They’re screaming it from the rooftops: “addiction is a disease, and you can’t stop it without medical treatment”! But why are they screaming it so loud, why are they browbeating us about it, why is it always mentioned with a qualifier? You don’t hear people constantly referring to cancer as “the disease of cancer” – it’s just “cancer”, because it’s obvious that cancer is a disease, it’s been conclusively proven that the symptoms of cancer can’t be directly stopped with mere choices – therefore no qualifier is needed. On the other hand, addiction to drugs and alcohol is not obviously a disease, and to call it such we must either overlook the major gaps in the disease argument, or we must completely redefine the term “disease.” Here we will analyze a few key points and show that what we call addiction doesn’t pass muster as a real disease.
Real Diseases versus The Disease Concept or Theory of Drug Addiction
In a true disease, some part of the body is in a state of abnormal physiological functioning, and this causes the undesirable symptoms. In the case of cancer, it would be mutated cells which we point to as evidence of a physiological abnormality, in diabetes we can point to low insulin production or cells which fail to use insulin properly as the physiological abnormality which create the harmful symptoms. If a person has either of these diseases, they cannot directly choose to stop their symptoms or directly choose to stop the abnormal physiological functioning which creates the symptoms. They can only choose to stop the physiological abnormality indirectly, by the application of medical treatment, and in the case of diabetes, dietetic measures may also indirectly halt the symptoms as well (but such measures are not a cure so much as a lifestyle adjustment necessitated by permanent physiological malfunction).
In addiction, there is no such physiological malfunction. The best physical evidence put forward by the disease proponents falls totally flat on the measure of representing a physiological malfunction. This evidence is the much touted brain scan[1]. The organization responsible for putting forth these brain scans, the National Institute on Drug Abuse and Addiction (NIDA), defines addiction in this way:
Addiction is defined as a chronic relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain – they change it’s structure and how it works. These brain changes can be long lasting, and can lead to the harmful behaviors seen in people who abuse drugs.
The NIDA is stating outright that the reason addiction is considered a disease is because of the brain changes evidenced by the brain scans they show us, and that these changes cause the behavior known as addiction, which they characterize as “compulsive drug seeking and use”. There are three major ways in which this case for the disease model falls apart:
- the changes in the brain which they show us are not abnormal at all
- people change their behavior IN SPITE OF the fact that their brain has changed in response to repeated substance use jump to section
- there is no evidence that the behavior of addicts is compulsive (compulsive meaning involuntary) (point two addresses this, as well as some other research that will be presented) jump to section
This all applies equally to “alcoholism” as well. If you’re looking for information on alcoholism, the same theories and logic discussed here are applicable; wherever you see the term addiction used on this site, it includes alcoholism.
Brain Changes In Addicts Are Not Abnormal, and Do Not Prove The Brain Disease Theory
On the first count – the changes in the brain evidenced by brain scans of heavy substance users (“addicts”) do not represent a malfunctioning brain. They are quite normal, as research into neuroplasticity has shown us. Whenever we practice doing or thinking anything enough, the brain changes – different regions and neuronal pathways are grown or strengthened, and new connections are made; various areas of the brain become more or less active depending upon how much you use them, and this becomes the norm in your brain – but it changes again as you adjust how much you use those brain regions depending on what you choose to think and do. This is a process which continues throughout life, there is nothing abnormal about it. Here, Sharon Begley describes neuroplasticity: [2]
The term refers to the brain’s recently discovered ability to change its structure and function, in particular by expanding or strengthening circuits that are used and by shrinking or weakening those that are rarely engaged. In its short history, the science of neuroplasticity has mostly documented brain changes that reflect physical experience and input from the outside world.
So, when the NIDA’s Nora Volkow and others show us changes in the brain of a substance user as compared to a non-substance user, this difference is not as novel as they make it out to be. They are showing us routine neuroplastic changes which every healthily functioning person’s brain goes through naturally. The phenomenon of brain changes isn’t isolated to “addicts” or anyone else with a so-called brain disease – non-addicted and non-depressed and non-[insert brain disease of the week here] people experience neural adaptations too. One poignant example was found in the brains of London taxi drivers, as Begley and Jeffrey Schwartz pointed out in The Mind and The Brain. [4]
Is Being A Good Taxi Driver A Disease?
A specific area of the brain’s hippocampus is associated with creating directional memories and a mental map of the environment. A team of researchers scanned the brains of London taxi drivers and compared their brains to non-taxi drivers. There was a very noticeable difference, not only between the drivers and non-drivers, but also between the more experienced and less experienced drivers:
There it was: the more years a man had been a taxi driver, the smaller the front of his hippocampus and the larger the posterior. “Length of time spent as a taxi driver correlated positively with volume in…the right posterior hippocampus,” found the scientists. Acquiring navigational skills causes a “redistribution of gray matter in the hippocampus” as a driver’s mental map of London grows larger and more detailed with experience. [4]
So, the longer you drive a cab in London (that is, the longer you exert the mental and physical effort to quickly find your way around one of the world’s toughest to navigate cities), the more your brain physically changes. And the longer you use drugs, the more your brain changes. And indeed, the longer and more intensely you apply yourself to any skill, thought, or activity – the more it will change your brain, and the more visible will be the differences between your brain and that of someone who hasn’t been focused on that particular skill. So, if we follow the logic of the NIDA, then London’s taxi drivers have a disease, which we’ll call taxi-ism, that forces them to drive taxis. But the new diseases wouldn’t stop there.
Learning to play the piano well will change your brain – and if you were to compare brain scans of a piano player to a non-piano player, you would find significant differences. Does this mean that piano playing is a disease called Pianoism? Learning a new language changes your brain, are bilingual people diseased? Athletes’ brains will change as a result of intensive practice – is playing tennis a disease? Are soccer players unable to walk into a sporting goods store without kicking every ball in sight? We could go on and on with examples, but the point is this – when you practice something, you get better at doing it, because your brain changes physiologically – and this is a normal process. If someone dedicated a large portion of their life to seeking and using drugs, and their brain didn’t change – then that would be a true abnormality. Something would be seriously wrong with their brain.
Its not just physical activity that changes our brains, thoughts alone can have a huge effect. What’s more, whether the brain changes or not, there is much research which shows that the brain is slave to the mind. As Begley points out elsewhere, thoughts alone can create the same brain activity that would come about by doing things[2]:
Using the brain scan called functional magnetic resonance imaging, the scientists pinpointed regions that were active during compassion meditation. In almost every case, the enhanced activity was greater in the monks’ brains than the novices’. Activity in the left prefrontal cortex (the seat of positive emotions such as happiness) swamped activity in the right prefrontal (site of negative emotions and anxiety), something never before seen from purely mental activity. A sprawling circuit that switches on at the sight of suffering also showed greater activity in the monks. So did regions responsible for planned movement, as if the monks’ brains were itching to go to the aid of those in distress.
So by simply practicing thinking about compassion, these monks made lasting changes in their brain activity. Purely mental activity can change the brain in physiologically significant ways. And to back up this fact we look again to the work of Dr Jeffrey Schwartz[3], who has taught OCD patients techniques to think their way out of obsessive thoughts. After exercising these thought practices, research showed that the brains of OCD patients looked no different than the brains of those who’d never had OCD. If you change your thoughts, you change your brain physically – and this is voluntary. This is outside the realm of disease, this shows a brain which changes as a matter of normality, and can change again, depending on what we practice choosing to think. There is nothing abnormal about a changing brain, and the type of changes we’re discussing aren’t necessarily permanent, as they are characterized to be in the brain disease model of addiction.
These brain change don’t need to be brought on by exposure to chemicals. Thoughts alone, are enough to rewire the very circuits of the human brain responsible for reward and other positive emotions that substance use and other supposedly “addictive” behaviors (“process addictions” such as sex, gambling, and shopping, etc.) are connected with.
