I have railed since day one when clinicians started calling bad choices and bad habits “diseases.”
The good news about calling alcohol and drug abuses “diseases” is that clinicians and others can reap financial rewards by charging insurance for their “medical” intervention.
The bad news about calling substance abuse a “disease” is that the individual is robbed of his real ability to exercise choice and self-control, and such labeling puts the onus on society to give that individual a “pass” on taking responsibility for the consequences of the addiction.
There is considerable proof that addiction is a choice: the book “Addiction: A Disorder of Choice,” by Gene M. Heyman, Harvard University Press, demonstrates many of them.
For example: in 1970, it was determined that between 10% and 25% of enlisted Army men were addicted to high-grade Vietnamese heroin and opium. When they were told they couldn’t come home without being drug-free, the vast majority stopped using narcotics as the word of the new directive spread. The vast minority who were detained for detoxification programs were clean when given a second chance. Only 12% of soldiers who were dependent on opiate narcotics in Vietnam became re-addicted at some point in the next three years.
The point is that calling alcohol or drug abuse a “disease” takes away from the individual the respect for his or her ability to choose. Every behavior we have is somehow tied to genetics and the brain. That doesn’t make it a disease unless the individual has no choice. Alzheimer ‘s disease gives you no choice. Multiple sclerosis gives you no choice. Alcohol abuse is a choice.
Addicts are drawn to drug abuse to salve depression, anxiety, boredom, and self-loathing. At the start of their addiction, they feel great, short-term, and they start giving up the joy in work, hobbies, family and friends. After a while, they need the drug to salve psychic pain (which is now increasing with the collapse of other factors in their lives), suppress withdrawal symptoms, and eliminate the craving. At some point, when these benefits come to be outweighed by the adverse fallout the balance shifts, and the addict chooses recovery.
The concept of disease includes the obliteration of choice-making ability. Fortunately, addicts can make a choice, and congratulations are in order to those who do!