Addiction is a disease?
 

I decided to post this here instead of in OOT (which seems to be my new home). When people say addiction is a disease without a cure, do they mean this literally or is it metaphorical? I am not as concerned here with the "cure" part as I am the "disease" part. And I am not just talking about gambling addiction. I mean, all types of addiction. From my understanding all addiction is the same, even if the drug, food, type of sex, etc... is different.

craig

Re: Addiction is a disease?
 

[ QUOTE ]
When people say addiction is a disease without a cure, do they mean this literally or is it metaphorical?

[/ QUOTE ]

Both. I can't speak for all addictions, but scientists believe that alcoholics have a genetic predisposition toward their addiction. Whether this makes their alcoholism inevitable from birth is not known.

What is known is that no alcoholic is ever cured of his disease. There are no ex-alcoholics, only recovering alcholics. The only solution is to abstain.

Re: Addiction is a disease?
 

Addiction is a disease.

When you see first hand what it can do to your family and people you know you will understand. People can become monsters and do things that they know are wrong and justify it with [censored] that only makes sense to them, they become posessed, they aren't even human, their mind is turned off and the drugs take over the conrols.

Re: Addiction is a disease?
 

[ QUOTE ]
From my understanding all addiction is the same, even if the drug, food, type of sex, etc... is different.

craig

[/ QUOTE ]

This part is not exactly true. For example a heroin addiction is going to have different features than a sex addiction.

Re: Addiction is a disease?
 

[ QUOTE ]
[ QUOTE ]
From my understanding all addiction is the same, even if the drug, food, type of sex, etc... is different.

craig

[/ QUOTE ]

This part is not exactly true. For example a heroin addiction is going to have different features than a sex addiction.

[/ QUOTE ]

Aren't the underlying traits of an addictive personality pretty much the same though?

Obviously something that causes a physical addiction (drug) will present differently than a psychological addiction. (sex, gambling etc.)

I'd argue that certain individuals are wired to be addicts. Physical or psychological. Multiple addictions are not uncommon.

Re: Addiction is a disease?
 

The American Medical Association identified addiction to alcohol as a disease. This is from one of the AMA’s publications:

“H-95.983 Drug Dependencies as Diseases

The AMA
1. endorses the proposition that drug dependencies, including alcoholism, are diseases and that their treatment is a legitimate part of medical practice, and
2. encourages physicians, other health professionals, medical and other health related organizations, and government and other policymakers to become more well informed about drug dependencies, and to base their policies and activities on the recognition that drug dependencies are, in fact, diseases. (Res. 113, A-87)”

Forget the definition of “disease” in the sense that you can take a pill or shot to “cure” it. The effects of addictions are physical, mental and spiritual and require treatment of all three areas.

The “drug of choice,” alcohol, chemical drugs or sex, doesn’t seem to matter. The stories of addicts usually have commonalities.

Re: Addiction is a disease?
 

[ QUOTE ]
Obviously something that causes a physical addiction (drug) will present differently than a psychological addiction. (sex, gambling etc.)

I'd argue that certain individuals are wired to be addicts. Physical or psychological. Multiple addictions are not uncommon.

[/ QUOTE ]


There is a widely-held theory as to a gene that either triggers or allows an addiction. The hardwiring you mention. There is a lot of debate about the psychological side.

The physical damage, some think, leads to the psychological damage. Others think it's just the opposite. But, IMO, given enough time, they'll always be in accompaniment.

Re: Addiction is a disease?
 

[ QUOTE ]
This part is not exactly true. For example a heroin addiction is going to have different features than a sex addiction.

[/ QUOTE ]


Yes, there are subtle differences. But the overall effects seem to be the same.

Re: Addiction is a disease?
 

[ QUOTE ]

When you see first hand what it can do to your family and people you know you will understand. People can become monsters and do things that they know are wrong and justify it with [censored] that only makes sense to them, they become posessed, they aren't even human, their mind is turned off and the drugs take over the conrols.

[/ QUOTE ]


Substitute the word "drugs" with alcohol, gambling, sex, food, etc., and you can say the same thing. It's the addiction, not the means.

Re: Addiction is a disease?
 

[ QUOTE ]
[ QUOTE ]
This part is not exactly true. For example a heroin addiction is going to have different features than a sex addiction.

[/ QUOTE ]

There are significant elements that make something like heroin different than other addictions. Your body rapidly develops a chemical dependency on heroin. Many people become addicated after one use. Almost everyone that uses heroing a few times becomes addicted and treatment is extraordinarly difficult....so much so that another dangerous and long term damaging drug, methadone, is used to allow people to sorta function because they cannot completely end the addiction.

So something like heroin is different because it is chemical based as well as emotion and mental based. Unlike sex addiction which is entirely emotional/mental.

Re: Addiction is a disease?
 