The Stolen Concept of Neuroplasticity in the Brain Disease Model of Addiction
Those who claim that addiction is a brain disease readily admit that the brain changes in evidence are arrived at through repeated choices to use substances and focus on using substances. In this way, they are saying the disease is a product of routine neuroplastic processes. Then they go on to claim that such brain changes either can’t be remedied, or can only be remedied by outside means (medical treatment). When we break this down and look at it step by step, we see that the brain disease model rests on an argument similar to the “stolen concept”. A stolen concept argument is one in which the argument denies a fact on which it simultaneously rests. For example, the philosophical assertion that “reality is unknowable” rests on, or presumes that the speaker could know a fact of reality, it presumes that one could know that reality is unknowable – which of course one couldn’t, if reality truly was unknowable – so the statement “reality is unknowable” invalidates itself. Likewise, the brain disease proponents are essentially saying “neuroplastic processes create a state called addiction which cannot be changed by thoughts and choices” – this however is to some degree self-invalidating, because it depends on neuroplasticity while seeking to invalidate it. If neuroplasticity is involved, and is a valid explanation for how to become addicted, then we can’t act is if the same process doesn’t exist when it’s time to focus on getting un-addicted. That is, if the brain can be changed into the addicted state by thoughts and choices, then it can be further changed or changed back by thoughts and choices. Conditions which can be remedied by freely chosen thoughts and behaviors, don’t fit into the general understanding of disease. Ultimately, if addiction is a disease, then it’s a disease so fundamentally different than any other that it should probably have a completely different name that doesn’t imply all the things contained in the term “disease” – such as the idea that the “will” of the afflicted is irrelevant to whether the condition continues.
People change their addictive behavior in spite of the fact that their brain is changed – and they do so without medication or surgery (added 4/18/14)
In the discussion above, we looked at some analogous cases of brain changes to see just how routine and normal (i.e. not a physiological malfunction) such changes are. Now we’re going to look directly at the most popular neuroscientific research which purports to prove that these brain changes actually cause “uncontrolled” substance use (“addiction”).
The most popular research is Nora Volkow’s brain scans of “meth addicts” presented by the NIDA. The logic is simple. We’re presented with the brain scan of a meth addict alongside the brain scan of a non-user, and we’re told that the decreased activity in the brain of the meth user (the lack of red in the “Drug Abuser” brain scan presented) is the cause of their “compulsive” methamphetamine use. Here’s how the National Institute on Drug Abuse (NIDA) explains the significance of these images in their booklet – Drugs, Brains, and Behavior: The Science of Addiction :
Just as we turn down the volume on a radio that is too loud, the brain adjusts to the overwhelming surges in dopamine (and other neurotransmitters) by producing less dopamine or by reducing the number of receptors that can receive signals. As a result, dopamine’s impact on the reward circuit of a drug abuser’s brain can become abnormally low, and the ability to experience any pleasure is reduced. This is why the abuser eventually feels flat, lifeless, and depressed, and is unable to enjoy things that previously brought them pleasure. Now, they need to take drugs just to try and bring their dopamine function back up to normal.
[emphasis added]
They go on that these same sorts of brain changes:
..may also lead to addiction, which can drive an abuser to seek out and take drugs compulsively. Drug addiction erodes a person’s self-control and ability to make sound decisions, while sending intense impulses to take drugs.
[emphasis added]
That image is shown when NIDA is vaguely explaining how brain changes are responsible for “addiction.” But later on, when they try to make a case for treating addiction as a brain disease, they show the following image, which tells a far different story if you understand more of the context than they choose to mention:
Again, this graphic is used to support the idea that we should treat addiction as a brain disease. However, the authors mistakenly let a big cat out of the bag with this one – because the brain wasn’t treated at all. Notice how the third image shows a brain in which the red level of activity has returned almost to normal after 14 months of abstinence. That’s wonderful – but it also means that the NIDA’s assertions that “Addiction means being unable to quit, even in the face of negative consequences”(LINK) and “It is considered a brain disease because drugs change the brain… These brain changes… can lead to the harmful behaviors seen in people who abuse drugs” are dead wrong.
When these studies were done, nobody was directly treating the brain of methamphetamine addicts. They were not giving them medication for it (there is no equivalent of methadone for speed users), and they weren’t sticking scalpels into the brains of these meth addicts, nor were they giving them shock treatment. So what did they do?
These methamphetamine addicts were court ordered into a treatment program (whose methodology wasn’t disclosed in the research) which likely consisted of a general mixture of group and individual counseling with 12-step meeting attendance. I can’t stress the significance of this enough: their brains were not medically treated. They talked to counselors. They faced a choice between jail and abstinence. They CHOSE abstinence (for at least 14 months!) – even while their brains had been changed in a way that we’re told robs them of the ability to choose to quit “even in the face of negative consequences.” [5]
Even with changed brains, people are capable of choosing to change their substance use habits. They choose to stop using drugs, and as the brain scans above demonstrate – their brain activity follows this choice. If the brain changes caused the substance using behavior, i.e. if it was the other way around, then a true medical intervention should have been needed – the brain would’ve needed to have changed first via external force (medicine or surgery) before abstinence was initiated. They literally wouldn’t have been able to stop for 14 months without a real physical/biological medical intervention. But they did…
Substance Use Is Not Compulsive, It Is A Choice
In his classic book Addiction & Opiates, Alfred R Lindesmith PhD explained the requirements of reliable scientific theories explaining the causes of things such as heroin addiction:
…a genuine theory that proposes to explain a given phenomenon by relating it to another phenomenon must, in the first place, have clear empirical implications which, if not fulfilled, negate the theory.
If the theory is that neural adaptations alone cause uncontrolled behavior, then this proposition can easily be shown to be false. I demonstrated above that in the midst of having fully “changed” or “addicted” brains, people do indeed stop using substances, so essentially, it is case closed. But the depths to which the brain disease theory of addiction can be negated go even further, because the basic theory of addiction as representing uncontrolled substance use has never been explained. Explanation of the mechanism by which substance use happens without the individual’s consent is conspicuously missing – yet such explanation is a necessary part of such a theory, as Lindesmith writes (again in Addiction & Opiates):
…besides identifying the two types of phenomenon that are allegedly interrelated, there must be a description of the processes or events that link them. In other words, besides affirming that something causes something else, it is necessary to indicate how the cause operates to produce the alleged effect.
“Here Comes the Bogey-Man” by Goya, circa 1799
There doesn’t seem to be any explanation or evidence that substance use is involuntary. In fact, the evidence, such as that presented above, shows the opposite. Nevertheless, when the case for the disease is presented, the idea that drug use is involuntary is taken for granted as true. No evidence is ever actually presented to support this premise, so there isn’t much to be knocked down here, except to make the point I made above – is a piano player fundamentally incapable of resisting playing the piano? They may love to play the piano, and want to do it often, they may even be obsessive about it, but it would be hard to say that at the sight of a piano they are involuntarily driven by their brain to push aside whatever else they need to do in order to play that piano.
There is another approach to the second claim though. We can look at the people who have subjectively claimed that their substance use is involuntary, and see if the offer of incentives results in changed behavior. Gene Heyman covered this in his landmark book, Addiction: A Disorder of Choice[3]. He recounts studies in which cocaine abusers were given traditional addiction counseling, and also offered vouchers which they could trade in for modest rewards such as movie tickets or sports equipment – if they proved through urine tests that they were abstaining from drug use. In the early stages of the study, 70% of those in the voucher program remained abstinent, while only 20% stayed abstinent in the control group which didn’t receive the incentive of the vouchers. This demonstrates that substance use is not in fact compulsive or involuntary, but that it is a matter of choice, because these “addicts” when presented with a clear and immediately rewarding alternative to substance use and incentive not to use, chose it. Furthermore, follow up studies showed that this led to long term changes. A full year after the program, the voucher group had double the success rate of those who received only counseling (80% to 40%, respectively). This ties back in to our first point that what you practice, you become good at. The cocaine abusers in the voucher group practiced replacing substance use with other activities, such as using the sports equipment or movie passes they gained as a direct consequence of abstaining from drug use – thus they made it a habit to find other ways of amusing themselves, this probably led to brain changes, and the new habits became the norm.
