http://crabbyexdrunk.blogspot.com/2017/10/okay-so-its-not-disease.html?spref=tw&m=1
You ask for it, you got it :)
I have long disliked calling addiction a disease. Diseases are caused by microbes. And alcoholism, say, can't be a thing if you don't start drinking and keep drinking. It starts as behavior. Addiction is out of control behavior that self perpetuates. If we someday find that there are microbes that assist with this, fine, it's a disease. But it's not a disease you can treat like a microbe, so far as I know.
HOWEVER! People with addictions need help quitting & maintaining sobriety like hoarders need organizers, ADD execs need personal assistants, and well, there are many disfunctions that are best overcome with the help of a partner or a group. Addiction is clearly a dysfunction, and can be an extreme one. The trouble is our society has few words to accurately label mental health deviations and elicit compassion in the populace. Most mental health descriptors, if not now pejorative themselves (retarded used to mean slower, now it's just a taunt, for instance) elicit judgement, self righteous pushback, and all manner of nasty responses, none of which help the person fighting an addiction. Diseases get insurance coverage. Diseases at least have a hope of eliciting compassion. Right now, "disease" may be the best word we have to elicit the responses we need. I would rather support using the wrong word to get the right effect than to insist on perfect descriptors that allow folks to flounder.
And mental health issues might be more hormonal/vitamin/nutritional imbalances than microbe based but we call those problems diseases too. I prefer dysfunction -a bad tune up (dysfunction) isn't the same as sugar in the gas tank (microbe disease) but both can wreck your engine - they're both problems. I guess I hadn't thought this through before now. I still yell "no it's not" at the addiction network ad. Probably I should stop now that I know what my position is.
Not having been an addict (except maybe for reading, and I don't say that to make light, just to share my least controlled behavior), I can't say if the disease model helps the treatment except as it allows people to step away from eternal blame. Because I do believe that some people have less control in certain situations thru natural disposition. Add to that years of response feedback conditioning in the brain which sets up repeated behavior seeking those rewards. It's not totally out of your control but not totally in your control either. Some things you control just fine, others not so much. I have ADD. My life is a minefield of distractions. I have to justify having an assistant CONSTANTLY to my mother. But having one means my life works & the opposite when I don't.
More like the addiction model: I have no "off switch" for potato/corn chips; one bag is one serving. I therefore buy tiny bags of chips and limit my visits to Mexican eateries with unlimited chips. If Chips had the addictive qualities of alcohol I would be 600 lbs. My brother and dad have no "off switch" for alcohol. Mom came from near teetotalers so keeps my dad from binging by limiting availability. Dad doesn't have many friends who drink at all. My brother dated teetotalers to dry out when he found himself doing risky things. Now he tries to savor good booze while remaining on guard. And his gf developed an allergy to brewers yeast(!) that helps him too. Also I knew I could be a chain smoker so I never started. But I was only able to do this because my family and most of my community was non-smoking. I had the info about smoking to make that choice. I try to remember that most smokers didn't start on 3rd base, as it were.
I hear there's a shot that stops the cravings for alcohol. Narcan, if dispensed like (formerly cheap) Epi-pens, would have saved at least one college friend. But our society both pushes addiction prone behaviors as worthy pursuits then punishes with almighty wrath any who dare be imperfect in their vices. We condemn, judge, WITHHOLD TREATMENT & HELP in the name of righteousness punishing wickedness as if we all weren't a tragedy or two from being there ourselves. The "it can't happen to me because I'm a good person" (similar to the "I can't be doing racist things because I'm a good person") delusion is a powerful distancing factor that drives a great deal of unhelpful behaviors. Like in Jenn Ashley Wright's book "Get Well Soon" the only way to limit the spread of disease is to treat those with the diseases with kindness & help them out. It makes sense to me that it's the only way to help addicts regain control over their lives too - by providing help with compassion. So I guess I'm ok saying it's a disease. (Especially if we can conquer it with a medicine...)
Lastly: there are resorts in regions with monkeys. These monkeys will come steal alcoholic & other drinks while people stroll or swim. Folks studying the monkeys found the SAME RATE of teetotaler/casual drinkers/addicts in the monkey population as exists in the human population. If there are traits we share that closely with evolutionary cousins, addicts just might have been born with that proclivity into a society that does its best to keep their kryptonite front and center.
(This got out of hand. Another 3 hours and I could probably edit it back some. If there are typos let me know in the comments as I'm trying this on my phone which has some odd proclivities wrt autocorrect.
ETA: 2024 edited 2 typos, no additions but this)