I won't comment on the other addictions you've listed, but I've studied drug addiction (this includes alcoholism) for over 12 years, and drug addiction is just as much a disease as AIDS and cancer. There is no cure for drug addiction, just like there's no cure for AIDS or cancer. For all practical purpose, one develops the disease of drug addiction the same way one contracts the HIV virus, by making one or more ignorant and irresponsible decisions (of course this excludes babies born with HIV or born with drug addiction i.e. crack babies, etc.).

Unfortunately, the money spent on research to cure/treat drug addiction is miniscule compared to the money spent on AIDS and cancer research. The most horrific thing of all with regards to drug addiction, is the war on drugs, which treats this disease as a crime rather than the massive health problem it is. Many drug addicts end up in prison or jail, and most get no treatment there. To make matters worse, drugs are readily available in prison/jail, and these drug addicts get the bonus of learning and being conditioned to be a violent criminal -- all because they have a disease.

Re: Addiction is a disease?
 

Addiction may be a symptom of a disease, but I don't believe addiction itself is a disease.

Re: Addiction is a disease?
 

No, addiction is not a disease. This is not a widely held position, but seems clearly true.

Consider a disease such as cholera, which cannot be fixed by a choice of the person who has it. Contrast this with being addicted to cigarettes, which people fix by quitting every day. There seems be a significant and substantial difference between the two so much that the same word should not apply to both of them. I highly recommend the following website as a resource for this subject:

http://www.schaler.net/

So in answer to your orignal question, if they aren't using it metaphorically, they should be.

Re: Addiction is a disease?
 

Anybody see last night's south park episode? They did a pretty good bit on this very topic....

Re: Addiction is a disease?
 

[ QUOTE ]
Anybody see last night's south park episode? They did a pretty good bit on this very topic....

[/ QUOTE ]

DAMN, beat me to it.

I cant say i totally agree w/ it, but it brought up some good points... and it was quite funny.

Re: Addiction is a disease?
 

[ QUOTE ]
[ QUOTE ]
This part is not exactly true. For example a heroin addiction is going to have different features than a sex addiction.

[/ QUOTE ]


Yes, there are subtle differences. But the overall effects seem to be the same.

[/ QUOTE ]

A heroin addict going through withdrawal experiences significant physical symptoms (chills, running nose, etc.). A so-called sex addict does not.

I'd be inclined to say that this difference was overt rather than subtle.

Re: Addiction is a disease?
 

Not all addictions are created equal, then. I was hooked on cigarettes for a decade, finally quitting in 1988. I spent this past October in Biloxi, Mississippi, doing hurricane relief work. Everyone there smoked, and it was a high-stress situation. It wasn't long before I started smoking again, too.

Just before I boarded my plane home, I threw away what remained of my cigarettes. There is no room for smoking in my home life. I resigned myself to a week or two of misery until the nicotine fits passed.

To my complete surprise, they never arrived. I noticed when the effects of my last cigarette wore off, but I never felt any of the shaking and nervousness that I remembered from my many earlier attempts to quit.

N.B.: Some addiction and recovery experts would not describe my physiological dependence on cigarettes in my youth as an "addiction"; under a widely-used definition, for a condition to be an addiction it has to have an immediate negative impact on one's life, relationships, or work situation.

Re: Addiction is a disease?
 

I find it foolish to say 'mental illness' or 'addictions' are diseases. What constitutes a mental illness or an addiction? Is it a lesion, an abnormal x-ray finding, elevated enzymes, tissue damage, insufficient insulin?

No, mental illneses and addictions are repetitive behaviors that are socially undesireable. The labels are a very convenient mechanism for both the 'sufferer' and the labeler. The person labeled wins because they are exonerated from personal responsibility. Instead of actively chosing to engage in undesired behaviors, the addict/neurotic is the victim of 'bad brain chemistry.' The labeler (such as a psychiatrist, psychologist, chemical dependency evaluator, social worker, medical doctor, drug company representative, parole officer) benefits because they have created a whole new class of clients needing assessment, treatment and diagnosis for these 'diseases.'

It's almost comical how many new 'diseases' are being evented each year. Look at the explosive growth of the DSM (Diagnosis and Statistical Manual of Mental Disorders) if you need proof. We are now being told that using too much caffeine, smoking, being shy, easily distracted, staying online for long hours, shoplifting, drinking, etc. are diseases. They are said to be the function of 'bad brain chemistry.' Every year we're told they're on the breakthrough of finding the cause of these pernicious disorders and disease. Of course, one is never found. It's called being HUMAN!

Why do think the advocacy groups were so hellbent on getting the AMA to call alcoholism a 'disease.' Because the label of disease conveys a lot of weight and exonerates the afflicted of responsibility. They no longer freely choose their behavior but are compelled to act in a certain way by virtue of 'brain chemistry disequilibrium.' There are financial incentives as well; think of the windfall created by labeling drug and alcohol abuse a disease. Insurance companies now are doling out billions to medically treat what was once thought of as merely immoral, sinful, neurotic, foolish behavior. And then there are billions spent on researching possible treatments.