Long story short, there is no evidence presented to prove that substance use is compulsive. The only thing ever offered is subjective reports from drug users themselves that they “can’t stop”, and proclamations from treatment professionals that the behavior is compulsive due to brain changes. But if the promise of a ticket to the movies is enough to double the success rate of conventional addiction counseling, then it’s hard to say that substance users can’t control themselves. The reality is that they can control themselves, but they just happen to see substance use as the best option for happiness available to them at the times when they’re abusing substances. When they can see other options for happiness as more attractive (i.e. as promising a greater reward than substance use), attainable to them, and as taking an amount of effort they’re willing to expend – then they will absolutely choose those options instead of substance use, and will not struggle to “stay sober”, prevent relapse, practice self-control or self-regulation, or any other colloquialism for making a different choice. They will simply choose differently.
But wait… there’s more! (Added 4/21/14) Contrary to the claims that alcoholics and drug addicts literally lose control of their substance use, a great number of experiments have found that they are really in full control of themselves. Priming dose experiments have found that alcoholics are not triggered into uncontrollable craving after taking a drink. Here’s a link to the evidence and a deeper discussion of these findings: Do Addicts and Alcoholics Lose Control? Priming dose experiments of cocaine, crack, and methamphetamine users found that after being given a hit of their drug of choice (primed with a dose) they are capable of choosing a delayed reward rather than another hit of the drug.
Three Most Relevant Reasons Addiction Is Not A Disease
So to sum up, there are at least two significant reasons why the current brain disease theory of addiction is false.
- A disease involves physiological malfunction, the “proof” of brain changes shows no malfunction of the brain. These changes are indeed a normal part of how the brain works – not only in substance use, but in anything that we practice doing or thinking intensively. Brain changes occur as a matter of everyday life; the brain can be changed by the choice to think or behave differently; and the type of changes we’re talking about are not permanent.
- The very evidence used to demonstrate that addicts’ behavior is caused by brain changes also demonstrates that they change their behavior while their brain is changed, without a real medical intervention such as medication targeting the brain or surgical intervention in the brain – and that their brain changes back to normal AFTER they VOLITIONALLY change their behavior for a prolonged period of time
- Drug use in “addicts” is not compulsive. If it was truly compulsive, then offering a drug user tickets to the movies would not make a difference in whether they use or not – because this is an offer of a choice. Research shows that the offer of this choice leads to cessation of substance abuse. Furthermore, to clarify the point, if you offered a cancer patient movie tickets as a reward for ceasing to have a tumor – it would make no difference, it would not change his probability of recovery.
Addiction is NOT a disease, and it matters. This has huge implications for anyone struggling with a substance use habit.
References:
- 1) NIDA, Drugs Brains and Behavior: The Science of Addiction, sciofaddiction.pdf
- 2) Sharon Begley, Scans of Monks’ Brains Show Meditation Alters Structure, Functioning, Wall Street Journal, November 5, 2004; Page B1, http://psyphz.psych.wisc.edu/web/News/Meditation_Alters_Brain_WSJ_11-04.htm
- 3) Gene Heyman, Addiction: A Disorder of Choice, Harvard University Press, 2009
- 4) Sharon Begley and Jeffrey Schwartz, The Mind And The Brain, Harper Collins, 2002
- 5) Links to the 2 methamphetamine abuser studies by Nora Volkow:
http://www.jneurosci.org/cgi/content/full/21/23/9414
http://ajp.psychiatryonline.org/cgi/reprint/158/3/377
Important Notes from the author to readers and especially commenters:
On “badness” or immorality:
Please do not attribute to me the idea that heavy substance users must be “bad” or “immoral” if they are in fact in control of and choosing their behavior. I do not think this. I think that at the time they’re using, it is what they prefer, given what life options they believe are available to them – and I don’t think it’s my job to decide what other people should prefer for themselves, and then declare them bad if they don’t live up to my vision of a “good” life. That’s what the disease recovery culture does, de facto, when they present the false dichotomy of ‘diseased or bad’. To say that addiction is chosen behavior is simply to make a statement about whether the behavior is within the control of the individual – it is not a judgment of the morality of the behavior or the individual choosing it.
On willpower:
Please do not attribute to me the suggestion to “use willpower.” I have not said that people should use willpower, nor do I think it’s a coherent or relevant concept in any way, nor do I think “addicts lack willpower” or that those who recover have more willpower, nor, and this is important, do I believe that a choice model of addiction necessarily implies willpower as the solution.
“Addicts” do not need extra willpower, strength, or support, to change their heavy substance use habits if that is what they want to do. They need to change their preference for heavy substance use, rather than trying to fight that preference with supposed “willpower.”
On compassion:
Please don’t accuse me of not having compassion for people who have substance use problems. You do not know that, and if you attack my motives in this way it just shows your own intellectual impotence and sleaze. I have a great deal of compassion for people with these problems – I was once one such person. I am trying to get at the truth of the nature of addiction, so that the most people can be helped in the most effective way possible. I don’t doubt the compassion of those who believe addiction is a disease, and I hope you’ll give me the same benefit of the doubt. I assure you I care and want the best for people – and I don’t need to see them as diseased to do so. When you see someone who’s gotten themselves into a mess, don’t you want to help, even if it’s of their own making? Why should we need to believe they have a disease to help them if the mess is substance use related? I don’t get that requirement.
Some Agreement I’ve Found From Addiction Researchers (added 6/10/14)
I began working out my understanding of the brain disease model back in 2005 as I started working on a book about addiction; published this article in 2010; and was happy to find in 2011 when I went back to work with Baldwin Research that they had arrived at a similar conclusion. The way they stated it amounted to “either everything is addiction, or nothing is” – referring to the fact that the brain changes presented as proof of addiction being a brain disease are so routine as to indicate that all behavior must be classified as addiction if we follow the logic.
I was also gratified to have found a neuroscientist who arrived at the same conclusions. I think Marc Lewis PhD and I may disagree on a few things, but it seems we may see eye to eye on the logic I presented above about such brain changes being routine, and thus not indicative of disease. Check what he wrote in 2012 for the PLOS Blog, Mind The Brain:
every experience that has potent emotional content changes the NAC and its uptake of dopamine. Yet we wouldn’t want to call the excitement you get from the love of your life, or your fifth visit to Paris, a disease. The NAC is highly plastic. It has to be, so that we can pursue different rewards as we develop, right through childhood to the rest of the lifespan. In fact, each highly rewarding experience builds its own network of synapses in and around the NAC, and that network sends a signal to the midbrain: I’m anticipating x, so send up some dopamine, right now! That’s the case with romantic love, Paris, and heroin. During and after each of these experiences, that network of synapses gets strengthened: so the “specialization” of dopamine uptake is further increased. London just doesn’t do it for you anymore. It’s got to be Paris. Pot, wine, music…they don’t turn your crank so much; but cocaine sure does. Physical changes in the brain are its only way to learn, to remember, and to develop. But we wouldn’t want to call learning a disease.
….
In my view, addiction (whether to drugs, food, gambling, or whatever) doesn’t fit a specific physiological category. Rather, I see addiction as an extreme form of normality, if one can say such a thing. Perhaps more precisely: an extreme form of learning. No doubt addiction is a frightening, often horrible, state to endure, whether in oneself or in one’s loved ones. But that doesn’t make it a disease.
I think that quote is very important, because it highlights neuronal changes that occur in the same region implicated in addiction (whereas the examples I presented earlier in the article represented some other regions).
In a brilliant paper titled “The naked empress: Modern neuro science and the concept of addiction”, Peter Cohen of The Centre for Drug Research at University of Amsterdam, states that:
The notions of addiction transformed into the language of neurology as performed by authors like Volkov, Berridge, Gessa or De Vries are completely tautological.
