Addiction A-Z

Disease model of addiction

Researchers have been studying addiction for decades, searching for what causes it, how to prevent it, how to treat or possibly cure it, why some people become addicted and others don’t. At one time addiction was thought to be a sin, borne by those of weak wills. For many years, addicts were looked upon as carrying a stigma, since addiction was considered low class. Fortunately, the prevailing thinking swung over to the theory that addiction has a physiological as well as psychological basis. This laid the groundwork for the disease model of addiction.

The National Institute on Drug Abuse (NIDA) says that addiction is a chronic disease similar to other chronic diseases such as cancer, type II diabetes and cardiovascular disease. Addiction, like other diseases, changes a person’s biology. Image scans of the brains of addicts show evidence of tissue malfunction. Furthermore, there are many factors involved in addiction and features that are shared with other chronic diseases. These include the tendency for addiction to run in families, an onset and course of disease influenced by behavior and environmental conditions and an ability to respond to appropriate treatment.

Human studies of addictive behavior show clear implications of environmental and genetic influences, as well as interactions between the two. Various studies (adoption and studies of twins, for example) have shown the influence of certain genes in a person’s vulnerability to addiction. Interacting with genetics to determine the course and outcome of disease are complex environmental and protective factors. These are areas that NIDA and other National Institutes of Health (NIH) are keenly focused on. Contributing factors in drug addiction include peers who use drugs, availability of drugs, witnessing or being a victim of violence, stress and early physical and/or sexual abuse.

NIDA and other experts stress that no one chooses to be a drug addict, but our lifestyle choices may strongly increase our risk of becoming addicted. Accepting personal responsibility and changing behaviors with the potential to lead to addiction are key components of effective treatment programs for addiction.

Alcoholism as a Primary Disease – American Society of Addiction Medicine

The American Society of Addiction Medicine (ASAM) issued a public policy statement on alcoholism as a primary disease in 1996. Their statement reads: “Based on many years of clinical experience, reinforced by recent and continuing research into the genetic, biochemical and physiological aspects of the effects of alcohol on living systems and of alcoholics and their families, the American Society of Addiction Medicine finds that alcoholism is a complex primary physiological disease, and neither a primary behavior disorder nor a symptomatic manifestation of any other disease process.”

American Medical Association

Since 1956, the American Medical Association (AMA) has formally recognized that addiction is a disease. The recognition of addiction to alcohol or other substances as a disease implies the following:

  • Like other diseases, such as cancer and cardiovascular disease, the illness of addiction can be described.
  • The course of addictive illness is both predictable and progressive.
  • Addiction is a primary disease. It is not merely a symptom of an underlying disorder.
  • Addiction can be treated, but it cannot be cured.
  • Without treatment, addiction can result in premature death or insanity.

American Psychiatric Association

The American Psychiatric Association (APA), on its HealthyMinds.org website, says “addiction is a serious illness…a chronic illness like heart disease, high cholesterol or high blood pressure.” The APA further states that:

  • Persons with these chronic diseases are prone to relapse.
  • Because substance abuse affects many aspects of an individual’s life, multiple forms of treatment are often required.
  • A combination of medication and individual or group therapy is most effective.
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