My personal bias is seeking explanations that maximize free will. Rather than viewing chronic alcohol abusers as 'diseased alcohlics' I see them as individuals who make the foolish and self-defeating choice to persist in drinking large quantities. I believe that labels of 'mental illness' and 'addictive disease' do represent true diseases in the traditional sense. Rather, they describe problems in living.

I am not trying to say that chronic drinkers or chronic drug abusers do not suffer as a result of their behavior. Obviously, an addict can create real disease states by persisting in chronic use of intoxicating agents. I believe that we largely choose our behaviors and destinies. I believe that 'addictive disease' and 'mental illness' are metaphors for problems in living; not legitimate or verifiable diseases. Unfortunately, many people tend to underestimate their ability to actively choose their thoughts and behaviors.

JeffreyREBT "Wherein I don't promise to make you rich without trying, or even trying very hard; I do promise to say things that will make you FEEL rich."

Re: Addiction is a disease?
 

[ QUOTE ]
I'd be inclined to say that this difference was overt rather than subtle.

[/ QUOTE ]

I was referring to the overall effects of, and damage done by addictions - psychological and spiritual. Of course physical withdrawal from dependence on a chemical substance differs from withdrawal from sex or gambling addictions. Sorry if I even implied that.

Re: Addiction is a disease?
 

[ QUOTE ]
Addiction is a disease.

When you see first hand what it can do to your family and people you know you will understand. People can become monsters and do things that they know are wrong and justify it with [censored] that only makes sense to them, they become posessed, they aren't even human, their mind is turned off and the drugs take over the conrols.

[/ QUOTE ]

I don't understand how this makes it a disease. I am not saying that it isn't, but just because it changes a person into something they are not, does that necessarily make it a disease.

craig

p.s. I have experienced it first hand.

Re: Addiction is a disease?
 

Craig, Alcoholism was defined/identified by the AMA as a disease because it met the criteria for their definition. For the life of me I can not find the list. The only one I remember is the one that I guess made the biggest impression on me - If untreated, the condition will cause/lead to death. (paraphrase?)

Re: Addiction is a disease?
 

[ QUOTE ]
I don't understand how this makes it a disease.



[/ QUOTE ]

A disease is a negatively abnormal (pathologic) change in the functioning of an organism. This change can be the result of any disease process (etiology). By this definition, alcoholism clearly is a disease.

Alcoholism runs in families and thus it is likely that certain individuals have a genetic predisposition towards the disease of alcoholism. No, they will not become alcoholics unless they start drinking but the same is true for many other diseases that have genetic predispositions but require environment stimuli to develop.

To those who have said that an alcoholic's behavior is "just part of being human" and therefore alcoholism is not a disease: do you claim that there is no biological basis for human behavior? And if there is, why can't these biological mechanisms be altered in a disease state (just like any other organ system) to produce abnormal effects?

Re: Addiction is a disease?
 

[ QUOTE ]
I find it foolish to say 'mental illness' or 'addictions' are diseases. What constitutes a mental illness or an addiction? Is it a lesion, an abnormal x-ray finding, elevated enzymes, tissue damage, insufficient insulin?

[/ QUOTE ]

Sometimes, any of these things other than "an abnormal x-ray finding" can cause mental illness.

[ QUOTE ]
No, mental illneses and addictions are repetitive behaviors that are socially undesireable. The labels are a very convenient mechanism for both the 'sufferer' and the labeler. The person labeled wins because they are exonerated from personal responsibility. Instead of actively chosing to engage in undesired behaviors, the addict/neurotic is the victim of 'bad brain chemistry.' The labeler (such as a psychiatrist, psychologist, chemical dependency evaluator, social worker, medical doctor, drug company representative, parole officer) benefits because they have created a whole new class of clients needing assessment, treatment and diagnosis for these 'diseases.'

It's almost comical how many new 'diseases' are being evented each year. Look at the explosive growth of the DSM (Diagnosis and Statistical Manual of Mental Disorders) if you need proof. We are now being told that using too much caffeine, smoking, being shy, easily distracted, staying online for long hours, shoplifting, drinking, etc. are diseases. They are said to be the function of 'bad brain chemistry.' Every year we're told they're on the breakthrough of finding the cause of these pernicious disorders and disease. Of course, one is never found. It's called being HUMAN!

Why do think the advocacy groups were so hellbent on getting the AMA to call alcoholism a 'disease.' Because the label of disease conveys a lot of weight and exonerates the afflicted of responsibility. They no longer freely choose their behavior but are compelled to act in a certain way by virtue of 'brain chemistry disequilibrium.' There are financial incentives as well; think of the windfall created by labeling drug and alcohol abuse a disease. Insurance companies now are doling out billions to medically treat what was once thought of as merely immoral, sinful, neurotic, foolish behavior. And then there are billions spent on researching possible treatments.