He essentially argues that Volkow et al take for granted that heavy drug and alcohol use is uncontrolled, identify neural correlates, and present them as evidence of uncontrollability. Yet they don’t do so with other behaviors, and he provides plenty of examples. He notes that they start with assumptions that certain patterns of behavior (e.g. heavy drug use) are uncontrolled, and others are controlled – based purely on cultural prejudices. He accurately identifies addiction as a learned behavior, or as routine bonding to a thing, and then expresses something very close to my thesis presented above (that all learned/intensely repeated behaviors result in “brain changes”).
The problem of course is that probably all learning produces temporary or lasting ‘change in neural systems’. Also, continuation of learned behavior may be functional in the eyes and experience of the person but less so in the eyes of the outsider. Who is right? We know of people remaining married in spite of-in the eyes of a beholder- a very bad marriage. Who speaks of lasting ‘neural change’ as the basis of the continued marriage? But, even when a person herself sees some behavior as counter functional, it is not necessarily seen as addiction. It may be seen as impotence, ingrained habit or unhappy adaptation. It all depends on which behavior we discuss, not on the brain.
The great points contained in this article would be done an injustice if I tried to sum them up here, so check it out for yourself at The Center for Drug Research University of Amsterdam. As with Marc Lewis, I suspect that Peter Cohen and I might have some substantial disagreements about the full nature of addiction and human behavior in general, but I think we at least agree that the changes in the brain of an “addict” do not necessarily represent disease, and more likely represent a routine process.
Writing in 2013 for the journal Frontiers In Psychiatry, esteemed behavioral and addiction researcher Gene Heyman pointed out something so painfully obvious that we don’t even take notice – no causal link has ever been found between the neural adaptations caused by excessive substance use and continued heavy use. That is, correlation is not causation:
With the exception of alcohol, addictive drugs produce their biological and psychological changes by binding to specific receptor sites throughout the body. As self-administered drug doses greatly exceed the circulating levels of their natural analogs, persistent heavy drug use leads to structural and functional changes in the nervous system. It is widely – if not universally – assumed that these neural adaptations play a causal role in addiction. In support of this interpretation brain imaging studies often reveal differences between the brains of addicts and comparison groups (e.g., Volkow et al., 1997; Martin-Soelch et al., 2001) However, these studies are cross-sectional and the results are correlations. There are no published studies that establish a causal link between drug-induced neural adaptations and compulsive drug use or even a correlation between drug-induced neural changes and an increase in preference for an addictive drug.
Did you get that? Let me repeat the words of this experienced researcher, PhD, and lecturer/professor from Boston College and Harvard who, in addition to publishing scores of papers in peer reviewed medical journals has also had an entire book debunking the disease model of addiction by Harvard University press (I say all of this about his credentials so that I can hopefully STOP getting commenters who say “but you’re not a doctor, and what are your credentials wah, wah, wah,……” here’s a “credentialed” expert who essentially agrees with most of what I’ve written in this article – so please, for the love of god, save your fallacious ad hominems and appeals to authority for another day!)- he (Gene Heyman PhD) said this, as of 2013:
There are no published studies that establish a causal link between drug-induced neural adaptations and compulsive drug use or even a correlation between drug-induced neural changes and an increase in preference for an addictive drug.
And this was in a recently published paper in a section headed “But Drugs Change the Brain”, in which he continued to debunk the “brain changes cause addiction” argument by saying:
There are no published studies that establish a causal link between drug-induced neural adaptations and compulsive drug use or even a correlation between drug-induced neural changes and an increase in preference for an addictive drug. For example, in a frequently referred to animal study, Robinson et al. (2001) found dendritic changes in the striatum and the prefrontal cortex of rats who had self-administered cocaine. They concluded that this was a “recipe for addiction.” However, they did not evaluate whether their findings with rodents applied to humans, nor did they even test if the dendritic modifications had anything to do with changes in preference for cocaine in their rats. In principle then it is possible that the drug-induced neural changes play little or no role in the persistence of drug use. This is a testable hypothesis.
First, most addicts quit. Thus, drug-induced neural plasticity does not prevent quitting. Second, in follow-up studies, which tested Robinson et al.’s claims, there were no increases in preference for cocaine. For instance in a preference test that provided both cocaine and saccharin, rats preferred saccharin (Lenoir et al., 2007) even after they had consumed about three to four times more cocaine than the rats in the Robinson et al study, and even though the cocaine had induced motoric changes which have been interpreted as signs of the neural underpinnings of addiction (e.g., Robinson and Berridge, 2003). Third [an analysis of epidemiological studies] shows that the likelihood of remission was constant over time since the onset of dependence. Although this is a surprising result, it is not without precedent. In a longitudinal study of heroin addicts, Vaillant (1973) reports that the likelihood of going off drugs neither increased nor decreased over time (1973), and in a study with rats, Serge Ahmed and his colleagues (Cantin et al., 2010) report that the probability of switching from cocaine to saccharin (which was about 0.85) was independent of past cocaine consumption. Since drugs change the brain, these results suggest that the changes do not prevent quitting, and the slope of [an analysis of epidemiological studies] implies that drug-induced neural changes do not even decrease the likelihood of quitting drugs once dependence is in place.
Read the full paper here – it’s an amazingly concise summary of the truths about addiction that contradict many of the accepted opinions pushed by the recovery culture – Heyman, G. M. (2013). Addiction and Choice: Theory and New Data. Frontiers in Psychiatry, 4. doi:10.3389/fpsyt.2013.00031
Why Does It Matter Whether or Not Addiction Is A Brain Disease?
When we accept the unproven view that addiction and alcoholism are brain diseases, then it will lead us down a long, painful, costly, and pointless road of cycling in and out of ineffective treatment programs and 12 step meetings. You will waste a lot of time without finding a permanent solution. When we examine the evidence, throw out the false disease concepts, and think rationally about the problem we can see that addiction is really just a matter of choice. Knowing this, we can bypass the rehabs, and find the true solution within ourselves. You can choose to end your addiction. You can choose to improv your life. You can choose to stop the endless cycle of “recovery” and start living. You don’t need to be a victim of the self-fulfilling prophecy that is the brain disease model of addiction. There are alternative views and methods of change which I hope you’ll take the time to learn about on The Clean Slate Addiction Site.
There are many different ways to argue against the brain disease model of addiction. I have only presented 3 basic arguments here. But beyond just addiction, many modern claims of “brain disease” are fatally flawed, in that they are founded on the logically impossible philosophical stance of psychological determinism. From this standpoint, any evidence of any brain activity is immediately interpreted as a “cause” of a particular mind state or behavior – with no regard for free will/the ability to choose one’s thoughts and thus behaviors. If you understand the impossibility of psychological determinism (or “epiphenomenalism”) then you’ll take all such claims with a grain of salt. For a detailed examination of this issue, see the following article: The Philosophical Problem with the Brain Disease Model of Addiction: Epiphenomenalism
How To End Addiction, Substance Dependence, Substance Abuse, Alcoholism, and General Drug and Alcohol Problems (updated 11/4/2015)
Due to the fact that most conventional rehab and addiction treatment programs follow the false belief that addiction is a disease, they are generally not effective at dealing with these problems – so I really can’t ethically recommend any “treatment” programs other than a run of the mill detoxification procedure if you feel you may be experiencing physical withdrawal symptoms – you can find that through your local hospital or emergency room; by asking your primary care doctor; or by calling 911 if you feel your life is in danger due to withdrawal (beware that withdrawal from alcohol and some prescription drugs such as the class known as benzodiazepines can lead to fatal seizures). But what comes after detoxification is simply personal choices, and treatment programs actually discourage productive personal choices by attempting to control people and feeding them nonsense such as the disease theory and idea of powerlessness.
If you want to end or alter your own substance use habits you need to make the choice to do so. Many readers will object to this answer as flippant, cruel, out of touch, et cetera. I realize this, but I chose to change, and in reality everyone who moves beyond problematic substance use chooses to change as well.
