Addiction; Disease or Not?

[jj22]

Many of us have known or even God forbid have experienced Addiction close to home rather it be a sibling (my story) or other friend or family members. I am apart of a group for "Heroin Angels" for family members who have lost someone to addiction. A lot of times I hear them say it is a disease, now these people are in pain and I certainly understand their pain after my family's loss, but I'm not sure I agree with them it's a disease.

I'd never say it, because I think it's such a painful experience you have to believe what you can to get through it as family member or friends of someone who suffers from an addiction.

So I ask, what are your thoughts? Is addiction a disease?

I'm just not sure how I feel about that excuse as many of these parents I read stories about are very passionate about it being a disease, and I just personally don't know if I agree.

[jj22]

Disease by definition:

a disorder of structure or function in a human, animal, or plant, especially one that produces specific signs or symptoms or that affects a specific location and is not simply a direct result of physical injury.

[*TheLeonardLeap*]

I don't particularly care for calling it a disease.

I know there are people who are genetically predisposed to be easier to become addicted, but I think it gives some people a bit too much sympathy/too much of an out by calling it a disease. It makes it seem like drunks can't help but beat their family because it's a disease, gambling addicts can't help but become massively in debt because it's a disease.

AA, NA, etc don't give you some kind of miracle cure. It's a matter of desire, willpower, and structure to be "cured". You can't willpower and structure away cancer or ALS. Those are proper diseases.

[SunsetBengal]

(08-30-2019, 05:35 PM)TheLeonardLeap Wrote: I don't particularly care for calling it a disease.

I know there are people who are genetically predisposed to be easier to become addicted, but I think it gives some people a bit too much sympathy/too much of an out by calling it a disease. It makes it seem like drunks can't help but beat their family because it's a disease, gambling addicts can't help but become massively in debt because it's a disease.

AA, NA, etc don't give you some kind of miracle cure. It's a matter of desire, willpower, and structure to be "cured". You can't willpower and structure away cancer or ALS. Those are proper diseases.

To your bolded, that is why I also do not feel like addiction is a disease, as much as a choice.  The only known cure is to choose not to use, and rely on the support of other individuals in times of weakness.  People with actual diseases have no choice in the matter (most cases, STDs and addiction related body failings not withstanding).

I'm not just talking out my backside, I know what addiction looks like.  My birth mother was an addict of all sorts, weather it be chemically induced or physical pleasures, she had to have it.  It eventually led to her body failing and early onset of Alzheimer's.  She spent her final 12 years in a lock down unit for Alzheimer's patients.  They did their best to bring her physical health back, but the brain was gone several years prior.  I'm not so certain that her issues were ones of physical dependence, as much as a lack of self worth and emotional emptiness.  

[oncemoreuntothejimbreech]

If a person can stop using drugs or alcohol through sheer willpower that isn't addiction, by definition.

[Beaker]

(08-30-2019, 05:24 PM)jj22 Wrote: Many of us have known or even God forbid have experienced Addiction close to home rather it be a sibling (my story) or other friend or family members. I am apart of a group for "Heroin Angels" for family members who have lost someone to addiction. A lot of times I hear them say it is a disease, now these people are in pain and I certainly understand their pain after my family's loss, but I'm not sure I agree with them it's a disease.

I'd never say it, because I think it's such a painful experience you have to believe what you can to get through it as family member or friends of someone who suffers from an addiction.

So I ask, what are your thoughts? Is addiction a disease?

I'm just not sure how I feel about that excuse as many of these parents I read stories about are very passionate about it being a disease, and I just personally don't know if I agree.

I think it has to do with genetics more than disease. You are genetically predisposed to have an addictive personality type.

[Belsnickel]

I am of the opinion that addiction is a disease. Let's look at the definition provided:

(08-30-2019, 05:26 PM)jj22 Wrote: Disease by definition:

a disorder of structure or function in a human, animal, or plant, especially one that produces specific signs or symptoms or that affects a specific location and is not simply a direct result of physical injury.