My personal bias is seeking explanations that maximize free will. Rather than viewing chronic alcohol abusers as 'diseased alcohlics' I see them as individuals who make the foolish and self-defeating choice to persist in drinking large quantities. I believe that labels of 'mental illness' and 'addictive disease' do represent true diseases in the traditional sense. Rather, they describe problems in living.

I am not trying to say that chronic drinkers or chronic drug abusers do not suffer as a result of their behavior. Obviously, an addict can create real disease states by persisting in chronic use of intoxicating agents. I believe that we largely choose our behaviors and destinies. I believe that 'addictive disease' and 'mental illness' are metaphors for problems in living; not legitimate or verifiable diseases. Unfortunately, many people tend to underestimate their ability to actively choose their thoughts and behaviors.

[/ QUOTE ]

Yes, crazy people are just stubborn.

Do you really believe this crap? Here's a question for you - why do you think people make those bad decisions?

And another question - have you ever known a person with a serious mental illness? I mean severe psychotic/anxiety/dissociative disorders, OCD and schizophrenia and the like. And have you ever been close to someone with a relatively "minor" mental illness?

I'll be the first to admit the line can be hard to draw, and the DSM is a rather poor piece of work. I also think treatment recommendations have a tendency to be drug-heavy and questionable. But no such thing as mental illness? That's absurd.

Re: Addiction is a disease?
 

[ QUOTE ]
A disease is a negatively abnormal (pathologic) change in the functioning of an organism. This change can be the result of any disease process (etiology). By this definition, alcoholism clearly is a disease.

[/ QUOTE ]

This ignores the possibility that alcoholism might be a symptom of some other disease. This is an important distinction for two reasons. First, if someone is "cured" of alcoholism, but the underlying condition remains, the "true cause" may continue to have an undesirable effect. Second, if alcoholism can be viewed as a symptom then correct treatment may depend on the nature of the underlying problem.

An example would be sore throats. To treat alcoholism alone is like giving someone with strep a painkiller. It may eliminate the "problem" (temporarily), but the disease remains. Also giving a person antibiotics just because they have a sore throat is definitely not justified, because a number of things may result in a sore throat - treatment could include antibiotics, antihistamines, or just plain waiting it out (among other things).

Personally I believe the compulsive element of addiction exists in everyone. It's just a mechanical thing. An addict, to me, is usually someone with an emotional problem that they can only cope with using some specific behavior. The need to deal with this problem overrides any desire to stop the behavior, and that is where the addiction itself comes from. Addiction can be overcome by handling the original problem, thereby removing the "need" for the addictive behavior. (Physical addiction is something else, of course)

Re: Addiction is a disease?
 

[ QUOTE ]
Craig, Alcoholism was defined/identified by the AMA as a disease because it met the criteria for their definition. For the life of me I can not find the list. The only one I remember is the one that I guess made the biggest impression on me - If untreated, the condition will cause/lead to death. (paraphrase?)

[/ QUOTE ]

I wasn't trying to claim it wasn't a disease, but that the person I quoted was not making a case for why it was a disease, just why it was bad.

I personally do think it is a disease.

Re: Addiction is a disease?
 

[ QUOTE ]
[ QUOTE ]
A disease is a negatively abnormal (pathologic) change in the functioning of an organism. This change can be the result of any disease process (etiology). By this definition, alcoholism clearly is a disease.

[/ QUOTE ]

This ignores the possibility that alcoholism might be a symptom of some other disease. This is an important distinction for two reasons. First, if someone is "cured" of alcoholism, but the underlying condition remains, the "true cause" may continue to have an undesirable effect. Second, if alcoholism can be viewed as a symptom then correct treatment may depend on the nature of the underlying problem.

An example would be sore throats. To treat alcoholism alone is like giving someone with strep a painkiller. It may eliminate the "problem" (temporarily), but the disease remains. Also giving a person antibiotics just because they have a sore throat is definitely not justified, because a number of things may result in a sore throat - treatment could include antibiotics, antihistamines, or just plain waiting it out (among other things).

Personally I believe the compulsive element of addiction exists in everyone. It's just a mechanical thing. An addict, to me, is usually someone with an emotional problem that they can only cope with using some specific behavior. The need to deal with this problem overrides any desire to stop the behavior, and that is where the addiction itself comes from. Addiction can be overcome by handling the original problem, thereby removing the "need" for the addictive behavior. (Physical addiction is something else, of course)

[/ QUOTE ]

See, I thought this as well, that handling the original problem would prevent the "addiction". But, if you read the 12 steps (of any of the Anonymous groups), they make it seem that the problem is the alcohol, coke, etc... I don't know if I agree with these 12 steps. But, on the other side of that coin, if you get 100 truly happy people and get them to try heroin, how many of them would really "want" to do it again? I don't mean where they just think about it and then get over it in a day, but where they think to themselves "I have never felt this good before, I want to feel this again". Cocaine and Heroin are both very psychologically addictive drugs (not just from one time though). Don't you think that people want to have that same feeling again?

