One of the most serious questions we encounter as drug addiction treatment professionals relates to the disease model of addiction. People ask: “Is addiction a disease? How can that be?” While our main focus as a drug treatment center is to help sick and suffering addicts and alcoholics, it also behooves us to provide education about addiction and why, exactly, it is a brain disease. Unfortunately, a lack of awareness around the disease model of addiction can form major barriers to treatment and social reform.
The most widely spread myth about addiction is that the addict “chooses” to use drugs and/or alcohol. In other words, addiction is a “choice”. This assumption is simply not true. However, it seems to be the biggest hurdle for skeptics to overcome. The first time an individual uses a substance, it is a choice. However, once the reward pathways in the brain are activated and changed by drugs or alcohol, the addict’s behavior no longer originates from a place of choice…it originates from a place of compulsion.
The key to understanding the disease model of addiction is to remember that drugs and alcohol change the brain. Normal brain transmissions are interrupted. Over time, the substance stops causing a feeling of euphoria. The brain is so severely impacted that it perceives a need for drugs or alcohol – not just to feel high – but to simply feel “okay” or normal. In other words, the brain is sending the message that it needs the substance just to function at a baseline level. The fun is over and physical dependence has begun.
“Yes, but why would someone choose to use heroin, methamphetamine, or other hard drugs…even just one time?” The answer to this question is complex and multilayered. The over-prescription of opioids is one of many pathways to harder drug use. Furthermore, according to the American Society of Addiction Medicine, “genetic factors account for about half of the likelihood that an individual will develop addiction”. This means that some individuals are genetically predisposed to having susceptible brains. Others grow up in environments where seeking relief in drugs or alcohol is the cultural norm. Since they haven’t been taught any coping skills, they don’t know how to live life differently. Another reason people may seek out “taboo drugs” is simply the progression of the disease. Once a substance ceases to create a feeling of euphoria – or even help the individual to feel normal – it may become necessary to achieve baseline functioning by supplementing with other substances.
An active addict’s brain is dying. That’s the long and short of the matter. Sometimes it happens quickly and sometimes it happens slowly, but over time brain functioning is severely impaired and dysfunction ensues in all arenas of the addict’s life. Chronic disease is, by definition, progressive and fatal if left untreated. The cruel irony of addiction is that the brain is demanding the very substance that is killing it. An addict must comply or suffer. This is why a crucial part of drug addiction treatment is helping to restore normal, healthy brain functioning. Healing is a holistic process which involves removing the substance and painstakingly rewiring damaged pathways with cognitive behavioral therapies.
If you’re out there and you’re feeling skeptical about the disease model of addiction, take a moment to think back on the first time you tried a beer or experimented with a drug. Perhaps you partied through college and left the lifestyle behind when you entered the workforce. Maybe you enjoy a glass of wine with dinner or let loose a few times a year with your friends. You’re pretty normal, right? Now imagine that the first time you tried a beer, your brain lit up and said: “I need more of this!” Imagine that one day you woke up and found that you couldn’t stop drinking. Or imagine that you partied your way through college, but when you entered the workforce, you discovered that you weren’t like all the others who left the party scene behind. Now try to picture getting injured playing your favorite sport. Imagine that the doctor prescribed painkillers. When you tried to stop taking them, you felt violently sick and renewed your prescription to avoid the discomfort. These kind of scenarios are a reality for millions of people around the world.
“If all this is true and addiction is a disease, then why don’t people have more compassion?” Unfortunately, the consequences of addiction have a more visible societal impact. The consequences of heart disease and diabetes are more subtle. They are expressed in terms of billions of dollars of health insurance costs. As a society, we know it’s a problem, but it’s not “in your face” like addiction. The consequences of addiction are more dramatic and shocking. Innocent people die in violent car crashes and families are torn apart. As the brain demands “more”, the sick and suffering addict feels powerless to do anything but comply, even as his or her world crashes and burns. It’s not that he or she doesn’t want to stop or that he or she likes hurting others; it’s that he or she may not know how to stop or that it’s even possible to live any other way.
Although an addict may not have a choice about pursuing drugs and alcohol to maintain baseline brain functioning, that does not mean that he or she is exempt from the consequences of his or her behavior. The disease model of addiction isn’t an excuse; it is merely an explanation. Part of the recovery process is taking responsibility for past behavior and taking action steps to make it right. On the same token, it’s important to note that although people don’t choose to have this illness…they can choose whether or not to ask for help. Recovery is a choice.
At the Process Recovery Center, we think that it is an unimaginable tragedy to suffer from an illness while simultaneously carrying the weight of judgement. We hope that you well help us continue to defeat stigma by educating others about the disease model of addiction and considering the cultural messages you spread about drugs and alcohol. If you need support or would like further information about the disease of addiction, please don’t hesitate to contact us at any time. We would be happy to answer your questions. If you are ready to choose recovery, please call (888) 649-1149 or contact us here. Suffering from addiction doesn’t make you a bad person; it means you have an illness. Just like a multitude of other diseases, treatment is possible. We are available 24/7 to help you embark on the road to recovery.
Autumn Khavari is the Process Recovery Center’s web content writer. She received an education in Substance Abuse Counseling from Beal College in Bangor, Maine.