Historically, addiction was viewed as a choice. In the eyes of many, those who abused alcohol, drugs, or both were making a conscious decision to drink, swallow pills, or introduce illicit substances into their body. Fortunately, over time science has determined addiction is not a choice. Many scientists, addiction treatment providers, and mental health counselors will agree, addiction is indeed a disease, and just like many other chronic and debilitating diseases, addiction can be treated.
What is Addiction?
Addiction is often referred to in clinical terns as a substance use disorder. Described in the simplest terms, it is the strong compulsion to get and used substances, despite ongoing adverse and potentially dangerous consequences. Addiction is also frequently described as “a mental health disorder that affects the brain and changes behavior.” The development of addiction or a substance abuse disorder can result from the use of various substances, including alcohol, illicit drugs, prescription medications, and even some (legal) over-the-counter medications.
Addiction is a complex process that affects various parts of the brain and body. Addiction is responsible for disruptions of regions within the brain responsible for reward, judgment, learning, memory, and motivation. As a result, people who chronically abuse substances may not be entirely aware of the impact they are having on their body and its functioning.
Is Addiction a Disease?
How society views addiction continues to evolve. The definition of addiction varies (sometimes significantly) between individuals, organizations, the medical community, and society in general. Addiction is considered a disease by several organizations, including the National Institute on Drug Abuse (NIDA), the Substance Abuse and Mental Health Services Administration (SAMSHA) and the National Institutes of Health (NIH). These organizations consider addiction a disease because:
- Addiction changes how the brain responds in certain situations and sometimes changes the brain structure.
- These changes are long term and can persist until well after a person has attained sobriety.
The best way to understand this is to compare addiction to another disease process, such as cardiovascular disease.
- Both addiction and cardiovascular disease affect or inhibit the regular functioning of an organ in the body- the heart for cardiovascular disease and the brain for addiction.
- They both lead to decreased quality of life and increased risk for premature death.
- Addiction and cardiovascular disease are largely preventable by making healthy lifestyle choices and avoiding bad habits.
- They are both treatable.
Addiction is also marked by periods of recovery and relapse, as is the case with many other disease processes that may affect the human body. Consequently, it mimics illnesses such as hypertension and type-2 diabetes in this regard. These are lifelong illnesses that require ongoing effort to manage; however, symptom mitigation can occur with treatment. However, if compliance or effort begins to wane, symptoms are likely to return.
Indeed, addiction often begins with a choice. Unlike many other chronic disease processes for which one is an unwilling patient. People don’t choose cancer, diabetes, or hepatitis; however, they do choose to experiment with or try substances. But, while the decision to use was not forced upon the addicted person, it is hard to imagine someone would be willing to bring ongoing ruin on their health, relationships, and other vital areas of their lives if they had total control over their choices. It is important to note; the “addiction is a choice” viewpoint is shared by a very small majority. There are very few nationally recognized substance-abuse treatment focused organizations whose views have not evolved to where addiction is viewed as a disease or disorder.
Like other chronic disease processes, addiction is treatable. When selecting a treatment program, it is essential to choose one that tailors therapy models to the specific needs of the individual. At The Hills in Los Angeles, California, we understand that not all addiction symptoms are the same, and therefore our treatments are designed with each individual in mind. This type of intensive and specialized treatment helps to ensure success both during rehab and after.
Addiction as a Disease Model
As previously mentioned, addiction is indeed defined as a disease by most reputable medical associations, including the American Medical Association and the American Society of Addiction Medicine. As with diabetes, cancer, heart disease, and other chronic diseases, the cause of addiction is not one specific thing. Addiction is caused by a combination of behavioral, psychological, environmental, and biological factors. All of these together contribute to both one’s risk for addiction and their “substance of choice.” It is also important to note that genetic risk factors account for approximately half of the likelihood of developing a substance use disorder or addiction to substances.