Also, why do a lot of people think that addiction is just getting the "fix"? There is much more to an addiction than just the actual high. The entire ritual is essential in the addicts mind.

craig

Re: Addiction is a disease?
 

I'm not religious, so I don't have much respect for 12-step programs in general. The whole "you need a higher power to get better" thing puts it straight into the [censored] category for me.

I do think sometimes treating "just the symptom" isn't a bad thing. If someone is addicted to heroin, stop that addiction. On the other hand, if someone is addicted to the internet or the library or something, I don't it's such a major concern.

I've met some 12-step folks who had stopped their big addiction and still really had issues. Most of them seemed to have moved on to some other (relatively harmless) addictions afterwards. I was never close to any of these people however. I know that 12-step programs can really help with dangerous addictions, but I think they are only a first step.

For the other question, I think only a person who has experienced addiction can understand what it's really like. Most people just look at the behaviors they can see, and from the outside looking in I think a focus on "getting the fix" makes sense.

Re: Addiction is a disease?
 

[ QUOTE ]
I'm not religious, so I don't have much respect for 12-step programs in general. The whole "you need a higher power to get better" thing puts it straight into the [censored] category for me.

I do think sometimes treating "just the symptom" isn't a bad thing. If someone is addicted to heroin, stop that addiction. On the other hand, if someone is addicted to the internet or the library or something, I don't it's such a major concern.

I've met some 12-step folks who had stopped their big addiction and still really had issues. Most of them seemed to have moved on to some other (relatively harmless) addictions afterwards. I was never close to any of these people however. I know that 12-step programs can really help with dangerous addictions, but I think they are only a first step.

For the other question, I think only a person who has experienced addiction can understand what it's really like. Most people just look at the behaviors they can see, and from the outside looking in I think a focus on "getting the fix" makes sense.

[/ QUOTE ]

In the "A" group's defense, the "higher power" doesn't have to be God or a god, it just has to be something that you believe in "bigger than yourself". This could be as "simple" as something like family. I think one reason they stress this is because an addict lives in a very selfish and narrow view of the world (so do a lot of non-addicts, but in a different way). So, without going into whether the "A" groups are good or bad, I just wanted to clarify that about them.

I guess the best example of how being an addict probably isn't just about getting a fix are smokers. It isn't just the "high" that nicotine creates, but the actual process of getting the cigs, opening the pack, hand to mouth, the nicotine entering the body, the high experienced, the comedown, and then the system repeates. If it was just the "high" then i think they would make the gum stronger (yes I know some get addicted to the gum as well, but I think it is obvious why they would). I don't really see how the Meth addict is any different. In fact, meth isn't nearly as physically addictive as nicotine (either is coke for that matter; in fact, don't they compare heroin as the closest physcial addiction to nicotine?). So, physical reasons for craving Meth can be ruled out a bit. But, the other parts, just like with smoking, really can't.

craig

p.s. I didn't know this until the other day, but if you took a heroin addict and an alcoholic and dumped them on an island with food, shelter, etc..., but no way for them to get the drug and no way for them to kill themselves, that the heroin addict would live, but the alcoholic would possibly die. I was under the impressiont that a smack addict had to have heroin or would die from physical withdrawal.

Re: Addiction is a disease?
 

[ QUOTE ]

an addict lives in a very selfish and narrow view of the world (so do a lot of non-addicts, but in a different way).

[/ QUOTE ]

....And it's an incredibly thin line between the two.

Ian

Re: Addiction is a disease?
 

[ QUOTE ]
I find it foolish to say 'mental illness' or 'addictions' are diseases. What constitutes a mental illness or an addiction? Is it a lesion, an abnormal x-ray finding, elevated enzymes, tissue damage, insufficient insulin?

No, mental illneses and addictions are repetitive behaviors that are socially undesireable. The labels are a very convenient mechanism for both the 'sufferer' and the labeler. The person labeled wins because they are exonerated from personal responsibility. Instead of actively chosing to engage in undesired behaviors, the addict/neurotic is the victim of 'bad brain chemistry.' The labeler (such as a psychiatrist, psychologist, chemical dependency evaluator, social worker, medical doctor, drug company representative, parole officer) benefits because they have created a whole new class of clients needing assessment, treatment and diagnosis for these 'diseases.'

It's almost comical how many new 'diseases' are being evented each year. Look at the explosive growth of the DSM (Diagnosis and Statistical Manual of Mental Disorders) if you need proof. We are now being told that using too much caffeine, smoking, being shy, easily distracted, staying online for long hours, shoplifting, drinking, etc. are diseases. They are said to be the function of 'bad brain chemistry.' Every year we're told they're on the breakthrough of finding the cause of these pernicious disorders and disease. Of course, one is never found. It's called being HUMAN!