There is too much to unpack within what people believe is contained in the statement “choose to change.” I have tried to address some of that here in the past, but I realize this article is not the place to do that. This article’s scope needs to remain limited to the question of whether or not addiction is a disease.
My conclusion is that addiction is freely chosen behavior, and that the person who continues heavy substance use despite mounting costs still sees heavy substance use as their best viable option at the time they’re doing it – even though they recognize many costs and downsides. Choosing to change then, really means that they rethink whether heavy substance use is their best viable option. The only way I know to come to new conclusions is to re-examine the issues methodically, and this may often mean gathering new information and perspectives. Thus, the help that can be given to troubled heavy substance users is information. Helpers can provide accurate information that troubled people can use to change their perspective and come to believe they have better viable options than continued heavy problematic substance use.
I endeavor to give accurate information here that will help people to understand that change is possible, and that they are not doomed to a lifetime of addiction. Hopefully, this helps them on their way to believing in better viable options.
About this article:
I originally published this article on September 25, 2010. I have since added some significant supporting work I was able to find over the years, and those additions are noted. Some other minor edits from the original article are not noted.
Author
Hi, I’m, Steven Slate, the author of this post and of all content on this website. Yes, I was what you would call an “addict.” If you want to know more about me, go to the About page. If you want quotes from PhDs and such (as if I haven’t given enough here already) go to my Quotes From Experts About Addiction page. Please be civil in your comments, and many of your angry comments may already be answered on my FAQs page, so maybe check that out before you scream at me.
This makes perfect sense.
How can You even think about stopping your personal addiction if you believe You are “living with a disease”?
I was taught in AA that i have a disease for the rest of my life!, so I continued to drink,and drug , using my “disease” as an excuse.
Oh I might as well give up my sobriety, because ill never be disease free….
Well thats the exact opposite of what I really needed to hear.
After learning about my addiction being a “Learned behavior” ,and NOT a disease, only then was I able to understand how to control myself,and my addiction, without any excuses.
Thanks for writing this up , it makes total sense, and i hope it will help someone else out there as well.
At last,I agree,something that makes perfect sense to me,it is liberating to read
Congratulations
i have been an alcoholic and opiate addict. and i believe that of course, use is a choice. but, when an addict is the throes of withdrawing, especially physical withdrawal from alcohol or opiates, your ability to choose has been usurped by cravings. cravings can literally drive a person insane, consequently leaving them with still–a choice–but the brain cannot recognize that choice while under the influence. your brain at that moment has been taken over and you honestly albeit mistakenly believe you must continue on using. it’s a trick the drugs do on the brain, convincing the compromised brain that it must take the substance.
when i was smoking crack years back, this drug was so obscenely addictive, the compulsion so overwhelming, that i erroneously believed at that moment, i could not stop. i’ve been in situations where the cravings were so immense, i felt completely at their mercy. but then again, as stated before, this was while i was using or withdrawing. if one can be put in a place, like lockdown rehab or jail, where they cannot get a hold of their drug, you are right: the brain adapts to the idea it won’t be getting it’s drug, and begins to concentrate on other things than taking drugs. but this can only occur after cravings have been attenuated, which takes time: anywhere between a month to six months generally. but please, do not tell me that people that have been smoking crack during the night can just simply stop on choice alone in the midst of being highly intoxicated. the brain goes through a major change while smoking crack. and your brain’s condition does take away choice. try and stop suddenly after using heroin for a couple of months straight. it can be done, but the cravings will undoubtedly, take a person back to the drug. choice or the ability to make a choice to stop has to happen when the individual is an environment where there drug is not available. .
Addiction is a disease, recognized as such by Jama. This website is a ridiculous way to make money at the expense of the lives of others. Shameful to see such BS presented as “science”/
You should be ashamed of yourself for taking the time to try to slander me when you know nothing.
I totally agree with you. The BS part is when you live with people who choose to be addicts & try to convince you that they have a disease in an effort to help themselves feel better about destroying so many lives.
If it were a disease you wouldn’t have to go find it. People make me sick.
Funny how they can cut their disease off long enough to get through parole or probation?
Labeling it as a disease helps people continue with their victim mentality. They are not responsible for their actions if they have a label.
It also makes lots of money for the people who treat them & the places they are treated.
It’s a cop out.
I never bought it.
Keep up the good work.
I enjoyed the read.
This will be posted to my fb page so that I can puss off the spineless😌
Do your own research Suzanne instead of believing what others say and write including Jama. I find it absolutely incredulous how most people believe everything they are told and read. There is absolutely no real and authentic scientific evidence of addiction being a disease. Absolutely NONE!!! Check it out for yourself, do the research……I have, after years of listening to the debilitating, disempowering nonsense handed out by AA!!!
Lets not forget that alcohol withdrawals can kill you. The same way not taking insulin can kill you if you are a diabetic. So if it was as simple as just stopping then just stopping wouldn’t kill you.
You might not be a drug addict, you’re just one of those idiots who did a little research and thinks he knows some science so you make this article like you think you’re some Dr. If you were a drug addict, you would know for a “FACT” that drug addiction is a disease of choice, and not a moral issue you fucking retard. Im tired of being hated on by people who think I’m just making bad decisions. It’s only a moral decision once the drugs have left your body and you have that free agency to choose again… Usually it takes at least 3 days, before then every minute 4 signals get sent to the brain because it shifts from the frontal cortex to the mid cortex and changes the order of importance from 1. kill .2 eat. protect too.. 1. drugs.. 2. kill. 3. eat
Man you should have wrote an article on something that you actually are, like an article on being a dumb ass. Sorry if I offended anybody but I am very offended.
http://alcoholism.about.com/od/sa/a/blnida041129.htm
You’re arguments sound like they hold cloud like the taxi cab argument, but that just changes random shit in your brain. Drugs target the area that is responsible for making “CHOICES” what a concept… Which makes it a disease because without intervention or it psychically being impossible me as a drug addict will go to any lengths to get it until I have had at least 3 days of it out of my system where I am finally set free to say NO, or YES to drugs. Ive read so many books on drugs and been to so many rehabs and have been a drug addict for over a century.. I know what I’m talking about, cause im talking about myself. Sometimes when you really wanna know something, it’s best to go straight to the source. In this case, The drug addict.
Well, I guess I can’t argue with a guy who’s been a drug addict for over a hundred years.
But just for argument’s sake, I’ll take your reasoning that the withdrawal symptoms are the problem. Go to detox. Like you said, three days, and you’re done. Now why do you need to deal with it for the rest of your life?
http://www.thecleanslate.org/dont-you-know-about-physical-tolerance-and-withdrawal-aka-physical-addiction/
Speaking from a the stand point of a person who has both been a drug addict and who has extensively studied addiction and neuroscience academically I can tell you that this article omits key data that suggests that drug addiction is BOTH a choice and brain based disease CAUSED by substances that DIRECTLY effect physiological processes in areas of the brain responsible for motivated behaviors. And if you have not read any neuroscience research in last like 100 years, I am going to let you in on a little secret. The brain is the organ that is responsible for producing all BEHAVIOR!! Another point I would like to make is that it is NOT generally disputed within the literature that addiction IS a brain based DISEASE. In fact it is quite well accepted that it IS. And we actually DO understand quite well what happens to the the brain in response to substance abuse (effects vary from substance to substance) What we do not understand is why some people are able to do a line of coke on Friday night and not develop an addiction. But some people do it once and spend the rest of their lives engaging in drug seeking behavior which has devastating consequences to their lives, and the lives of their loved ones. What is worse is we do not understand very well how to help someone with an addition.
If you can claim that addiction is not a brain based disease then you would also have to claim that any other disease of thought or behavior is also not a disease. Its like saying schizophrenia is not a disease that bi-polar affective disorder, or autism is not a disease. How ridiculous is that?
I will tell you one thing right now. TELLING AN ADDICT THAT THEIR STRUGGLE IS A SIMPLE CHOICE IS BULL$H!T
it is a choice but it is FAR from simple.
