Is Addiction a Disease?

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Our lives changed the day we began looking inside ourselves for ways to move towards more joy and less suffering for us and those around us. We took ownership of the good and bad from our past and learned that if we came from a place of inner strength we could frame much of our future. The lessons and necessary mentoring that led to us reshaping our experiences happened within the context of addiction treatment. This treatment for us, and many others, consisted of working on ourselves with the guidance of people who had re-built – or built for the first time – daily lives rich in meaning and social connection.

Prior to this awakening, we spent many disastrous years looking outside of ourselves for solutions to life’s complexities. Encouragement came from the mental health system; to look to pills and therapy modalities to make us “normal” or “fit in.” Ultimately, we sought external solutions in very dark and unhealthy places. Responding to emotions for us meant looking to disease-model psychiatry and addictive behaviors in order to be ok with our worlds.

The last several years we have sat with painful emotions from time to time and have continuously learned from our past experiences. A practice we simply had never done. Our emotions and feelings had always been something that needed to be erased with psych drugs or in other ways. Our emotions were signs of our being broken. People who had walked through the fire we were currently walking through came into our lives and taught us invaluable life lessons. The most poignant and constant lesson was the idea that we are responsible for ourselves. This message sent us on a journey seeking healthy ways to channel our best selves. Meditation, yoga, healthy foods and nourishing relationships have helped us maximize our human experience. It has been important to us that we cultivate a sense of spirituality and a connection to something more significant than our individual lives.

The mental health system conveys a different message. The diagnostic process strips people of personal agency. After being diagnosed, people are often told to lower life expectations and avoid stress. Emotions are viewed as signs of disease to be medicated away. Therapies are often used to try and mold us into people others want us to be. The outcomes of this approach have been tragic.

Filled with sadness and concern, we have been watching the addiction treatment world moving away from the philosophy that saved our lives. “Medication assisted recovery” is rapidly becoming the first option for people dealing with addiction. Rehab facilities that we respected and have referred people to have recently employed full-time psychiatrists. Funding for Methadone and Suboxone “treatment” is readily available to providers. Various psychiatric drugs are used at an increasingly alarming rate in rehab facilities.

Advocates and others calling addiction a disease have played a role in this disturbing shift in philosophy. The reasons why advocates want addiction framed as a disease are understandable. They feel a disease model will make it easier to get recovery supports funded by insurance companies (parity being a goal). Identifying addiction as a disease might also garner more empathy and understanding for addiction experiences – leading to less discrimination.

The problem is that when you use disease language and ask for parity you might actually get what you ask for. Parity means addiction will be treated equally under the medical model. In this country, that means drugs. Drugs mean huge profits for big pharma and ultimately a paradigm shift. This was an unintended consequence partly resulting from people’s advocacy – most of whom rebuilt their lives within drug free frameworks. It seems that the language of addiction is being hijacked by big pharma.

We are witnessing the erosion of a process that has been effective for many. What is happening is eerily similar to what happened within the “mental health field.” Drugs that were designed for short term use are being prescribed for years. Drugs with serious “side effects” are being prescribed as necessary to treat this “disease.” New drugs are appearing at a high rate.

Maybe the biggest concern is a shift away from a self-responsibility approach. For us, the shift from looking outside of ourselves to inside was pivotal to our personal transformations. People have recently said to us that for their addiction treatment they, “just need to take their medication.” People are giving up their personal agency and not being encouraged to tap into their inner strength. People are not sitting with their experiences and learning from them. They are not learning to feel their emotions. They are not looking into why they developed an unhealthy relationship with a substance or behavior. Instead, they are looking for personal salvation to come from the empty promises contained in pill bottles.

It was not that long ago that we felt anger and sadness that people dealing with emotional distress were not given the same options as those dealing with addiction. We hoped that the way we ultimately dealt with our suffering would be available to everyone. Instead, the destruction that comes from looking externally to professionals for medical solutions to human experiences is becoming common place in addiction treatment. For those wondering what the potential consequences of treating addiction as a medical condition are – we encourage you to spend time looking at the disastrous outcomes of the disease/medical model within the “mental health” context.

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

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Deron Drumm
Deron Drumm is the Executive Director of Advocacy Unlimited, the Vice President of the Board of Directors for the National Association of Rights Protection and Advocacy (“NARPA”), a Qigong practice leader for Toivo, and a holistic stress management instructor. Deron writes and speaks about the need for a more holistic and compassionate way of supporting people experiencing emotional distress.
Kelvin Young
Kelvin Young is the manager of Advocacy Unlimited’s intentional living space, “Toivo.” He believes that healing begins from within. After many years of suffering from emotional distress and drug addiction, Kelvin began his healing process while in prison. He looked within himself to find inner strength in a very hostile and restrictive environment through meditation and yoga. Kelvin speaks and writes about overcoming drug addiction and taking personal responsibility for health and wellbeing.