Why do think the advocacy groups were so hellbent on getting the AMA to call alcoholism a 'disease.' Because the label of disease conveys a lot of weight and exonerates the afflicted of responsibility. They no longer freely choose their behavior but are compelled to act in a certain way by virtue of 'brain chemistry disequilibrium.' There are financial incentives as well; think of the windfall created by labeling drug and alcohol abuse a disease. Insurance companies now are doling out billions to medically treat what was once thought of as merely immoral, sinful, neurotic, foolish behavior. And then there are billions spent on researching possible treatments.

My personal bias is seeking explanations that maximize free will. Rather than viewing chronic alcohol abusers as 'diseased alcohlics' I see them as individuals who make the foolish and self-defeating choice to persist in drinking large quantities. I believe that labels of 'mental illness' and 'addictive disease' do represent true diseases in the traditional sense. Rather, they describe problems in living.

I am not trying to say that chronic drinkers or chronic drug abusers do not suffer as a result of their behavior. Obviously, an addict can create real disease states by persisting in chronic use of intoxicating agents. I believe that we largely choose our behaviors and destinies. I believe that 'addictive disease' and 'mental illness' are metaphors for problems in living; not legitimate or verifiable diseases. Unfortunately, many people tend to underestimate their ability to actively choose their thoughts and behaviors.

JeffreyREBT "Wherein I don't promise to make you rich without trying, or even trying very hard; I do promise to say things that will make you FEEL rich."

[/ QUOTE ]

You're working with a pretty limited understanding of the human condition if you seek only explanations that attempt to "maximize free will." I mean come on the whole "addiction is people making bad choices" thing is so old and played out. That is primarily a religious/moral argument that is not particularly helpful in explaining or helping anything.

Re: Addiction is a disease?
 

[ QUOTE ]

See, I thought this as well, that handling the original problem would prevent the "addiction". But, if you read the 12 steps (of any of the Anonymous groups), they make it seem that the problem is the alcohol, coke, etc... I don't know if I agree with these 12 steps.

craig

[/ QUOTE ]

This is not entirely true. The First Step of AA reads "I am powerless over Alcohol", reflecting the fact that the original 12 steps were written in the 1930s, a time before the disease concept had been fully realized in the treatment of addiction when medicine and society viewed chemical dependency as a moral defecency, . About 20 years after the steps were originally written they were adapted to the treatment of drug addiction by members of AA who were attempting to create a new fellowship that would become Narcotics Annonymous. In this adaptation, the first step reads "We are powerless over addiction..."; NA seeks to treat the disease of addiction, not the dependency upon a specific substance. Identification as an addict in reference to membership in the NA fellowship is all encompasing and does not differentiate between substances.

Re: Addiction is a disease?
 

Greetings,

Thank you for the replies to my perspective on labels of 'mental illness' and 'addictive diseases.' First of all, let me respond to a poster who replied:

"Yes, crazy people are just stubborn. Do you really believe this crap? Here's a question for you - why do you think people make those bad decisions?"


The poster starts off with a personal attack, completely irrelevant to the truth value of my premises. Whether or not my idea seems counterintuitive, unexpected, socially unacceptable, incredible, silly, contrary to popular opinion does not matter. Ironically, he/she professes that people afflicted with 'mental illness' or 'addictive illness' have real diseases then he refers to them as 'crazy?' I wouldn't call somebody with cancer or diabetes 'bizarre or zany.' I wonder why he would chose this socially stigmatizing description for helpless victims of "true diseases."

Ok, now you ask me why people make bad decisions. First of all, what you consider 'bad' will hinge on your value system as to what constitutes 'bad.' Lets assume 'bad' means resulting in undesireable consequences. Here is my basic answer. People make bad decisions because people are inherently flawed creatures prone to doing stupid things. More specificially, people's behaviors are a function of their beliefs about things. For example, lets assume I believe that I must have the approval of everybody I meet. Let assume you indicate you don't approve of me and my goofy ideas regarding "mental illness." What is the likely result? I will likely have a negative cognitive-emotive consequence in light of my belief about needing universal approval.

You see, I believe people and things do not disturb us; rather we disturb ourselves by believing they CAN disturb us. I belief we needlessly disturb ourselves (often in very severe ways) by allowing inflexible and irrational ideologies to guide our thinking. You are not depressed because you lost your job; you are depressed because you believe losing your job is all-important.

"And another question - have you ever known a person with a serious mental illness? I mean severe psychotic/anxiety/dissociative disorders, OCD and schizophrenia and the like. And have you ever been close to someone with a relatively "minor" mental illness?

