Is addiction a disease? It’s a question that divides opinion across society – from scientists to healthcare professionals, policymakers to the public and amongst people with addictions themselves. Many point to genetic and physiological factors that increase the risk of substance addiction. Others argue that addiction is a response to pre-existing mental distress or illness. Some say that addiction is a lifestyle choice.
According to UKAT, a leading provider of addiction treatment nationwide, what matters most in this debate is not who is right or wrong – it’s the outcomes for people with harmful and often life-threatening addictions. Does the disease model help people to access treatment and recover? And what is the case for moving beyond a diagnosis?
The Origins of the Disease Model of Addiction
Though addiction has been debated and documented for centuries, today’s definitions in western society originated in 20th century America. In 1956, the American Medical Association proposed that alcoholism was an illness. By 1987, they had defined addiction as a disease. [1]Additionally, the first official literature from Narcotics Anonymous (published in 1956) was based around the disease concept of addiction. NA proposed no permanent cure for addiction, instead a means to arrest the disease with abstinence and ongoing participation in a 12-step programme. [2]
Today, the World Health Organisation lists a wide range of disorders due to substance use and addictive behaviours in their International Classification of Diseases (ICD) – including alcohol and drug disorders, as well as behavioural addiction such as gambling and gaming disorder. [3]
How Has the Disease Concept Helped Addicts?
According to Jason Shiers, Psychotherapist at UKAT, the disease model has helped people to access addiction treatment and rebuild positive lives. ‘Though the debate continues to this day, the modern-day disease concept has led to advances in addiction research, sophisticated medical interventions and specialised therapies,’ Shiers says. ‘There is also far greater choice for people with addictions, in terms of where and how they are treated. Some patients qualify for insurance coverage, to fund detoxification and rehabilitation. Without a doubt, this progress has saved and improved peoples’ lives.’Furthermore, treatment approaches that are underpinned by the disease concept of addiction typically promote abstinence over reduced usage or substitute medications – a principle that can help people to move away completely from problematic substances or behaviors, rather than just limit the amount of harm done. Abstinence isn’t for everyone but for those who embrace the approach, it can often simplify the path towards long term recovery.
Moving Beyond the Disease Concept – Addiction as a Symptom
What if addiction is not a disease in its own right – instead, it’s a symptom of disordered thinking? What does this really mean and how could it improve treatment outcomes?Jason Shiers explains: ‘If we move away from the disease concept and see addiction more as a set of faulty coping strategies for underlying distress, then we can empower people to look towards peace of mind as the permanent solution to their addiction. By emphasizing people’s intrinsic health and abilities, people with addictions can move beyond their symptomology and struggles – looking towards a life without fear of relapse or limitations of disease. Of course, it’s essential for treatment professionals to assess each individual and determine the most appropriate interventions – but in giving people more choice, we open up roads to lasting change.’
For a detailed exploration of whether addiction is a disease, please visit the UK Addiction Treatment website – including a discussion between UKAT psychotherapist Jason Shiers and psychiatrist Dr William Pettit Jr MD.
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