Addiction involves changes in the functioning and sometimes the structure of the brain. It also results in changes to the body and functions of bodily systems due to the persistent use of alcohol or drugs. If addiction goes untreated, there are often significant consequences. These adverse effects include physical illness and the development of new (or exacerbation of pre-existing) mental health disorders that require medical attention. Similar to other chronic disease presses, if left untreated, addiction can become disabling and even life-threatening.
Is Addiction a Chronic Disease?
A chronic disease is a long-lasting condition that can be controlled but not cured. Some people who engage in substance use do not develop an addiction. However, about twenty-five to fifty percent of those with a substance use problem will develop a severe, chronic addiction disorder. For them, addiction is a progressive, relapsing disease that requires treatment at a facility like The Hills in Los Angeles, CA, to recover and attain sobriety. For these individuals continuing aftercare, monitoring, and family or peer support are also essential after completing their stay at a treatment center.
Substance Use Changes the Brain
Addiction changes the brain, which is one of the main reasons it is often classified as a disease instead of “a choice.” People have basic human needs, including thirst and hunger. When these needs are met, feelings of pleasure generally result. These feelings of pleasure are linked to the release of certain chemicals in the brain, reinforcing the need for these life-sustaining functions by providing an incentive (pleasure) to repeat these behaviors. Most addictive substances cause the brain to release high levels of these same chemicals that are associated with pleasure and reward from the completion of “natural” behaviors.
As time passes, the continued release of these chemicals causes significant changes in the brain to the systems involved in reward, motivation, and memory. In turn, the brain tries to get back to a balanced state by minimizing its reaction to rewarding chemicals or by releasing stress hormones. Consequently, one who is struggling with addiction may need to use increasingly more substantial amounts of the substance just to feel closer to “normal.” One may experience overwhelming desires or cravings for the substance and will continue to use despite adverse consequences to ensure repeated feelings of pleasure. In the most chronic forms of the disease, a severe substance use disorder can cause a person to stop caring about their own well-being or that of others. They may also show a lack of concern for their own survival.
These changes to the brain can persist for some time, even after the person stops using substances. It is also believed these changes may leave those with addiction increasingly vulnerable to triggers, which can increase the chances of relapse even after a full treatment program has been completed.
Why Do Some Say Addiction is not a Disease?
The belief that addiction is not a disease, but a choice has been at the forefront of opinions related to addiction for many years. Some people feel addiction cannot be a disease because it is caused by the individual’s choice to use substances. While it is true that the first use may be by choice, once the brain has undergone changes related to addiction, most experts believe one loses control over their ability to decide.
Choice, or the ability to choose, does not determine whether something is a disease. In fact, personal choice is involved in a great many chronic diseases. Heart disease, some forms of cancer, and diabetes all involve some level of personal choice such as sun exposure, diet, exercise, etc. A resulting disease is what happens to the body as a consequence of those individual choices.
Others may argue that addiction is not a disease because some people may achieve sobriety without treatment. Those with a mild substance use disorder may indeed recover with little or no treatment. However, those who struggle with the most severe forms of addiction usually need intensive, medically supervised treatment at a residential addiction treatment facility such as The Hills to successfully attain sobriety.
People do not choose how their brain and bodily systems respond to substances. For this reason, people with addiction are unable to control their use of substances. People with addiction can and do stop using substances; it takes work and ongoing treatment and care. If you or your loved one are struggling with a substance use disorder or addiction, it is never the wrong time to ask for help.
Professional addiction treatment at The Hills in Los Angeles, California, is an evidence-based, effective way to address all elements of your addiction. Addiction affects your entire body, including your physical and mental health. A treatment plan needs to take both your addiction and any other medical or mental health issues you may be experiencing into consideration when creating a treatment plan. Addiction treatment is not meant to be cookie-cutter in nature. Each treatment plan must be carefully and thoughtfully designed for the person seeking treatment.
Getting help may be intimidating, but at The Hills, we offer the resources, compassion, and empathy needed to make the process as easy to navigate as possible. If you or a loved one are ready to seek treatment for addiction, contact The Hills today.