Is addiction really a disease?

Sara - posted on 07/26/2011 ( 32 moms have responded )

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I thought this was an interesting article:

I’ve known a lot of addicts in my life – some of them all too well. Some were hooked on booze, some on cigarettes, a few on pot and one or two on harder stuff. Sometimes, their destructive behaviour wrecked marriages and careers, and occasionally it killed them. Some have died of lung cancer and cirrhosis of the liver, one of an overdose, and one from falling down the stairs dead drunk.

But most of these people eventually recovered – usually when they became totally disgusted with themselves, or when they realized that the alternative (losing their spouse, going broke, social ostracism or winding up dead) was even worse. Tough love often helped.

And so I’ve always doubted that addiction is best described as a “disease.” A disease is a condition that’s beyond your power to control. There’s a fundamental difference between kicking your nicotine habit (which millions of us have managed to do, at the urging of the state ) and kicking your lung cancer.

The disease metaphor has been crucial – and very welcome – in the struggle to destigmatize mental illness. Now it also dominates enlightened public discussion of addiction. Redefining addiction as a disease and not a vice has powerful effects. It encourages compassion toward the sufferers (and that’s a good thing). It also suggests that punishing, or even criticizing, them for their dependency is cruel and unjust.

The medicalization of addiction is fundamental to the case for Insite, the supervised-injection site in Vancouver that may become a precedent for other sites elsewhere. Insite’s advocates argue that by reducing overdoses, it saves lives and minimizes the impacts of the disease – just as cancer drugs do – and should therefore be provided as a medically necessary service under the Canada Health Act.

Advocates for the disease model of addiction say their arguments are evidence-based, and that their opponents are driven by ideology. But the closer you look, the shakier is the evidence for the disease model of addiction. The most cogent critique comes from Gene Heyman, a research psychologist and lecturer at Harvard Medical School. His book Addiction: A Disorder of Choice makes a convincing case that choice plays a much more important role in addiction than in other psychiatric disorders. And it demolishes the current “enlightened” picture of addiction as a chronic, relapsing illness with a bleak prognosis for recovery.

In fact, a mountain of research shows just the opposite. Most people – even hard-core addicts – successfully quit by themselves. In one study of U.S. soldiers who became addicted to heroin in Vietnam, no more than 12 per cent stayed hooked after they got home. Doctors and airline pilots who get addicted to drugs (and there are lots) have recovery rates of 85 per cent or more. Even in the roughest neighbourhoods, most people with a drug habit manage to kick it by the time they’re 30. “Whether addicts keep using drugs or quit depends to a great extent on their alternatives,” Mr. Heyman writes.

The trouble is that experts have based their views on an unrepresentative sample of addicts – that is, the kind of people you tend to find at Insite. These are the hardest of the hard cases. Most have additional psychiatric disorders, and few have meaningful alternatives. They are poor candidates for treatment (which doesn’t mean we shouldn’t try). But does that make their addiction a disease? No. Drug addiction is a set of self-destructive impulses that are out of control – just like all the other impulses that lead us to choose short-term pleasure at the price of long-term pain. Drug addiction isn’t measles, and Insite is not a hospital, and we should stop pretending that it is.

So what do you think? Is addiction a disease that is outside of the control of the user or is it a choice of destructive behavior?

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JuLeah - posted on 07/26/2011

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It is a disease and within that, there is choice. One might be diabetic and refuse treatment until the condition becomes a matter of life or death.



It IS about brain chemistity. The drugs (and behaviors) cause your brain to make/release chemicals that create a sense of well being and pride/happiness.



Your brain gets use to the chemicals doing this work and stops doing the work on its own so the only way you get these feelings is with the drugs or behaviors and in time, you need more and more to get the same impact.



The process of retraining your brain to do this work is a long one and a person feels ... not good... until the brian starts to kick in to action again



You said you have know addicts. As have I. I have never ever known anyone who wanted that to be their life, wanted everyone to be pissed at them, wanted to lose their job. wife, kids .... wanted to be homeless .... recovery is HARD and the pain one is in usually has to be wrose then the recovery to make it worth the effort ... that can take time



I once thought addiction was not a disease but a choice .... it was pointed out to me that unless I had walked in their shoes, that was not a judgement I was allowed to make.



