It is medically appropriate to refer to addiction as a disease – but no one really believes it. People struggle with thoughts, such as:
- Nobody puts a gun to an addict’s head and makes them drink or drug, so it looks like a choice.
OR
- Calling it a disease defies logic – it is not contagious.
I am compelled to explain. It turns out that in spite of historical beliefs, it is difficult to drink or drug your way into addiction. In reality, addicts are born genetically vulnerable and have physiological differences from people who are not genetically vulnerable. An example is that their livers metabolize alcohol more slowly than other people – before they have ever had a drink. Practically speaking, this means they have a natural tolerance to alcohol and can drink more and longer than the average person – without as many of the typical, negative consequences (puking, passing out & hangovers).
These consequences teach non-addicts to proceed with caution; those vulnerable to addiction have intensely positive experiences, which reinforce excessive use. They start drinking alcohol and smoking pot – like many teens do today – but often feel intense relief when they use. To complicate things further, many addicts have a neurochemical imbalance (experienced as depression or anxiety), which makes them drawn to the relief they feel from getting high.
Social drinkers control their drinking because that feels best to them. They simply don’t like the loss of control and negative consequences. Addicts, on the other hand, don’t control their drinking because that feels best to them. They are not morally or intellectually inferior. By the time addicts REALIZE that something is problematic with their relationship with drugs or alcohol, they have altered their body on a cellular level and have no other coping skills. It feels like when you get REALLY hungry and HAVE to eat – AND their compulsion can be intensified by their impaired judgment.
Addiction is a chronic illness – like heart disease. You can’t “catch” heart disease, either! If you know you are vulnerable to heart disease (family history), the responsibility falls on you to eat right, exercise and take your meds. MANY people who SHOULD do this DON’T – and end up in crisis. But we don’t say “two heart attacks are your limit. You are no longer eligible for medical care because you are making bad choices.” We help them learn to change their behavior over time. Addicts deserve the same support in spite of their relapses. Calling addiction a disease does not excuse addicts’ behavior. Relapse simply means they do not yet have the needed skills and need more treatment. Call and see if I can help!