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?)

[ezratei]

[ 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?

[ 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.

[ 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)

[craig r]

[ 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.

[craig r]

[ 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

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.

[craig r]

[ 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.

[ 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

[noggindoc]

[ 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.