Someone suggested too that I stop drinking coffee, and at the time I drank a LOT of coffee/sugar.



Coffee/sugar has a simplar impact on the brain as beer, pot .... Well, I took them up on the challenge and tried to quit drinking coffee eating sugar .... really, it took years for me to have much sucess with this and I still eat suagr from time to time. It taught me a big lesson.

Amber - posted on 07/26/2011

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Chicken or egg? Are they addicts because they are depressed...or are they depressed because they are addicts?



My dad is a severe alcoholic, as was his dad and grandpa. I've seen him go downhill over the years and it has gotten to a point that I don't associate with him unless I really have to. It's incredibly sad because I remember those snippets from the moments he was sober. He was a happy man and a good father....then he had a drink and would beat us. And he doesn't remember any of that.



I've seen him put in the hospital for diseases caused by his alcoholism. I've seen him nearly die because of it. He drank himself to diabetes and his body is falling apart because of his consumption of alcohol.



He has lost all 5 of his children for his alcohol. He has lost all 6 of his grandchildren for his alcohol. He only has a handful of people in his life that will continue to watch him steadily deteriorate. The rest of us have gone the tough love route.



The courts recently took his license and CDL away; it was his "first" DUI. So, his career is suffering now too.



Tough love, rock bottom, nearly imminent death....NONE of that has worked. He stays clean for a few months, then relapses to his alcohol.



That IS a disease. He cannot stop on his own and he doesn't believe that he has a problem, so help isn't going to happen.



I do believe that he has some choice in the matter. He could choose to get help because we keep trying to tell him he has a problem. That is his pride getting in the way of his future. But he cannot make the choice to give up alcohol on his own, that has been proven over and over again in the last 30 years. So, maybe SOME addicts have the strength and will power to quit on their own, but many simply don't.



Quite frankly, the person that he is sober is NOT the person that he is drunk. It's like Jekyl and Hyde. So it is the alcohol talking when he's on a crazed rampage. He is not my father once that alcohol hits those lips.



Trust me, I'm the last person who wants to stand up for the man who literally tried to kill me while in a drunken rage. But that doesn't change the fact that alcohol has consumed his life and it changes the person that he truly is inside.



One last thought. If addiction isn't a disease, then why does it seem to be genetic? The children of addicts are much more likely to become addicts than their peers who have little to no history of addiction in their family. Before prescribing medications that can potentially lead to addictions, many doctors will require questions about family history of addiction be answered.

Valerie - posted on 09/02/2011

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It's not a chosen behaviour, it's a mental illness. The ability to create dopamine and seratonin (or have those hormones bind to receptors in the brain) is severely affected in addicts.
Of course, the disease is caused by the consumption and subsequent abuse of the substance, but diseases like type 2 diabetes, start the same way. The brain, like the pancreas, is an organ after all - Mess with its processes enough, and they'll stay messed.
The problem with addiction, like with most mental illnesses, is that getting treatment, following healthy habits, etc. is the patient's responsibility. Someone with cancer will obviously be interested in curing themselves and is likely to take great steps in making that happen. That's rational. Someone who is mentally ill, particularly the addicted, is not rational - especially when it comes to their disease.

Amber - posted on 07/27/2011

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Addiction: "compulsive physiological need for and use of a habit-forming substance (as heroin, nicotine, or alcohol) characterized by tolerance and by well-defined physiological symptoms upon withdrawal"

Compulsive synonyms: "uncontrollable, irresistible, overwhelming, urgent"

This isn't a "choice" like you(general) or I make. It is an absolute obsession. It is something that they cannot go without. To them, it IS a need. They literally cannot control the urges....this is why it IS a disease.
This is rarely something that can be controlled without medical or psychological intervention.

If the chemicals in your body are altered to a state that is not "normal" for you, then you are not acting as yourself or any form of yourself.

