Why Is Addiction a Disease?

Addiction is a disease in a similar way to type 2 diabetes is a disease. To make the analogy, we should look at type 2, or adult onset, diabetes. First, we know there is a genetic component. We also know that not everyone with the propensity for type 2 diabetes will get the disease. They will exhibit the symptoms if their diet is high in carbohydrates, they gain excessive weight, and they do not exercise enough. So, there is a genetic component and a social, or life style component. This mirrors how addiction works.

Alcoholism is the most studied in this way. People are born with a tendency toward alcoholism (estimates are from 30 -60% genetic basis) but they are not guaranteed to become alcoholics. The disease depends on social exposure to alcohol, just like diabetes depends on behavior. Environmental factors (family history, exposure) account for the other 40 – 70% blame.

Just like adult onset diabetes, without treatment (in this case abstinence) the condition will progress. For diabetics, this means increased need for insulin, organ and nerve damage, and an early death from related illnesses – kidney failure, heart disease or stroke being the most dramatic consequences. Alcoholism and other addictions are also progressive, although the damage done depends on the drug and route of delivery.

While the parallels are strong, there is still a criticism that addictions are due to moral failings, a lack of spirituality, or character flaws. A better way to look at it is that behavior affects the speed at which the disease destroys someone. An overdose can kill immediately; infections take longer and nutritional deficits longer still. But the end result is the same – sickness or death from the secondary effects of the drug or alcohol.

Addiction is am active disease when the compulsions and behaviors remain out of control. The fact that they can be controlled doesn’t matter. It’s the disposition that is beyond the addict’s control, not the behavior that is driven by the disease. A diabetic is still a diabetic, even if they ignore hunger cravings, exercise and manage their disease without medications. In the same way, an addict is still an addict (at least in some sense) even when they no longer drink or use. The disease is a fact, what someone does about it and the consequences are the visible result of the fact.

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