Whoever the f@$k wrote this article cherry picked neuroscience research and contorted it in a way to make it seem like they were making a case for their argument by using buzz words like neuroplasticity and functional magnetic resonance imaging. When they were not at all. In fact much of what we understand about neuroplacticity and the targets of drugs of abuse tells us that substance abuse is very much a brain based disease. Comparing the neuroplacticity that occurs in taxi drivers to the plastic changes in the brain of a user is like comparing apples to oranges. The networks within the brain that were examined in that example have NOTHING to do with motivated behavior. The mechanisms of drugs like cocaine methamphetamine heroine etc. DO!!
All drugs of abuse have specific targets on parts of the brain that are responsible for motivated behaviors (i.e. choices). They are the same areas of the brain that motivate you to engage in essential survival behaviors like eating drinking water and having sex. The part of the brain that is most intricately involved in this process of reinforcement is the nucleus accumbens (NAcc) and the ventral tegmental area. The NAcc is rich with dopaminergic neurons. When a behavior like eating occurs, dopamine is released which activates this “pleasure center” in the brain. Each time this occurs the behavior that caused it is reinforced (i.e the likelihood of it happening again increases). ALL major drugs of abuse have direct mechanisms which potentiate the release of dopamine.
First, a very vague and simplistic explanation of how neurons communicate in the brain
When a neuron is activated it sends an electrical signal (action potential) down its axon, at the end of this axon are terminal boutons which contain chemicals called neurotransmitters (i.e. dopamine). when the action potential reaches the terminal bouton it is signaled to release its neurotransmitter into the synaptic cleft (the space between the axon and dendrite of 2 neurons). When the neurotransmitter is released into the synaptic cleft it stimulates receptors on the dendrite of the adjacent neuron. If a large enough stimulation is produced (i.e. enough neurotransmitters bump into these receptors) an action potential is propagated down the second neuron and so on.
depending on the type of neurotransmitter, it can have different effects and different targets in the brain. The pleasure centers in the brain are rich in dopaminergic neurons. Dopamine is involved in many other processes like voluntary/involuntary movements, memory, cognition emotion etc. Are any of these affected by substance abuse?
One of the “jobs” of dopamine is to stimulate the pleasure centers of the brain that tell us “That was a good behavior, doing what you just did will keep you alive!!” Activation of these key centers has allowed us to stay alive and reproduce (If this system was not developed in our brain we would not exist, we would not eat, drink or have sex, and our species would not exist). For any of the neuroscience savvy people out there I am aware that the hypothalamus plays a key role in many of these behaviors, for simplicity sake I am merely reiterating the core concepts in the biological mechanisms of addiction in relation to the reward system, I have no intention to delve very deep into the entire motivation system. I’m not even going to touch very much on the effect of drugs on structures that affect top down control of behavior in relation to addiction. Which BTW there is a TON of literature on.
I am going to use the example of methamphetamine to demonstrate how the mechanisms of this drug stimulate those pleasure centers (drugs like cocaine and heroine have similar outcomes metabolically speaking but not in exactly the same way). Mehtamphetamine (meth) is a drug that is chemically very similar to dopamine. once in the blood stream and across the blood brain barrier and inside a dopaminergic neuron it has a triple effect on the release of dopamine. It not only stops the pre-synaptic neuron from reabsorbing dopamine out of the synaptic cleft but it injects MORE dopamine into the synaptic cleft by the part of the neuron that is suppose to pull it out (Dopamine Transporter). it inhibits the action of the enzymes that break down dopamine . All of this translates to a flood of dopamine across all dopaminergic systems in the brain.
At this point i would like to state that drugs of abuse affect more neurotransmitters than just dopamine and effect more parts of the the brain than just the NAcc, but it is historically the most relevant system to addiction that is effected by drugs (by the way whoever wrote this article made NO mention of this system when talking about the brain mechanisms of addiction. And this stuff is “Addition and the Brain 101” go back to the drawing board HACK. )
Remember from the explanation of how neurons communicate? If dopamine does not leave the cleft somehow it will continue to stimulate the post synaptic neuron. All of this translates to an activation of the pleasure centers that are WELL in excess of anything you could do naturally. This is why drugs feel good. Besides making us feel good these “pleasure centers” are responsible for making it more likely that we will engage in the behaviors that caused it. This is all screaming “Do that again, it will keep you alive”
This is a good thing in the case of eating drinking and having sex. (there are mechanisms that produce a sense of satisfaction which terminate these behaviors, which by the way are absent in aforementioned example). So all your brain is hearing is again again agian
We can see in brain stimulation experiments with rats how powerful of a effect stimulation of NAcc can have on behaviour. Electrodes were placed into the NAcc of rats. These electrodes were controlled by levers in the rats cage. When allowed to self stimulate they would not eat or drink or engage in sex, but rather press the bar until they died from exhaustion!!
That TOO was a choice the rat made!!
If any of you out there are reading this and say that a study on rats is not relevant to humans, I am going to let you in on another little secret!! We have all the brain parts that rats do!! Just more built on top. Its called the neocortex. One BIG part of what our new brain lets us do is inhibit motivational drives in order to achieve a long term goal. Like not eating all day when you have a busy day at the office so that you don’t get fired, otherwise you cannot buy food and you will die. (Slightly exaggerated, but you get the point).
The point that I am making is that these substances hijack the part of the brain that motivate us engage in behaviors essential for survival. Which in turn tells the brain that engaging in substance use was essential for survival. I understand the concept that you may be able to easily cognitively dismiss that statement, but believe it or not motivated behaviors are automatic!! But our frontal lobe allows us to make a choice about what we are going to do about the motivation signal. If you don’t believe me, next time you have a busy day at the office, you miss breakfast lunch and dinner at 8:00 pm tell yourself that you are not hungry. You will still be hungry. But you do have a choice in whether you do something about that hunger or not. In this case the smart thing to do is eat, which is what your brain is screaming at you to do. Same thing applies to an addict, but the brain is screaming much louder, and the smart thing to do is not “eat”. Best analogy for the experience that I have.
In response to Steven Slate’s comment. Why addicts relapse following the initial withdrawal symptoms pass, is because the withdrawal symptoms are only a small part of the puzzle. What causes the symptoms of withdrawal is complicated and have varying causes depending on the substance. So I will not get into that right now. Generally what you need to know is that withdrawal has a tendency to increase the drive to use drugs because it negatively reinforces the act of using a substance by ameliorating the painful effects of withdraw. If you don’t know what negative reinforcement is (or don’t understand anything else I have mentioned). GOOGLE THAT $H!T !!
So the drive to engage in a behavior is not principally caused by withdrawal symptoms. But have more to do with plastic changes in the motivational system that tells the brain that doing drugs is essential for survival. Again that is why the taxi cab driver experiment is completely irrelevant to the topic!! It has nothing to do with the motivation system.
So, is the act of using a drug a choice? Yes it is. You can choose to do it or not do it. The issue that I have with this article is that it completely downplays how difficult of a decision that really can be. And there ARE physiological explanations for why people will steal from their mother and buy drugs instead of food for their child. Actions that completely defy logic and the survival instinct. The explanation can be found in how they effect some parts of the brain involved in survival behaviors.
Again speaking from that standpoint of an addict and an academic. Learning about the mechanisms of addiction does not come anywhere near explaining the subjective experience.
Also to anyone out there reading this and struggling with addiction. You CAN stop. You CAN have a life free from drugs. Remember that it is your brain telling you that you need to use to stay alive. But I assure you the opposite is true!! Take it one day at a time, no matter what anyone else says, it IS tough. If you slip don’t sweat it.
Great response to the author of this ridiculous article. I am a recovering person of 16 years and if it was as simple as the author states it addiction would not be a problem, we could all just make better choices LOL.
Most of what you have said here rests on the impossible theory of psychological determinism. You are the one trying to impress by talking about neurotransmitters, nucleus accumbens, etc. As an analogy for my readers, imagine if someone tried to explain your trip to the beach by discussing the pistons in the engine of the car you drove to get there. Wouldn’t that be somewhat irrelevant? Would it explain why you chose to pack your stuff, start up the car, and get on the road to a beach? Would it explain why you chose the particular beach? No, it wouldn’t.