I'll be the first to admit the line can be hard to draw, and the DSM is a rather poor piece of work. I also think treatment recommendations have a tendency to be drug-heavy and questionable. But no such thing as mental illness? That's absurd."




BTW, I will risk subjecting myself to the psychoanalytic fallacy and confess I have been diagnosed with a 'mental illness.' Specifically, panic disorder, OCD, Aspergar's disorder and bipolar disorder. In my early twenties I was involuntarily committed and have met hundreds of people with both brain diseases and problems in living.

I used to buy into the medical model of mental illness and felt like a hopeless victim of brain chemistry disequilibrium. It was very empowering when I stumbled upon Rational Emotive Behavioral Psychology. REBT enabled me to appreciate the role my goofy and rigid ideologies played in perpetuating my own self-defeating behaviors and irrational ideas (which many call 'mental illness').

I personally think labels of mental illness are not helpful for most people. Many people become the personification of their 'disease' and capitulate, assuming a victim role. Also, labels of mental illness are stigmatizing and hurt people in terms of employment, education, social advancement, and consitutional rights. Generally, I don't think people are served well by these labels.

I never stated that I believed brain disease didn't exist. Now that would be a difficult position to defend. To reiterate, I don't believe 'mental illness' literally exists. To say a mind is all is analogous to saying society is disease; an abuse of language. The mind a hypothetical construct, a concoction, an invention, a means of explanation. True disease like diabetes has a concrete referant.

JeffreyREBT 'Wherein I don't promise to make you rich without trying; or even trying very hard; I do promise to say things that will make you feel rich."

Re: Addiction is a disease?
 

[ QUOTE ]
[ QUOTE ]
When people say addiction is a disease without a cure, do they mean this literally or is it metaphorical?

[/ QUOTE ]

Both. I can't speak for all addictions, but scientists believe that alcoholics have a genetic predisposition toward their addiction. Whether this makes their alcoholism inevitable from birth is not known.

What is known is that no alcoholic is ever cured of his disease. There are no ex-alcoholics, only recovering alcholics. The only solution is to abstain.

[/ QUOTE ] I didn't read past here but...
This can't be true I don't think, such a universal statement. While wise as a rule for any, can't some alchoholics drink just a few beers or what have you later in their recovery?

Re: Addiction is a disease?
 

I apologize for offending you, that wasn't my intent. (well, maybe a little bit just to shake things up)

Personally I think the "mind" is really an abstraction of brain interactions that we can't mechanically describe (belief, memory, emotion, etc). But even if we do away with the term, I don't see how something like addiction fails to qualify as indicative of disease.

I assume a "belief" has a neurochemical existence here and that there is therefore some concrete referent. We just can't describe it in physical terms because it can only be identified through behavioral symptoms. Also many mental illnesses seem to be independent of belief - they are "brain diseases" as you say. A number of mental illnesses have also been show to have a strong biological component through twin studies, etc.

I disagree with you on certain points, but I don't think most of them are relevant to the topic. If you agree that mental illness is a problem (and not something that is just willed away magically) then I suppose whether we call it an actual "illness" is just semantic.

The thing I do take issue with is your claim that the labels don't help. It's easy to see where this is true, of course, but I think they do more good than harm. Being able to put a name on your problems can make them much less intimidating. A person who has "x disorder" knows he isn't alone, knows he can't be expected to just "buck up and deal with it," and knows that there is help out there for him. Treatment is also more efficient with categories and labels - most labels are based on strong symptomatic correlations, and while the labels themselves may not have any real accuracy, identifying those correlations seems like a clear step forward in understanding and treating the problems.

I don't think it's realistic to think that a single treatment will be effective for every problem. Do you believe that REBT is an effective cure-all? If not, how can we create alternative treatments without using labels and categories?

Re: Addiction is a disease?
 

Greetings,

And I wasn't offended in the least. In fact, I generally choose not to let anything 'offend' me. First of all, I have read your definition of the mind. If my understanding is correct, you basically believe the mind is the brain in motion. And the reason the mind construct is important here has everything to do with volition and free will. The disease theory proponents often argue free will has been thoroughly sabotaged and annihilated by the 'disease process.' They are not referring to the kidney or the spleen as the cause of alcoholism; they are referring to the mind construct. Alcoholics Anonymous argues in their twelve steps, "Admitted we were POWERLESS over alcohol; that our lives our lives had become unmanageable." Ironically, they also hold this seemingly irrational and contradictory position that they can be 'restored to sanity' if they 'come to believe a power greater then themselves can restore them to sanity.' As you can see, they are arguing alcoholism is a problem of belief (as I argue as well, just differently). They believe the prescription for stopping chronic alcohol abuse is belief in God's ability to remove "character defects." I think AA's philosophy is hogwash. I think the prescription for stopping chronic alcohol abuse is thinking more rationally through disputing and changing irrational beliefs .

