Is addiction a disease? Should it be treated as such?
The following is a summary of an NY Times opinion article written by psychiatrist David Sack on February 11, 2014.
Addiction has three main characteristics that cause it to be considered a disease. First, it has a lifelong course characterized by frequent relapses, cross addiction and a common set of behavioral changes. Second, like other chronic medical disorders, genetics plays an important role is determining who is at risk to become addicted. Finally, there are effective medications that treat drug addiction by blocking the rewarding effects of drugs and decreasing drug cravings. Let’s examine each of these.
Research has shown that it has the properties of other medical disorders, including genetic links and a susceptibility to medication.
A recent study of heroin addicts found that at the end of one year, approximately 50 percent remained in treatment and more than 80 percent had used heroin regardless of the type of treatment they received. By the end of three years, only 8 percent were continuously abstinent. Although outcomes for heroin are somewhat worse than for other drugs, a large proportion of addicts continue to use in the years following treatment regardless of the particular drug involved. These outcomes are not dissimilar to those observed in Type II diabetes, hypertension or asthma, where only a minority of patients achieve clinical control after extensive treatment.
In many individuals the risk to addiction appears to transcend the particular drug involved. Data shows that anyone who has been addicted to drugs has many times the risk of becoming addicted to alcohol, and similarly, anyone who has been dependent on alcohol has a much higher risk of becoming addicted to another drug. One interpretation of these observations is that once a person has become addicted to drugs, the changes that occur in the brain-reward centers leave them vulnerable to succumbing to a second addiction.
Numerous family and twin adoption studies have confirmed that genetics plays a powerful role in determining who is at risk to become addicted. The genetic risk for the various drug addictions has been estimated to range from 40 percent to 60 percent for alcohol, and other common drugs of abuse. Genetic studies have been interpreted to support the hypothesis that multiple genes contribute to this risk rather than a single recessive or dominant gene. Genetic variations in specific genes offer an explanation of why some populations are so susceptible to alcoholism and others are not.
Over the last 25 years several medications have received F.D.A. approval to treat addictions. In most cases these medications work by blocking the rewarding effects of addictive drugs or by decreasing drug cravings and other protracted withdrawal symptoms that occur after the drug abuse has stopped. Most recently, research efforts have focused on developing vaccines to fight addiction. The vaccine that has moved closest to clinical approval is for the treatment of cocaine addiction. The idea here is to use the body’s immune system to attack the drug and prevent it from reaching the brain.
Is Addiction a DISEASE-Should it be treated as such…. Interesting vision* Addiction as a Dis-ease vision is how some of us look at this focus. Being in addiction is a dis-ease, meaning not at ease with self or others* Being treated as a dis-ease is only the beginning of a process that can bring one from dying to living for some… The medical people want to treat us with drugs and sessions that did not help me* We found a way out of our addiction by facing experiences that lead to FEAR then finding replacements of Faith that lead to TRUST* We have observed many without control having no answers as to what happen to them. We do believe this addiction is a disease that is fatal*
We do believe one can recover* The process is learning to live a new way of thinking-not think a new way of living*