Addictive Disease

January 21, 2002

A reader commented on a remark in a previous article as follows:

I noticed you called it an “addiction disease” or something like that. And I have seen and heard that people resist thinking of these things as diseases.

What I’m wondering is if there is some cross-communication going on there? I mean, the word “disease” implies an external source — you “catch” a disease. Even technically, I’d think addictions would be Syndromes, and not diseases? The connotation of a syndrome is an illness that comes from within.”

Actually, the reader is mistaken. A syndrome is a collection of symptoms that, taken together, suggest a condition but do not in themselves constitute a disease. The collection of opportunistic diseases, Kaposi’s Sarcoma, Pneumocystis carinii, Thrush and the others that, taken together, make up Acquired Immune Deficiency Syndrome (AIDS) are an excellent example. His remarks are, however, a wonderful lead-in to a basic discussion of the disease concept of addiction/alcoholism.

Since most of us are given the impression from an early age that addiction is simply a matter of low morals or deficient will power, one of the more difficult things to get across to newly-recovering alcoholics and addicts is the indisputable fact that they do have a recognized disease. Webster’s Collegiate Dictionary (10th Edition) reads: “disease: a condition of the living animal or plant body or of one of its parts that impairs normal functioning : sickness, malady.”

Before continuing, for the sake of clarity, I need to note that professionals in the recovery field almost invariably refer to alcoholism and addiction in more-or-less the same breath, and tend to use the terms interchangeably. This is because–like it or not, you “pure” alcoholics–they are different aspects of the same disease, as we shall see shortly. I will primarily be using “addiction” for the sake of brevity, and you should understand that unless I specifically state otherwise I’m referring to alcoholism as well. And let’s get real here: how many “pure” alcoholics are there, anyway?

In fact–and now we’re back to the main subject–we don’t become addicted to alcohol and drugs at all. Before all the AA and NA folks come to lynch me for such a blasphemous statement, let me explain. All intoxicating drugs, including alcohol, cause changes in (or mimic) brain chemicals called neurotransmitters. These changes in neurotransmitter (NTX) levels are what cause the alterations of mood and body function that we call “getting high.” After a period of drug use that varies according to a number of factors, our brains and bodies become accustomed to the altered levels of NTX, and we no longer become as intoxicated. We develop a tolerance to the drug, and require more of it to achieve the “high.” This tolerance is one of the first obvious indications of addiction.

Eventually we reach a point where our bodies rebel if we try to reduce the levels of the drug(s), and we need to use chemicals simply to feel normal. When we try to cut back or quit, our bodies and subconscious minds tell us, in no uncertain terms, that they consider the loss of the drug unacceptable. At that point, gentle readers, we have a well-developed addiction. We feel compelled to continue the use of our drug(s) of choice, or similar ones, despite our attempts to cut back or quit, and despite the problems that they begin to cause in our lives.

A definition of addiction that I like a great deal is something that is causing us problems, but that we feel compelled to continue doing. Sometimes we aren’t aware of the compulsion, but if we have problems with our home life, jobs, the cops, relatives and so forth, and continue the behavior that’s causing the difficulty–hey, is something wrong with this picture, or what?

What’s causing all of the above? The inability of our brains (and sometimes the rest of our bodies) to tolerate the reduced levels of neurotransmitters that go along with quitting drugs or alcohol. Our bodies have reached a point where they cannot function without the effects of the drug–or at least that is how we perceive it. Is this “a condition…that impairs normal functioning?” I’m here to tell you, from painful personal experience and a number of years observing of other addicts and drunks both in and out of treatment centers, that is exactly what it is. Addictive Disease.

An interesting point is that the American Medical Association began defining alcoholism as a disease in 1956. Not too long thereafter, they included other forms of addiction as well, but for some reason the “disease concept” has failed to gain wide public understanding. This is exacerbated by some individuals who rail against the idea for their own reasons–often the fact that their particular livelihoods are tied up in other ideas. Of course, the Man on the Street tends still to consider alcoholics “weak” people who don’t have enough “willpower” to Just Say No–and those drug addicts, well, they must just be some kind of degenerates.

I have this to say about that: Some of my best friends are recovering addicts and alcoholics. Furthermore, the most interesting people I know–virtually to a (wo)man–are in recovery. The average addict has an IQ several points above the national average, and many are exceptionally gifted.

We need to understand this disease, in order to recover from it and, in the case of “normal” folks, to understand those who suffer from it. Addiction costs hundreds of billions of dollars annually in the US alone! We pay for lost productivity, broken homes, damaged potential, medical and social welfare costs, the costs of incarcerating a criminal population that is overwhelmingly afflicted with addiction or the effects of growing up in a dysfunctional or addicted family.

Addiction, in its various forms, is the number-one health problem in the United States, and for most of the other Western societies as well.

We need to stop looking at drunks and junkies as society’s detritus, and instead realize the potential they represent. On a simple basis of cost-effectiveness, we make money every time an addict gets clean. The average alcoholic/addict costs taxpayers hundreds of thousands of dollars before they die. The average recovering addict contributes at least that, and often much more. This ain’t rocket surgery, folks. It’s plain old common sense.

Here are a couple of links you may find interesting:
Alcoholism as a disease

Addiction History in Families-A Genogram

Have a great day (unless you had other plans)!

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