Lady Heather - posted on 07/26/2011

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You know, now that I think of it the alcoholics in my family are probably all depressed. So I guess they do have a disorder of sorts. I'm sure that is pretty common. I imagine it is probably more difficult for a self-medicating person to even get the urge to rehabilitate themselves.

I also know three people who have had problems with hard drugs and also suffered from bipolar disorder. They self-medicated until families stepped in at which point they were diagnosed and properly medicated. I wonder if perhaps this article underestimates the numbers of addicts who might have an underlying condition that makes it more difficult to stop.

Also wanted to add that I don't care what we call Insite - hospital, clinic or something else - I want it open and continuing to make a difference to the Downtown Eastside.

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~♥Little Miss - posted on 10/18/2012

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Iteresting thread but old. Please feel free to start a new one.



~DM MoD Little Miss~

Jenni - posted on 10/17/2012

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I think that people who become addicted already have some other underlying issue that has caused them to seek the use of drugs to begin with such as depression. Once they take these drugs long enough they begin to alter their thinking. They no longer think like a normal non - addicted brain thinks. They now do not feel normal until they have this particular drug. Now they feel they have to have it because it has altered their brain and even when they want to stop they are by this point in the self destruction mode. I think the beginning of drug abuse begins with individuals seeking something they feel they are missing and then ends up as a mental disorder. So would I classify it as a disease? Mental illness is more like it.

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i think that addicts need to be held accountable for their actions, but that every person is different. you can't say that all addicts are addicts because it's a disease or that they are all addicts because they choose to be. there are a lot of different factors that cause a person to be addicted to something, and i have no problem with the insite program. also, the studies quoted say that they kicked the habit but it's entirely possible (and often happens) that a person can be clean for years and then suddenly relapse and with the article provided, you don't know how long they followed these people for. it isn't a black and white issue.

also people who become addicts tend to have similar personalities and often if they kick one addiction they take up another (food, alcohol, smoking).

Sal - posted on 08/15/2011

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i just had a full post on how addiction wasn;t a disease because the patient directly causes it by their life style choices, but i have changed that to being that it is a Lifestyle based disease as i am perfectly happy for type 2 diabites and aids to be diseases and they are also for the (except children born with aids) also almost completely in the hands of the patient, their lifestyle choices make them get the disease while others can completely avoid it only again by their lifestyle choices (again there are exceptions but generally speaking) so i am going to say it falls into a disease or class of lifestyle disease...i also feel that people can be born with addictive tentedcies which may or maynot affect them later in life but are there for birth,

Lacieann - posted on 08/15/2011

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I personally feel it is a choice. Though once an addict reaches a certain point (this varies for different people) they need someone else to help them and can't quit just by wanting too. I don't think there should be disability for addicts. I think the federal funding should focus on Rehab and counseling for them. I don't think they should be getting SSI or Disability pay just for being unwilling to seek treatment. There should be a program in place that helps them treat their addiction, and supports them only while they are "clean" whatever that entails.

Danielle - posted on 08/11/2011

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I'm really not sure if it's a disease or not. My father is a closet alcoholic. At one time he was a pastor and we moved here for him to preach at a new church and it didn't go through and he became really depressed and turned to alcohol. He's ashamed that he drinks but just didn't have the willpower to stop. This started 10 yrs ago. I got a call one night from a police officer that my father had been drinking and driving and my 5 yr old (at the time) was in the car with him and I needed to come pick him up. I was livid. I've always respected my father but that night I cussed him like a dog. I put a stop to my son going over there. Period. If they wanted to see him they had to come here. That seemed to wake him up and he stopped drinking for a while. About a mnth and a half a go my Mom called me crying b/c he had borrowed my brother's truck and got arrested again. This is his third DUI. He may be facing jail time this time. It scared him and he started going to classes and called me the other day and before he got off the phone he said "Hey,...30 days" That's the longest he's been sober in ten yrs. I started to cry and told him how proud I was of him. It's a constant fight for him to stay sober but so far he's doing it. I think it comes down to the person making their mind up to stop. But they have to WANT to.