Yes, the physical activity of the brain is involved in everything we think and do – but claiming such activity to be the cause of what we do is a leap. Correlation is not causation. I have addressed psychological determinism/epiphenomenalism at this LINK. I’m not here to deny the technical facts of the neural correlates of “addiction”, but I am here to to get at understanding exactly what they mean. I’m afraid most of the psychological world has been in great error over this issue, and I’m DEFINITELY not the first or only on to think so: see Beyond determinism and materialism, or isn’t it time we took consciousness seriously? by Edwin A. Locke
There’s another thing we need to know. Despite all of the horrific brain changes, people do choose to cease their “addictions” all the time without a scalpel to the brain or even taking a medication. How is that so, if the brain changes CAUSE the heavy substance use and/or craving??? How is it possible, that later, after they choose to stay abstinent, the brain changes again to look more like the brain of someone who hasn’t had a heavy substance use habit???
I’ll tell you how – because people are still free to make their choices, and the brain reflects habitual choices. There’s no reason to assume that brain changes cause substance use. That’s a leap in logic based on a bad foundational philosophy of epiphenomenalism.
Your problem with seeing addiction as some kind of disorder rests on a false dichotomy between disorder ( biological determinism) and addiction ( bad choice made by a free agent). The very language we use, by opting to describe ourselves and others as ‘addicted’ shows us that this is not a dichotomy but a area with very complex interaction between the two – a very grey area. There are also varying levels of addiction. I am speaking of very high levels here from personal experience.
My father, one of the best people I have ever known – came from a long line of alcoholics. He succumbed when my mother became mentally ill and the two of them suffered greatly. I would have to say that his suffering was the worse to witness. Before he died prematurely of sepsis of the liver, his addiction to alcohol took him through unimaginable degradation. Social services saw my mother as a victim and my father as a moral reprobate. In addition to his fear and horror of his own degradation and looming premature death, my father was made to feel like a bad person and one undeserving of any compassion. Up to and following his death I read a great deal about alcohol and the brain and was surprised to find that there are studies showing that chimpanzees and elephants exposed to alcohol (the first from safari drinkers dregs, the second from natural fermented fruits), show the same percentage behaviours as human groups. In each of these mammal groups a small and constant percentage showed bad addiction, another small percentage showed an aversion, and the majority could take it or leave it. This would seem to suggest to me that there is a physical problem here in the larger mammalian brain in addition to the idea that individuals make bad choices.
There is of course, also the question of whether deciding something is an illness is really setting up someone for some kind of fatalistic determinism at all. Mental breakdowns, autism and all manner of things were once considered to be results of societal conditioning and some people still resist the idea of disorder. In these cases, thank god science has prevailed and we no longer blame families and people for their own autism and schizoaffective disorder etc. These are treated as disorders and they are treated all the more successfully for it.
I have no problem with another addict with a different experience to my Dad’s stating that their addiction was different – and that they did not feel in the grip of a disorder. It is a grey area. At the hard end of it – where people don’t recover – please understand that your insistence of free will may be helpful to you, but it is killing other people and consigning them to a hard death without the comfort of compassion. It is actually your stance that feeds into this bleak determinism. I am sure that if my father had been treated in the same manner as my mother and detained under the Mental Health act to dry out periodically, he would have lived a happier, longer and more productive life.
Excellent article Steven. Neuroplasticity is a wonderful thing and should make people realize that people really can change and not condemned to the bad habits and behaviors we’ve acquired throughout life.
. It’s difficult for some to accept–myself at one time– that addiction is a choice. I drank heavy for 20 years never sure I could really stop and never cared to try. Believing I was sick. What a crock!! . I was a heavy drinker and had countless consequences because of it. I’m not trying to judge, but if a person really looks at themselves and where they’re at in their life, then the choice becomes obvious: quit and move on with your life, or keep suffering in despair. Allow the neuroplastic capabilities of the brain to create a new reality. It doesn’t happen over night but it does happen. Trust me.
The disease concept is determinism at it’s worst.
Realizing you don’t have a disease doesn’t make you immoral. Just misinformed. Look at the obstacles that our society has constructed over the last 75 years to convince addicts of their victimization and powerlessness over a non-existent disease.
I feel I have justification to talk, having been an heavy binge drinker for 20+ years and suffering countless failings in career, school, relationships, you name it. My failings just became my excuse to drink. I wired my brain to feel shitty and wanting to drink whenever possible. I just plain wanted to. Nothing compelled me to drink except me, myself and I. I would take breaks for weeks or months with no intention of ever really quitting but knowing I would need to sooner or later(preferably later)but kept putting it off. I felt great during my breaks, but still resumed my stupidity later because I wanted to; thought I was missing out. It’s always fun at first and later becomes burdensome and ridiculous. Withdrawal again huh? Don’t you ever learn? But eventually, after 3 DUI’s, losing my R,N. license, 3 bouts of jaundice , 4 seizures along with several bouts of shakes and unsteadiness from rather serious withdrawal and all not medically supervised except for my own knowledge (not recommended), I had had enough (not the drinking but the problems) and quit for good. I’ve never looked back.
I had lost my privilege to drink in my mind. I’m no exception and have no special gifts of will or self-control obviously.
Nobody can say I didn’t fit the definition of what would be considered addictive disease. But there is no disease.
I’m not going to say that it was an easy pill to swallow, it was bitter. Realizing that I had essentially wasted 20 good years of my life feeling sorry for myself and not mustering the courage to change was eye opening. I was a loser. I’d love those years back, but I won’t get them and don’t want to create any more of them. I think sometimes the remorse we carry around fuels the addiction. The anger at the time wasted. “Fuck it, why bother?” as more time passes and hopelessness builds and the cycle continues. You ride the carousel and never really step off. There’s no disease forcing you to ride, only your own self-imposed vicious circle of self-indulgence and escapism. It’s nothing to be ashamed of. Step off and move on.
When people ask why you don’t drink, Don’t label yourself with the scarlet A of alcoholism or addict Alcoholics still believe they have a disease and attend the cult-like meetings of AA. Though I believe well-intentioned, are a disaster to a true recovery and disallow people to consider themselves recovered and able to live productive happy lives without their support and continued “management” of your” disease”. It’s only supervised dwelling and regret on issues that will fade with time if given the chance. Their endless meetings only fuels the possibility of relapse and telling you it’s o.k. and relapse is part of recovery. No, it is not! Get on with living.
You make a plan to quit and you stick to it. You make a commitment to never use again. No, not the one day at a time nonsense that AA espouses. It seems too simple but it really is that simple. It’s only hard at first. I’m now a super healthy, athletic health nut with zero cravings to drink. I surf and mountain bike, go to the gym. Yes, my liver is fine too( I don’t know how) I did the same thing with smoking 12 years ago, long before I quit drinking believe it or not. I’m now in the process of having my R.N. license restored. Though AA meetings are required I will either not attend and just sign my own sheet off (done it before for DUI’s, they can’t check it’s anonymous)or attend and just not participate. I believe it’s unconstitutional anyway and has been upheld in court that AA is a religious organization and cannot be forced onto people.
“Do the best with what you have where you are”–Theodore Roosevelt
Just by removing the offending substance and moving on with life, repairs, or at least lessens many of the issues that may have compelled one to use in the past. But you have to remove the poison first and then deal with any lingering issues that remain after abstinence. You might find after some abstinence that you have the energy and clear head to now deal with any of the lingering issues that may still exist. Learn to meditate, it’s very powerful and will hasten and strengthen neuroplastic change.
Don’t allow yourself to be a victim of a disease that doesn’t exist. There’s no shame in being blind to our own absurdities and the misinformation that’s being disseminated by the “recovery movement”. Their power will make you doubt yourself, but rest assured, they have no leg to stand on and the real evidence is on your side.