20 COMMENTS

  1. Yes I agree. Can I cure myself from my addiction to alcohol with will power? Can I stop my nicotine habit with my thoughts? Yes.. millions have done so. Disease? Can I cure measles with my will power? Can I cure my cancer with my thoughts? No. Addiction is not a ‘disease’ although it may have metaphorical similarities that confuse us. Can I cure my oppositional defiant disorder? Or am I just ODD?

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  2. “Maybe the biggest concern is a shift away from a self-responsibility approach.”

    Of course the late Dr Szasz was one of the first to adopt this attitude. But since I am completely bi-polar, not to mention my schizoidal tendencies, I can now blame my brain for my actions and not myself. When my sons were infants they had their excuse for bad behaviour.. ‘I could not help myself’ Adults should not use this excuse should they? Or are we all infants now?

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    • Nick Stuart,

      I really appreciate and agree with your comments. Just because a person’s life gets out of control and they are on a destructive trajectory does not mean they are either a bad person or have a brain disease they have no control over. Addiction is being framed as a disease partially because there seems to be no room in our culture to simultaneously view oneself as at fault for our actions and not be a bad or weak person.

      Deron

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  3. Deron and Kelvin, thank you for this thoughtful and poetic piece. As “medication-assisted treatment” becomes more prevelent in addiction treatment, I’ve often wondered how the field could be so seemingly unaware of the surpreme irony of trying to treat addiction to drugs with other drugs. I’m currently reading Mad Science, by Kirk, Gomory & Cohen, and they have a section discussing in detail the false dichotomy treatment professionals make between “drugs” and “medications.” Thank you again for sharing so openly.

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    • Darby,

      Thank you for taking the time to post a comment. We appreciate your words and will be reading Mad Science. The focus of my work is mainly centered on “mental health.” The number of calls I have received from people concerned about the drugging and labeling that is happening at addiction facilities precipitated this article. The trend is alarming.

      In solidarity,

      Deron

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  4. The first thing most substance abuse treatment centers do is shuffle there clients off to the doctor to be labelled with something and put on medications during acute and post acute withdrawals !

    It is known that many people fighting with addiction and especially their families prefer a diagnosis of “physical disease” because maybe to some it does not convey the stigma and blame commonly associated with addiction problems. Also clients are more compliant to psychiatric drug treatment when they are lied to and told they have a physical disease.

    Many people that go for drug and alcohol treatment got addicted as a RESULT of prescriptions for psychiatric drugs. The sad irony is that psychiatry controls the drug rehab field, even though it can show little results for the billions spent on its services every year.

    The disease of addiction, what a perfect scapegoating tool for psychiatry to blame the victims when it’s treatments turn unsuspecting people into ‘addicts’.

    Psychiatry just says “Not our fault… you are an addict cause of some undetectable fictitious DNA defect that runs in your family…”

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  5. I read that Alcoholism, a medical concept, was welcomed by the brewers and distillers as it let them off the hook. It makes excessive and destructive drinking an individual, medical problems and not a societal one.

    Every society has to decide how to manage psychoactive substances, medicalising the problems of excessive use lets the producer off the hook

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    • John Hoggett,

      I really appreciate your comment. One of the unhealthy relationships I developed was with gambling. It is sad to watch governments and the gambling industry blame the social costs associated with gambling on a brain “defect” that they claim resides in certain people. They take no responsibility for their part. Terrible stuff.

      Deron

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  6. Addiction AS disease; not addiction IS disease. The first is a conceptual metaphor, where there are some some things that correspond between the two halves, yet they are different. “War as a drug” is another conceptual metaphor. Watch the “Hurt Locker” to see it.

    Current thinking on addiction is ignoring this and creating an identity (addiction Is disease) where there is only correspondence. It is reductionistic and dehumanizing.

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  7. “The mental health system conveys a different message. The diagnostic process strips people of personal agency. After being diagnosed, people are often told to lower life expectations and avoid stress. Emotions are viewed as signs of disease to be medicated away. Therapies are often used to try and mold us into people others want us to be”.

    True, this used to be the case, it still is with many treatment programs using the medical model but the situation is changing with advocacy, peer led programs and professionals who are willing to treat people as people and not a disease. This is also the case for addictions which have never been a disease but has been labeled as such by 12 step and the “treatment industry” for monetary gain. What is needed is human interaction, a change in the public perception of psychological issues as “mad and bad” and the pharmaceutical industry’s strangle hold on treatment options and the minds of psychiatrists. We need more social awareness, public education and community involvement with helping others in need.

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  8. Jeffgishkin,

    I agree that things are changing in some places – Western Mass for example. I think we need to be really concerned about Congressman Murphy’s proposed legislation taking back all the changes people fought so hard for. Advocacy is definitely needed.

    Deron

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