Charlie - posted on 07/30/2011

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For some people it absolutely is a disease , it is also a symptom of something much deeper ...it really is hard for some to understand who have never experienced themselves and it is those with great empathy and unerstanding who can understand it looking from the outside.

Katherine - posted on 07/30/2011

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Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in the individual pursuing reward and/or relief by substance use and other behaviors. The addiction is characterized by impairment in behavioral control, craving, inability to consistently abstain, and diminished recognition of significant problems with one’s behaviors and interpersonal relationships. Like other chronic diseases, addiction can involve cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.

http://en.wikipedia.org/wiki/Addiction

Christina - posted on 07/30/2011

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I don't think of it as a disease, but rather a disorder. Just like a child with autism can not help their behaviors and need professional help in the way of therapists, ect, an addict needs professional help to "stop" the behavior.
Someone who is a true addict can not stop their addiction. Just like someone who is anorexic can just stop, ect.
The reason it is called a disease is because even with intervention, the addiction never ceases to end. You are still an alcoholic even if you live to be 100 and never take a drink again. You are still anorexic, even if you eat and take care of yourself. You are a cutter, even if you haven't cut in 27yrs. The addiction part is always there, and it is always a struggle.

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I dont exactly believe it should be catagorized as a "disease" per-say, but I do know that for ALOT of addicts they get to a point where they literally can not contol it. The drug of choice takes over whether they want it to or not, I know this because I have seen it more times than Id like to admit. For some adicts all it takes is losing a job, spouse, kids for them to get their shit together, others it takes years of rehab and therapy and even sometimes then its not enough. A sister of a long time friend of mine was in and out of rehab four times, had both kids taken from her, one taken literally as soon as she was out of the womb and this girl didnt learn until the fourth time in rehab. My mother became a very heavy drinker when my grandmother died, she spent the better part of about 15 years drunk every day untill me and my siblings started giving her pep talks and we went so far as to threatin to keep the grandkids away and still it didnt help. She had to realize it was a problem before doing anything about it and come Aug her and my dad will be one year sober.

Anyway lableing it a "disease" is in my opinion a copout for most, even when they have reached the point where they cant do anything to change it, but on that same note change comes from within, if they dont see a prolem they will keep doing it. We ALL make conscience desicions and choices every day of our lives, and if someone is making the choice to polute their bodies in that way, they are doing it knowing the out come or possible out come, we know what can come of it and most are smart enough to say "I dont need that, I dont want that" .... im rambling now sorry guys :)

Rosie - posted on 07/27/2011

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i guess i'm not sure if it's either of the options. i think its kinda like ADHD, a disorder. it is something than can be controlled, yet always has the ability to rear it's ugly head.

there is something genetic about alcoholism (not sure about other addictions) and to me that signals addiction is much more than someones choice.

i don't feel it's a disease because it can be conquered without medication, or surgery. but i do believe it is hardwired in our brains somehow that makes it so it isn't something people simply choose to do.

~♥Little Miss - posted on 07/27/2011

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Personally, I think the whole statement "it is not the person, it is the drugs/alcohol making them act that way" Is a bunch of crap. I feel different substances enhance parts of your personality that a person may not regularly show without a chemical of some sort enhancing it.

Mary - posted on 07/27/2011

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But, Amber, when sober, are they not choosing (again) to partake of the substance which alters their behavior? Yes, there is both a physical and psychological dependence and need that drives that choice, but it is still their choice to use.

Is there behavior different sober compared to when they are chemically impaired? Of course. But I don't think that means that you are only seeing the "real" person when sober. The "real" person is them in their entirety - both sober and drunk., since (to me) an addict is someone who is doing this on a regular basis, and not just over-indulging every so often.

If the chemistry in your brain is changed as a result of your frequent and habitual use of a mind-altering substance (or even the overwhelming cravings when not high), that is who you are right now. You are someone who is living in a chronically altered mental state, as opposed to the person who just gets knee-walking drunk one night out with friends. Perhaps, with treatment, you may return to "that person" you were before habitual substance abuse, but for the here and now, what you are is chronically chemically altered.