I am still trying to discover which mental illnesses are independent of belief. Isn't mental illness really just a problem of irrational belief and subsequent deviant behavior? I assume you are thinking of more severe 'mental illness' like schizophrenia. Most people call this a mental illness and I call it brain disease. And yes, there is some convincing proof that it's a serious disease. For example, schizophrenics are abnormal responders on EDA. Also, there is the enlarged fourth ventricle theory, PET scan findings, etc.

Let me lastly address your point that belief has a neurochemical existence and is therefore the concrete referant. Doesn't EVERYTHING have a neurochemical existence. We might assert almost all human behavior is the product of "mental illness" if we believe brain chemistry abberation is the culprit. Does your brain chemistry not deviate from its usual course when you engage in different activities? Are you then mentally ill sometimes and not at other times. What constitutes an ideal brain chemistry profile? For example, assume I lose a significantly large amount of money on a hand of poker (or win a large amount). Wouldn't my brain chemistry change from its equilibrium point and therefore be in an abberant state. Would I be temporarily mentally ill until my brain chemistry re-orients itself? Can you see where this reductionism leads?

And your point about labels. Are labels useful? Well, I assume they are used as a means of facilitating communication. The utility of the DSM-IV is that it affords behavioral health professionals a common language. Uniform language helps conduct research and acquire compensation from insurance companies. A common language would seemingly be necessary for the purposes of assessment, treatment and research of behavioral problems. I do not deny this. However, labels also can lead to negative consequences such as stigma and discrimination. Also, the labels can result in clients capitulating and assuming a victim or sick role.

Lastly, let me briefly address the efficacy of REBT and its utility in treating 'mental illness' and addictions. I don't believe I can emphasize enough the proven utility of REBT and CBT in general. The founder of REBT, Albert Ellis, pioneered cognitive behavioral therapy. The meta-analytic studies show a consistent advantage for CBT over all other forms of psychological talk therapy and even medication for most mental illness (excluding psychotic disorders) and behavioral health problems. You might have noticed the decline in popularity of psychoanalysis. This is because psychoanalysis is being replaced by electic therapy and cognitive behavioral therapy, which generally produce more desireable results in a shorter period of time.

While REBT might be useless in stopping command hallucinations it might help a schizophrenic or somebody with a psychotic disorder deal more effectively with other challenges posed by their disease. I believe REBT and CBT (cognitive behavioral therapy) will generally improve the lives of those who apply this therapeutic approach.

JeffreyREBT "Wherein I don't promise to make you rich without trying, or even trying very hard; I do promise to say things that will make you FEEL rich."

Re: Addiction is a disease?
 

I suppose with that distinction between mental illness and brain disease, I can agree. I do think brain disease can increase the risk of addiction, however. Also sometimes it is very difficult to make that distinction.

Going by dictionary.com disease is "A pathological condition of a part, organ, or system of an organism resulting from various causes, such as infection, genetic defect, or environmental stress, and characterized by an identifiable group of signs or symptoms." So I would say if your belief structure could be considered "pathological" it would qualify as an illness. Personally I would say that any set of beliefs that causes harm to an individual can be considered a disease.

I believe that people who choose to treat themselves as victims will choose to treat themselves as victims, whether or not they have a convenient label. Many of these people do use labels as excuses, but I think they would assume victims roles regardless. In my opinion they want to believe they are victims, and they will use any tools at their disposal to reinforce that belief. I don't think the label itself is actually causing harm. My view on the stigma surrounding mental illness is similar - I think the stigma was actually stronger before the labels, and now that mental illness is coming to be understood that stigma is diminishing.

With regard to CBT, I agree that it is effective, but I also think it's limited. Other approaches to treatment are also very effective, and in some cases necessary. Group therapy, medications, humanistic therapies, and even treatments like ECT have their place. Labels help determine which treatment to administer when. Even cognitive behavioral therapies aren't universal. For example, patients with borderline personality disorder don't respond all that well to REBT - but they do respond well to dialectical behavioral therapy, a different CBT which takes the specific diagnosis into account.

Re: Addiction is a disease?
 

Addictions to things that are not physically addicting (cocaine, sex, gambling, etc.) are totally for pussies with no self control and most likely a cry for help.

Being serious,
Capo

Re: Addiction is a disease?
 

So, nicotine, alcohol, heroin, and benzos are the only drugs not for "pussies"? Those who do a few bags of smack a day are not crying for help, but those who snort 3 eight balls a day are?

craig

[ QUOTE ]
Addictions to things that are not physically addicting (cocaine, sex, gambling, etc.) are totally for pussies with no self control and most likely a cry for help.

Being serious,
Capo

[/ QUOTE ]

Re: Addiction is a disease?
 

Hey guys, south park covered this last Wendsday, just a heads up.

Re: Addiction is a disease?
 

All I'm saying is that if someone is "addicted" so something NOT ADDICTIVE then they are bitches.