brain.
The brain changes associated with addiction occur in the learning, memory, and reward systems of the brain and involve, in part, the neurotransmitter dopamine, which is responsible for feelings of pleasure. Normal pleasurable activities like sex and eating produce a dopamine rush, which plays a key role in memory and learning. It keeps us seeking out these pleasurable activities in order to promote the survival of the species.
But when one takes drugs or alcohol, the dopamine release is far greater than what is found in nature. The reward system of the brain is hijacked, and the brain begins to associate the drug abuse and the associated environmental cues with intense pleasure. Soon, this association becomes engrained, and the result is intense cravings whenever a cue–also known as a trigger–occurs. Triggers are the people, places, and things that your brain associates with using and which cause unbearable cravings and compulsive drug use–think Pavlov’s dog, who salivated every time a bell rang because he associated the sound with food.
Is Addiction a Disease that Can Be Cured?
So, is addiction a disease that you’ll have to live with for the rest of your life? The National Institute on Drug Abuse stresses that once addiction develops, professional help is almost always needed to send the addiction into remission for the long-haul.
There is no cure for addiction, but like other chronic diseases, it can be sent into remission for the long-term. Recovery from addiction requires addressing its underlying causes, which often include chronic stress, a history of trauma, and co-occurring mental illnesses. Central to recovery are making healthy lifestyle changes, changing dysfunctional thought and behavior patterns, and developing essential skills for handling stress, cravings and other triggers.
Once you’re in recovery, using again will almost always lead back to compulsive use despite negative consequences. It will lead back to tolerance and the onset of withdrawal symptoms when you try to stop again.
Addiction Isn’t a Moral Issue
Some people question the disease model of addiction. They wonder, is addiction a disease, or is it a moral failing or a lack of willpower? The truth is, morality and willpower have nothing to do with it. People abuse drugs and alcohol for various reasons, but for those who become addicted, it almost always boils down to using as a way of coping with difficulties in life.
Learning to cope with life without drugs or alcohol is a major focus of treatment. Treatment works to not only send the addiction into long-term remission but also to improve your life on many fronts and help you find purpose and meaning in a life without drugs. Treatment works, and it can work for you, too.