Is Addiction a Disease?

The argument goes like this: Addiction is no more a disease than any other habit or compulsion. It isn’t a disease because there isn’t a demonstrated genetic cause, it isn’t contagious, and you can’t take a medicine to cure it. In fact, according to AA and other organizations, the treatment is spiritual. At best, addiction is an expression of another, underlying mental illness. Addiction is no more a disease than depression – and even less so, since it can be treated by just talking about it.

The counter argument goes like this: Of course it is a disease, people get sick and die from it. And they can get better with treatment. It’s a chronic condition with a known prognosis (bad to worse to death). It’s not only a disease, but a disease that costs the US more than $300 billion a year. Adding tobacco addiction to that raises it to more than a half-trillion dollars a year. So it’s not just a disease, but an epidemic.

Why does it matter?

At first glance, it shouldn’t matter how addiction is defined. And from the point of view of any particular addict, it probably doesn’t matter much. They are suffering no matter how addiction is categorized. It does matter, though, when it comes to insurance and policy decisions.

If addiction is just a bad behavior, you address it by making addictive substances illegal and try to change behavior that way. If it truly is a disease, the proper way to deal with it is by offering treatment, just like any other disease. It also plays into who will foot the bill. Insurance regulations and social programs are largely directed toward treating demonstrated diseases. Funding is directly tied into the definition.

Both of these approaches are currently in play.

The other important consideration is where society places blame. If you have a character flaw that leads you into addiction, that’s entirely on you – your problem and your responsibility to fix it. If it is a disease, then you don’t carry the blame. After all, diseases can inflict anyone – it isn’t a moral issue at all.

The medical community tends to view addiction as a “chronic condition” rather than a disease per se. But that comes from a tradition of marking out a specific physical change or infection that yields the symptoms and damage. With addiction, there seems to be many drivers and psychology plays a strong role. So, just as there is no one disease that can be rightly called cancer (rather, cancer is labeled and treated by type), the word “addiction” is probably too broad as well.

In fact, psychologists currently diagnose by looking deeper to determine what is driving the behavior. For them, someone who is addicted might be self-treating depression, have a compulsive disorder, or any of a number of other, underlying problems. Addiction is a symptom in this view, not a disease outright.

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