Lady Heather - posted on 07/27/2011

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I'm all for a bit of enabling if the overall goal is harm reduction for both the addicted and the general public. Also, providing a safe place to do drugs isn't the only thing that goes on there. I suppose needle exchanges are enabling too, but hey - since ours opened here there are no more needles on my street for my kid to step on. Considering how prevalent HIV is in our local drug user population, that's quite a big deal. And frankly, before these places came along there was nowhere for any of these marginalized people to go if they wanted help. The homeless shelters here don't provide those services. The only place that might is the women's shelter, but well...that doesn't help the dudes. And there's nothing that gets them in the door initially. The lure of safe drugs might be the thing that gets them in there and gets them talking.

I don't see how we lose here. Our drug population was only increasing anyways. People were not going to rehab. They had no way to even get there if they wanted to.

Amber - posted on 07/27/2011

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I think the distinction that many are missing with the "it's the drug/alcohol, not the person" issue is that those people are NOT the same when they aren't actually ON the drugs/alcohol.

Yes, they always have the disease of addiction, but I'm specifically speaking of when they are ON the drug/alcohol. It does affect their mind and cause them to do things that they would not do if they were sober.

Withdraws can also make people react in ways that they wouldn't normally. It is an actual chemical change in your brain. If the chemistry of your brain is entirely different, then you are NOT yourself and are not making decisions as the person you truly are.

I'm not denying that my dad is an asshole when he's drunk. I'm not denying that he has a problem that seriously needs to be fixed. I'm just stating the absolute difference in behavior between sober and drunk. Drugs and alcohol simply DO make people do things that are completely out of character...hence, the outside force doing things and not them all by themselves.

It doesn't mean that they aren't responsible for the things they do or that anybody is letting them "run rampant over yourself and others". It just means that their mind is not truly their own because chemicals that trigger reactions are literally changing.

Mary - posted on 07/27/2011

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I'm not sure whether or not the distinction of addiction being a disease vs a "set of self-destructive impulses out of control" is all that important. The impact upon both the afflicted and their family is still devastating.



Like Sara, I have a hard time with that "It's not her doing this, it's the addiction/drugs/alcohol/disease doing it" mentality.

Sorry, but that statement, to me, smacks strongly of denial. It is "her"...just not the "her" you want her to still be. She is no longer that person she was pre-addiction. She is now an addict, and that is the reality of it. Yes, perhaps she would never have stolen from you, forgotten to feed her kids (or worse), or robbed a store, but this is who she is now and the presence of an addiction does not make these behaviors any less harmful or excusable. Just because a person has a "disease" does not mean you should enable them by putting aside the pain that they cause, and give them a free pass to continue.



That doesn't mean you don't forgive them when they are both truly sorry and the hurtful behavior is ceased. It doesn't mean that you should not encourage and support genuine efforts to seek treatment. It just means that you do not allow them to run rampant over yourself and others just because they have a "disease" or addiction.



As for a place such as Insite...yeah, I kind of see that as enabling. If a person has cancer, you don't treat them by feeding the cancer - you try to remove it. Just because you are making drug usage physically safer through preventing things such as infection, overdose, I don't know that it is necessarily helpful in overcoming or treating the actual addiction. To me, it just seems like they are making them less likely to suffer personal physical harm while using in the short term. Yes there is the added bonus of saving public healthcare dollars from treating the repercussions of either unsafe paraphernalia or overdose, but it's also enabling their continued addiction by making it both safer and "acceptable".

JuLeah - posted on 07/27/2011

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Rebecca, Al-Anon IS help and Good on your mother for attending and teaching you different. Your post gives me hope. I attend Al-Anon with the idea that it will not only change my life, but break the cycle for my child.

Katherine - posted on 07/27/2011

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I see disease as something there is no cure for. And right now there is no cure for addiction or mental illness. Both run in my family and it's a sore subject for me.
But I believe 100% they are diseases.

