Why Is Addiction Classified as a Disease?

Since the introduction of the disease concept model research studies have examined a possible genetic link in alcoholism/addiction. One such study demonstrates that the offspring of alcoholics are approximately three to five times more likely to develop alcoholism than offspring of non-alcoholics .

The disease model has been so profitable and politically successful that it has spread to include problems of eating, child abuse, gambling, shopping, premenstrual tension, compulsive love affairs, and almost every other form of self-destructive behavior… From this perspective, nearly every American can be said to have a disease of addiction.

Because it gives the addicted person an excuse. They now do not have to take responsibly for their condition. They are now a victim of circumstance; they have caught a disease.

Not all doctors agree on what addiction or dependency is, because traditionally, addiction has been defined as being possible only to a psychoactive substance (for example alcohol, tobacco, or drugs), which is ingested, crosses the blood-brain barrier, and alters the natural chemical behavior of the brain temporarily. Many people, both psychology professionals and laypersons, now feel that there should be accommodation made to include psychological dependency on such things as gambling, food, sex, pornography, computers, work, exercise, cutting, and shopping / spending. However, these are things or tasks which, when used or performed, cannot cross the blood-brain barrier and hence, do not fit into the traditional view of addiction. Symptoms mimicking withdrawal may occur with abatement of such behaviors; however, it is said by those who adhere to a traditionalist view that these withdrawal-like symptoms are not strictly reflective of an addiction, but rather of a behavioral disorder. In spite of traditionalist protests and warnings that overextension of definitions may cause the wrong treatment to be used (thus failing the person with the behavioral problem), popular media, and some members of the field, do represent the aforementioned behavioral examples as addictions.

In the contemporary view, the trend is to acknowledge the possibility that the hypothalmus creates peptides in the brain that equal and/or exceed the effect of externally applied chemicals (alcohol, nicotine etc.) when addictive activities take place. For example, when an addicted gambler or shopper is satisfying their craving, chemicals called endorphins are produced and released within the brain, reinforcing the individual’s positive associations with their behavior.

Despite the popularity of defining addiction in medical terms, recently many have proposed defining addiction in terms of Economics, such as calculating the elasticity of addictive goods and determining, to what extent, present income and consumption (economics) has on future consumption.

The disease model of addiction holds that addiction is a disease, coming about as a result of either the impairment of neurochemical or behavioral processes, or of some combination of the two. Within this model, addictive disease is treated by specialists in Addiction Medicine. Within the field of medicine, the American Medical Association, National Association of Social Workers, and American Psychological Association all have policy as to addictive processes representing a disease state. While there is some dispute among clinicians as to the reliability of this model, it is widely employed in therapeutic settings. Most treatment approaches involve recognition that dependencies are behavioral dysfunctions, and thus involve some element of physical or mental disease. Critics like Stanton Peele describe an absence of medical evidence for an implied physiological process (beyond that of simple mood state changes) that can be equated with the disease of addiction. Organizations such as the American Society of Addiction Medicine believe the research-based evidence for addiction’s status as a disease is overwhelming.

The genetic model posits a genetic predisposition to certain behaviors. It is frequently noted that certain addictions “run in the family,” and while researchers continue to explore the extent of genetic influence, there is strong evidence that genetic predisposition is often a factor in dependency. Researchers have had difficulty assessing differences, however, between social causes of dependency learned in family settings and genetic factors related to heredity.

The cultural model recognizes that the influence of culture is a strong determinant of whether or not individuals fall prey to certain addictions. For example, alcoholism is rare among Saudi Arabians, where obtaining alcohol is difficult and using alcohol is prohibited. In North America, on the other hand, the incidence of gambling addictions soared in the last two decades of the 20th century, mirroring the growth of the gaming industry. Half of all patients diagnosed as alcoholic are born into families where alcohol is used heavily, suggesting that familiar influence, genetic factors, or more likely both, play a role in the development of addiction. What also needs to be noted is that when people don’t gain a sense of moderation through their development they can be just as likely, if not more, to abuse substances than people born into alcoholic families.

A blended model attempts to consider elements of all other models in developing a therapeutic approach to dependency. It holds that the mechanism of dependency is different for different individuals, and that each case must be considered on its own merits.