A disorder is "an abnormal physical or mental condition." Addiction is most certainly a disorder as it is an alteration of the normal function of the brain. Addiction changes the brain and body in ways that create the dependence on the substance, often dopamine but other neurotransmitters are also involved. The desensitization to these transmitters is what creates the dependence as there is the constant "chase" for that feeling, which requires more and more of a substance to initiate.

So a disease is a disorder of structure of function that produces signs and symptoms, not the result of an injury, and addiction is absolutely a disorder that has signs and symptoms and is not the result of an injury, but rather a combination of genetic, environmental, and epigenetic factors.

(09-02-2019, 01:52 PM)Beaker Wrote: I think it has to do with genetics more than disease. You are genetically predisposed to have an addictive personality type.

You can also have genetic predispositions to diabetes, heart disease, and cancer. You can genetically be more likely to have a disease, but that doesn't make it less of a disease.

[Beaker]

(09-02-2019, 02:16 PM)Belsnickel Wrote: You can also have genetic predispositions to diabetes, heart disease, and cancer. You can genetically be more likely to have a disease, but that doesn't make it less of a disease.

Nor does it make a disease a personality type.

[Au165]

(08-30-2019, 05:35 PM)TheLeonardLeap Wrote: I don't particularly care for calling it a disease.

I know there are people who are genetically predisposed to be easier to become addicted, but I think it gives some people a bit too much sympathy/too much of an out by calling it a disease. It makes it seem like drunks can't help but beat their family because it's a disease, gambling addicts can't help but become massively in debt because it's a disease.

AA, NA, etc don't give you some kind of miracle cure. It's a matter of desire, willpower, and structure to be "cured". You can't willpower and structure away cancer or ALS. Those are proper diseases.

Is depression a disease? 

[*michaelsean*]

I'm an alcoholic (Hi Mike) and I've never been able to decide. I think a lot of addicts use it to shift blame off themselves though.

[*michaelsean*]

(08-30-2019, 10:16 PM)oncemoreuntothejimbreech Wrote: If a person can stop using drugs or alcohol through sheer willpower that isn't addiction, by definition.

Not sure where you get that.  I was physically addicted to alcohol.  I no longer am.  I drank all day every day.  I no longer do so.  

[Belsnickel]

(09-03-2019, 01:35 PM)michaelsean Wrote: Not sure where you get that.  I was physically addicted to alcohol.  I no longer am.  I drank all day every day.  I no longer do so.  

Yeah, I was going to say I disagree with that, as well. As a former smoker I was physically addicted to nicotine and I went cold turkey.

It ain't the norm, but it does happen.

[oncemoreuntothejimbreech]

(09-03-2019, 01:35 PM)michaelsean Wrote: Not sure where you get that.  I was physically addicted to alcohol.  I no longer am.  I drank all day every day.  I no longer do so.  

I get that from education, training, and experience.

Physical dependence and addiction are not the same.

I'll use pain management patients as an example.  Most pain management patients are prescribed opioids to control their pain.  One hundred percent of those patients will eventually become physically dependent upon the opioids if they take them long enough and will go through withdrawal if they stop them abruptly without weaning off of them.  Some of those patients may progress from physical dependence to addiction, but not 100%.  If you're physically dependent upon a medication such as an opioid to treat pain, but you are taking it therapeutically, aren't abusing it or taking it for non-therapeutic reasons, and it isn't causing other problems in your life then that patient isn't addicted, but they are physically dependent. 

[*michaelsean*]

(09-03-2019, 03:01 PM)oncemoreuntothejimbreech Wrote: I get that from education, training, and experience.

Physical dependence and addiction are not the same.

I'll use pain management patients as an example.  Most pain management patients are prescribed opioids to control their pain.  One hundred percent of those patients will eventually become physically dependent upon the opioids if they take them long enough and will go through withdrawal if they stop them abruptly without weaning off of them.  Some of those patients may progress from physical dependence to addiction, but not 100%.  If you're physically dependent upon a medication such as an opioid to treat pain, but you are taking it therapeutically, aren't abusing it or taking it for non-therapeutic reasons, and it isn't causing other problems in your life then that patient isn't addicted, but they are physically dependent. 