Stifler's - posted on 07/27/2011

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I think it's a result of repetitive behaviour IMHO. Not that that makes it any less of an illness.

Lady Heather - posted on 07/26/2011

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Oh, I'm pretty sure the people in my family are addicts because they are depressed. You can actually trace it back and see where it all started. Depression and anxiety issues run in the family, whether alcoholism is present or not. And it definitely was a cyclical problem in our family. Goodness knows how far back the depression went. My dad and his siblings saw their dad medicate himself with alcohol and they did the same. It was just how shit was dealt with in their house. Throw back some whiskey and forget about it. Fortunately those of them who had kids mostly married people who recognized the problem and worked their tails off to not let the craziness continue (thanks Mum!). I definitely have the anxiety issues that are present in my dad's family. This is why I'm so sure they are self-medicating an already existing problem. I am one of them and I recognize it. But my mum showed me other ways to handle it so I didn't follow the pattern. Of the 10 in my generation, 2 have a problem. Of the 7 in my dad's generation (not counting cousins who also deal with various mental issues), all 7 have a problem. I think that's a pretty big improvement!

I think it is kind of similar to a chronic illness, like Rebecca said, but I'm not so sure that makes it super easy to change. I have fibromyalgia. I know many people with this illness who wallow in self-pity and don't really try to change things. I did it myself for three years and I know it's really hard to get out of the rut. It's possible when you find the right care provider and you trust in the process (a little bit of exercise every day will make me less tired??? Wha???), but it is not easy to take that first step on the treadmill, let me tell you.

Mrs. - posted on 07/26/2011

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" If raised in a family of addicts, they have been raised to think/behave like an addict. They themselves might avoid drugs and beer out of fear, but will raise their children in the same fashion as they were raised (if they don’t get help) and their kids who don’t have the avoidance of drink and drugs but do have the genetic pre-disposition and the behaviors will become full on addicts. That is why it is said this disease will skip a generation."



Yeah, my mother's father was a drunk and so was my father's father...oh and two of my uncles who are both dead now because of their addictions....and out of four kids, none of us are addicts.



So, you can still choose despite genetics and learned behaviours. You can break the cycle, otherwise what is the point of my mother attending all those Al-anon meetings?



It is not a hard and fast rule that it skips a generation.



Edit: I know you said if "they don't get help", I just want to give an example of how the cycle can be broken.

Sherri - posted on 07/26/2011

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Yes addiction is disease that is outside the control of the user in my opinion and most can not kick the habit without help.

JuLeah - posted on 07/26/2011

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My grandfather has the strength of will to put the plug in the jug all on his own power. BUT he was still a drunk. Addicts have 'thinking errors' they struggle to understand many social/human concepts. They move through the world from a different place. Some people with the behaviors of an addict never themselves drink, but marry a person who does and they become a great partner for the drunk. They are just as sick really until they get help and get healthy (Al-Anon)

To stop drinking or drugging is only half the battle.

And, if they started young, emotionally, they are still that age even if 30 years have passed.

The problem with treatment centers (one of many problems) is that the emotion/maturity is not addressed.

The get the person sober, but wil no skills on how to deal with life while sober, they kick them back out onto the street.

Someone asked, Amber, I think why if this is not a disease does it seem to be genetic.

Two reasons: 1) one can be genetically wired to addiction. They might have a brain that does not produce enough, or store and release enough Endorphins, therefore are much more susceptible when a drug comes along that will do the brains work for it.
2) If raised in a family of addicts, they have been raised to think/behave like an addict. They themselves might avoid drugs and beer out of fear, but will raise their children in the same fashion as they were raised (if they don’t get help) and their kids who don’t have the avoidance of drink and drugs but do have the genetic pre-disposition and the behaviors will become full on addicts. That is why it is said this disease will skip a generation.

Kids raised in this environment will drunk, raise kids who drink, or marry one who drinks … it is a family disease.

Mrs. - posted on 07/26/2011

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Like many diseases, as others have said, there is a choice to treat one's self and take responsibility.

