Doubters ask, “How can addiction be a disease or disorder? Don’t people choose to drink or do drugs?”
Addiction is much more than a few bad choices. It disrupts the areas of the brain that are involved in reward, motivation, learning, judgment, and memory. Not only can it damage brain and body functions, but it can also damage relationships, families, and workplaces. As defined by both the National Institute on Drug Abuse and the American Society of Addiction Medicine, addiction is absolutely a treatable, diagnosable chronic brain disorder. This aspect is evident in the term they use: “substance use disorder.”
What’s the difference between a disease and a disorder?
It seems like these words should have clear definitions and rigid boundaries between them, but that isn’t the case. The definitions of diseases and disorders change over time as the perspective of the medical community evolves, and they often overlap. Both disorders and diseases are considered to be disruptions to healthy functioning. The most popular division between disease and disorder is the concept that a disease has a definitive cause (an etiology), while a disorder may have many contributing factors. Since there are many possible (and intersecting) causes of addiction, it is usually classed as a disorder. But you will definitely see people calling it a disease, and that’s not inherently wrong.
So what causes addiction?
Once thought to be a moral failing, it’s now understood that substance use disorders and addictions actually develop in response to a combination of behavioral, environmental, and biological factors. Biological risk factors alone can account for almost half of the likelihood that a person will become an addict. A substance use disorder is not an indication of weak willpower.
Anyone who knows someone struggling with substance use disorder or anyone who has experienced addiction themselves understands that it drastically changes you as a person. This is because it’s a complex disorder involving functional changes of the brain and body, resulting in the compulsive use of substances despite consequences (and the consequences may be physical, mental, legal, financial, social, and more). Untreated addiction can also exacerbate other physical and mental disorders. As with some other serious diseases and disorders, the ultimate consequence of addiction can be death.
How does addiction change the brain?
When a person feels pleasure, the feelings are caused through the secretion of certain chemicals (called neurochemicals or neurotransmitters) in the brain. Drugs and alcohol affect the way the neurochemicals are produced and the ways the brain processes them.
As a person develops a tolerance to a substance over time, they may need larger amounts of the substance in order to feel normal. This can cause intense experiences of cravings or desires for the substance, mood swings, lowered inhibitions, and even an overall loss of interest in normal life activities or healthy pleasures. These changes in the brain can remain with a person throughout their life, sometimes long after they stop using the substance, but the brain is also often able to adapt and heal in recovery. Learn More: This Is Your Brain On Opioids
These changes in the brain explain why people in recovery from substance use disorder can be more vulnerable to physical and environmental cues they associate with the substance. These cues are known as triggers, and can increase the risk of relapse. People in recovery can learn their triggers. This awareness can prevent relapse, as can coping skills that can be learned in recovery.
Addiction is a chronic disorder
We now understand that addiction is a chronic disorder. Chronic means that it is long-lasting and cannot be cured, but rather can be controlled or maintained. Think of it like diabetes, which can’t be cured, but can be treated through medication, lifestyle changes, or both.
We wish there was a magic pill or a simple solution to fix addiction, but there isn’t. The good news? Recovery is possible. Even the most severe case of the chronic form of addiction can be treated.
Why can some people seem to recover so easily?
Recovery itself can cause confusion. Because some individuals are known to recover without treatment, many people find it hard to accept that addiction is a medical condition. How can some people seem to give up problem drinking or drug use on their own without issue, while others can’t?
One reason is how severe a person’s substance use disorder is. Individuals with a milder or lower acuity substance use disorder are more likely to recover by themselves than people whose condition is more severe. For individuals with severe substance use disorder, more intensive treatment and continuous support may be required.
There’s also an element of choice. Many people don’t want to stop using, so harm reduction strategies are important for their safety. But even for people who do want to recover, addiction causes changes in the brain. These changes in neural networks can affect an individual’s decisions—including the decision to seek treatment and to comply with their program. The kind of support needed also varies from person to person, which is why there are so many possible pathways to recovery.
With help, people can and do recover
Regardless of the intensity of addiction, people can and do recover. Depending on the amount and kind of support they need, people recovery through inpatient treatment, intensive outpatient, medication, therapy, faith-based groups, mutual support groups, and more. Workit Health offers an online clinical treatment program to help people recover from addiction as soon as they are ready.
To sum it up? Addiction is a disorder, not a choice or a moral failing. It causes changes in the brain. The good news is that it’s possible to recover from the disease of addiction. We need to shift our mindset, shed stigma, and focus on treatment options for those still struggling.