I think I mentioned I drank every day all day as well.  18 to 24 beers or other drinks every day.  I no longer do that.  Nobody is restraining me.  Are you claiming I wasn't addicted?  Do you believe Matt didn't have a psychological addiction to nicotine? And you are telling me that in one of the medical classes you took they stated a person cannot stop using through willpower? Maybe if you gave us your definition of addiction because I don't see any that say what you are saying. The AMA doesn't state that in their definition. If someone goes to rehab, what do you consider that? Or AA? I'm guessing you look at the word "inability" as something that can't be changed. It can.

[Belsnickel]

(09-03-2019, 01:35 PM)michaelsean Wrote: Not sure where you get that.  I was physically addicted to alcohol.  I no longer am.  I drank all day every day.  I no longer do so.  

(09-03-2019, 01:47 PM)Belsnickel Wrote: Yeah, I was going to say I disagree with that, as well. As a former smoker I was physically addicted to nicotine and I went cold turkey.

It ain't the norm, but it does happen.

(09-03-2019, 03:01 PM)oncemoreuntothejimbreech Wrote: I get that from education, training, and experience.

Physical dependence and addiction are not the same.

I'll use pain management patients as an example.  Most pain management patients are prescribed opioids to control their pain.  One hundred percent of those patients will eventually become physically dependent upon the opioids if they take them long enough and will go through withdrawal if they stop them abruptly without weaning off of them.  Some of those patients may progress from physical dependence to addiction, but not 100%.  If you're physically dependent upon a medication such as an opioid to treat pain, but you are taking it therapeutically, aren't abusing it or taking it for non-therapeutic reasons, and it isn't causing other problems in your life then that patient isn't addicted, but they are physically dependent. 

This may help in this discussion: https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/there-difference-between-physical-dependence

Quote:Addiction—or compulsive drug use despite harmful consequences—is characterized by an inability to stop using a drug; failure to meet work, social, or family obligations; and, sometimes (depending on the drug), tolerance and withdrawal. The latter reflect physical dependence in which the body adapts to the drug, requiring more of it to achieve a certain effect (tolerance) and eliciting drug-specific physical or mental symptoms if drug use is abruptly ceased (withdrawal). Physical dependence can happen with the chronic use of many drugs—including many prescription drugs, even if taken as instructed. Thus, physical dependence in and of itself does not constitute addiction, but it often accompanies addiction. This distinction can be difficult to discern, particularly with prescribed pain medications, for which the need for increasing dosages can represent tolerance or a worsening underlying problem, as opposed to the beginning of abuse or addiction.

There is also a site from the Addiction Center on this: https://www.addictioncenter.com/addiction/addiction-vs-dependence/

Here is one section I pulled out:

Quote:Addiction is marked by a change in behavior caused by the biochemical changes in the brain after continued substance abuse. Substance use becomes the main priority of the addict, regardless of the harm they may cause to themselves or others. An addiction causes people to act irrationally when they don’t have the substance they are addicted to in their system.

Those biochemical changes would move the situation into disease territory.

[oncemoreuntothejimbreech]

(09-03-2019, 03:14 PM)Belsnickel Wrote: This may help in this discussion: https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/there-difference-between-physical-dependence


There is also a site from the Addiction Center on this: https://www.addictioncenter.com/addiction/addiction-vs-dependence/

Here is one section I pulled out:

Those biochemical changes would move the situation into disease territory.

That plus the harm they cause and the inability to quit (edited to add) without treatment.