As a chronic pain patient with several diseases, a huge part of taking responsibility and truly living with them is "choosing" to do everything I can to make the most positive choices I can with my treatment and management of the diseases.

Addiction is the same as any other chronic illness, you have those examples of people who say things like, "Well, I can't help it, I have a disease!" Then you have people who take every measure they can to accept they have a condition and seek help, manage their ongoing issues.

These people are not always the most visible because they are managing and the disease is not always standing out in a crowd like say....a junkie passed out on the street.

In my opinion, addiction being a disease does not mean the people with the disease are helpless to it and don't make the move to do what they can to treat themselves. I feel this way about most illnesses too...including some cases of the Big "C". There are those who fight, even if it is not successful in the end, and there are those who choose to lay down and die.

That is not to devalue those who were taken very quickly, like my uncle was with colon cancer, sometimes there is no time or no thing you can do to prevent death...some diseases are killers, regardless of what you do. However, I'm not sure the disease of addiction is one of them. There is sooo much room for choice there.

Lady Heather - posted on 07/26/2011

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I sort of think addiction is a disease that we all suffer from. ha. Name me one person who isn't addicted to something. I try my best, but I still love my tea and I can't deny it. I don't get headaches without it in the morning, but my day just isn't right without it and I can usually tell by about 3 pm if I missed my tea. I just don't feel...right. That's a pretty weak one too. I'm just lucky I went with tea instead of some crazy drug.

As much as there is a level of personal responsibility involved, so many addicts made their choice of drug at a young age. I have a hard time blaming the 16 year old kid with a horrible family life for being told they could escape it with this substance and thinking that was a good way to go. There but for the grace of God I suppose. I didn't have that experience and was frankly never offered any hard drugs so it was easy for me to not make that choice. Once that initial choice has been made, you just don't know which way you are going to go. Do we really fully understand why some people get clean and others don't? They mentioned psych disorders, but I'm sure not all struggling and relapsing addicts have them. How do we really know there isn't something about some people that makes it more difficult for them?

I'm just throwing thoughts out at random. This probably won't make any sense. I do have a really hard time calling it a choice though. The decision to initially take a drug is a choice. The decision to keep going with it or stop is a little less so. I watched my sister struggle to quit smoking. It took her 10 years. She did it, but there were many times where she gave up. How do I judge that as someone who has never smoked?

And speaking personally - most addicts I know have not recovered. Most addicts I know are alcoholics. Half of them have seen their marriages fall apart. They watched their father and grandfather die of liver cancer. Their families have made every attempt to plead with them to stop. They continue. I could judge them I suppose. It does make me angry. But it's hard for me to really know how simple a choice it would be to stop. It certainly doesn't seem simple. I'm thinking if it was, there wouldn't be so damn many of them.

Becky - posted on 07/26/2011

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I aree with you, Sara. I don't like referring to it as a disease because it seems to absolve the addict of any responsibility for their addiction, when in fact, addiction is 100% preventable. Even if a person has a genetic predisposition to addiction, if they never smoke that first cigarette, never take that first drink of alcohol or that first hit of cocaine or heroin, etc, then they are never going to become addicted. Also, when it comes to something like cancer, you can do everything in the world to fight it, have all the willpower to overcome in in the world, but you may or may not beat it. Ultimately, it is not in your control. I believe beating an addiction is in your control, if you want it badly enough.

Sara - posted on 07/26/2011

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I really have been thinking a lot about this lately. There is someone in my family who is an addict and she has really hurt a lot of people in our family through the course of her addiction. My mom will say stuff like "It's not her doing those things, it's a disease" and to be quite frank, I think that's a load of crap. I understand that a lot of addicts may have underlying psychiatric conditions and whatnot, but I also don't think it's fair to take personal accountability out of the equation. They are choosing a behavior that is destructive and hurtful to those around them, and I'm not going to forgive it so easily as saying they have no control over it. And I don't think it's fair to put it in the same category as someone who has cancer, a diesese that is truly out of their control.



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