[oncemoreuntothejimbreech]

(09-03-2019, 03:14 PM)michaelsean Wrote: I think I mentioned I drank every day all day as well.  18 to 24 beers or other drinks every day.  I no longer do that.  Nobody is restraining me.  Are you claiming I wasn't addicted?  Do you believe Matt didn't have a psychological addiction to nicotine? And you are telling me that in one of the medical classes you took they stated a person cannot stop using through willpower? Maybe if you gave us your definition of addiction because I don't see any that say what you are saying. The AMA doesn't state that in their definition. If someone goes to rehab, what do you consider that? Or AA? I'm guessing you look at the word "inability" as something that can't be changed. It can.

I'm using the same definition, but maybe my understanding or perspective is different. Rehab and AA are forms of treatment used to overcome addiction. Those people aren't quitting through sheer willpower alone. (Edited to add) Look at the definition of addiction in the drug abuse.gov link Matt provided, characterized by an inability to quit. So it's listed in the definition.

I want you to Google "can you stop an addiction through willpower." There are lots of sources of information you can find there. After you have read some of those sources let me know if you still have questions.

[*michaelsean*]

(09-03-2019, 04:41 PM)oncemoreuntothejimbreech Wrote: I'm using the same definition, but maybe my understanding or perspective is different. Rehab and AA are forms of treatment used to overcome addiction. Those people aren't quitting through sheer willpower alone. (Edited to add) Look at the definition of addiction in the drug abuse.gov link Matt provided, characterized by an inability to quit. So it's listed in the definition.

I want you to Google "can you stop an addiction through willpower." There are lots of sources of information you can find there. After you have read some of those sources let me know if you still have questions.

Yes it's an inability.  An inability is not necessarily permanent.  Life events such as having a child or just saying enough is enough or hitting rock bottom can shift that.  Once you overcome that inability, you are no longer addicted.  It's odd that you think attending meetings means it's more than sheer willpower and therefore qualifies as an addiction.

Ummm no I don't have any questions for you.

[oncemoreuntothejimbreech]

(09-03-2019, 05:24 PM)michaelsean Wrote: Yes it's an inability.  An inability is not necessarily permanent.  Life events such as having a child or just saying enough is enough or hitting rock bottom can shift that.  Once you overcome that inability, you are no longer addicted.

Well, I've obviously done a poor job explaining.

You're correct.  It is not a permanent inability to quit nor did I state it was.  However, the inability to quit is a key distinguishing feature between abuse and addiction.  Addiction involves the compulsive use and the inability to quit.  Compulsive as in a mental disorder (similar to the compulsive component of OCD) in which they aren't able to stop abusing the substance even though they want to and they know it is adversely affecting them and most likely those around them.  They usually have multiple failed attempts at quitting because they aren't able to quit on their own without some sort of intervention/treatment.  This stems from the fact they have physiological changes from the abuse. (Akin to diabetic ketoacidosis . . . their body's chemistry is abnormal resulting in dysfunction.)

If someone is able to quit through sheer willpower they are more likely to suffer from substance abuse rather than addiction.  There is an exception for almost every rule, but to quote WebMD, "Alcohol use disorder is what doctors call it when you can’t control how much you drink and have trouble with your emotions when you’re not drinking. Some people may think the only way to deal with it is with willpower, as if it’s a problem they have to work through all on their own.

But alcohol use disorder is actually considered a brain disease. Alcohol causes changes in your brain that make it hard to quit. Trying to tough it out on your own can be like trying to cure appendicitis with cheerful thoughts. It’s not enough."

To put it in football terms, suggesting an addict can quit with just willpower alone is like suggesting every PeeWee WR should run routes and catch the ball like A.J. Green.  Neither idea is realistic for the vast majority.

Quote:It's odd that you think attending meetings means it's more than sheer willpower and therefore qualifies as an addiction.

Ummm no I don't have any questions for you.

I don't think a person suffers from addiction because the attend meetings like AA.  But, participants in AA are engaged in a type of group therapy/counseling and behavior modifications similar to seeing a psychologist for one on one counseling.  It is a form a treatment above and beyond just sheer willpower.  What would make me more likely suspect someone suffered from addiction is if they were finally able to overcome their addiction with the help of AA after failing to quit on their own (usually multiple times).  Does that make more sense?