I recently discovered Rational Recovery by Jack Trimpy. He has books and a web site. I didn’t use his technique to quit but it’s a great reinforcement and makes self-recovery that much more clear. Actually. I guess I used my own version of his technique. He’s blunt and bashes AA deservedly, but he’s pretty right on. I’m doing some bashing myself.
I’m not trying to sound preachy or all-knowing. I just know what I know and I’ve put myself through a lot.
I know I sound like it’s all so simple and easy. That’s because it really is for most if you just try to set aside all the misinformation that’s presented as fact. I have medical training and experience (no, I never went to work drunk or committed malpractice, the last DUI did me in.)Having M.D. or Ph.D after one’s name doesn’t mean their immune to the dogma of the disease concept of addiction. Many many doctor’s secretly chuckle at the idea of addiction as disease, but fear being ostracized by colleagues for making these opinions known and condemn people to a life of diseased hopelessness by following status quo.
I’m afraid that it is not a disease. Whatever substantial evidence people point to I’m apparently unaware of, it’s all hearsay as far as I know.. The THIQ study that the good Dr. speaks of is the only tenuous evidence I’m aware of. Rats don’t generally have free choice or human consciousness. It’s hardly proof. But some try to grasp to it. We are in control of of our voluntary muscles and can refuse to use them to procure a desired substances of our self- indulgence and misery . Nor are we Pavlov’s dogs, destined to self- destruct at the ringing bell of our painful pasts or when life seems overwhelming. It’s a way of thinking: of being. You can change it when you really decide to. No disease present and no treatment needed.
Everyone, including those whose misery is self-induced, myself included, deserve compassion from themselves and society. We are all individuals and hopefully eventually wake up in our own time before disability or death occurs first. Most wreckage from the past can be fixed over time with abstinence. I just wish society and especially medicine and social services would wake up. People who abuse just need a compassionate nudge and reassurance that they are in control and can quit if they choose. It’s big money though and the false disease concept employs many but needs a new paradigm that doesn’t disseminate false information and ruin lives and essentially waste money. I can assure people there is politics and economics involved.
All the misinformation leaves us confused not diseased.
Those of us who reject the disease concept have little or no intention of looking down our noses on others. Most of us have already been through all the bullshit. We’re only trying to persuade people to REALLY look at the evidence of addictive disease and see that there is none. I’m no exception to the rule, I just came to a realization. I don’t want to see others waste as much time as I did to realize and continue the misery of abuse and the humiliation of the recovery movement. Be aware that 60 to 70% of addicts quit using on their own. The disease concept only allows for excuse and the hopeless idea of a life of addiction that has to be “managed” for life, or else, or the equally hopeless life in the recovery community making sobriety your primary concern, rather than just going out and living for a change, and only becomes another dependence and an anathema to a fuller life. Another crutch to lean on.
GO LIVE!
. The whole disease concept is more urban myth than scientific fact, gaining acceptance through word of mouth rather than concrete evidence. AA’s 5% success rate evidence of it’s complete and utter failure as a deterrent to abuse and a model for treatment. AA itself has admitted that 60% of addicts that pass through the program eventually quit on their own. If that’s not telling, I don’t know what is.
They believe they’re the only way. How frightening that must be for some like myself that aren’t going to put their life in the hands of a benevolent being and let him control our life and addiction. Sorry, that’s my job.
I’ve attended these meetings before and listened to people describe how they “slipped” and went on a (fill in the blank) day bender and that God must have wanted them to do that. People were nodding their heads in agreement and I just wanted to vomit at the absurdity.
It’s not your fault and that addiction is a disease of relapse is utter bullshit!! Put the shit down and move forward because things will only get better. Learn from your experiences or die when your jar of luck runs out.
I’m not trying to preach because I’ve lived it. If someone who’s put their life and their body through what I have can quit on their own and thrive, than most anyone else can. Your brain, body and spirit will heal on it’s own. We’re resilient creatures, give yourself credit. Give yourself a chance.
Addiction/abuse doesn’t need expensive treatment and endless participation in meetings with the cult-like surrogate family of AA and their 12-steps to diseased imprisonment. Sadly, even their silly sayings have infiltrated common culture.
If you feel you need support I would urge you to go to a non-12 step program that provides individual therapy and not the group therapy model, it’s been proven much more successful.
Personally, I’d rather just be a drunk again.
Sorry for the rant. I felt compelled. I must have the disease of Rantism.
Firstly, I think that this article only focuses on certain aspects of post addiction and not active addiction (where the crux of the problem seems to lie). In my experience as an active and non-active drug addict (a person with increased potential to express an addictive personality), I cannot say for sure that addiction “is” or “isn’t” anything. Addiction seems to be the elusive culprit for behavioral malfunction that no one can seem to pin down. I cannot find anything online, at least, that conclusively says that addiction “is” a disease or that it “is not” a disease. I guess the jury is still out on that one. I can say from my own experience that there have been times in my life when I have felt in control of my drug use and that my choices could determine whether or not I could stop. I have had some limited success in this area. There have also been times in my life when I couldn’t stop using drugs, no matter what the cost or reward. Active Addiction has cost me more in life, that if it were simply a choice, I simply would not have paid. Experience tells me that this problem has many layers with no “one size fits all” solutions.
Lastly, when writing such an informative article stressing one’s own opinions with such merit, I humbly offer a suggestion: Making truth statements in the form of an informative essay/ article can put oneself into a predicament of clashing opinions and contention for argument. One might consider using English Prime as a method to articulate an educated opinion without passing it off as biased fact. This way one could present an option for thought without drawing oneself into lengthy, pointless debates on the validity of one’s opinion. I, personally, agree with several points in this article. Although, there are some that I do not agree with.
Cheers to you and I hope that your research and efforts into shedding light on this awful condition of the human experience will yield much useful fruit!
To the idiot who wrote this article… Shut up! You really don’t know what your talking about and all the fancy words in the world won’t change that. Your obviously not an addict because you are talking out of your ass! Go ahead and use meth for one month then come back and tell us what you think. You are a moron! G Garcia drug addict for 27 yrs. clean for 7.
Dear author,
You are wrong. Be thankful you do not understand alcoholism and addiction. You are very blessed.
I am not smart enough to get into the scientific debate here …. But I thought the article was just saying “disease” might not be the right word given it’s actual definition. I do not think addiction is a disease but I also agree that it influences your choice and is extremely difficult to stop.
You just wrote a book long comment and sounded like a moron. Good job. Using drugs is not a disease. Unless there’s a new disease called “must try drugs” or “must say yes to drugs” them its not a disease. Everyone has a CHOICE to try drugs or nor. If you say yes like an idiot when you know they’re bad for you, then oh well. You deserve the consequences. Being depressed of your shitty life, mommy and daddy issues, money problems, peer pressure ect. Is not an accuse. I’ve had some of those problems yet I’ve never once tried any drug or even a cigarette. People called me a “prude” “bitch” ect. But I don’t give a fuck. They’re the idiot losers at the end of the day.
Great article by the way.
Hi Mike – I’m glad you like the article, but I hope you’ll give it a closer read, because it stands opposed to the opinion you’ve expressed here.
Nobody loses control of their substance use, thus they don’t become addicted in the popular understanding of that term. Trying drugs doesn’t make you an addict, and if it did make you an addict – someone whose biology had turned against them and causes them to behave in ways they do not choose – then it would be a disease – in the same way that various STDs/STIs are diseases. Yes, you can make careless decisions that lead to you acquiring STDs/STIs, but that doesn’t change the fact that they are in fact diseases that can’t be directly controlled by the will once acquired.
What I’m trying to say is that it can be “your fault” that you caught a disease. You can make choices that lead to disease. This has nothing to do with whether a particular condition is a disease or not.
No one ever loses control. Using a particular amount of drugs or alcohol will not cause anyone to cross an invisible line beyond which they’ve become “addicted” and lost control. They are always in control, whether they realize it or not. The reason that addiction is not a disease is because their is no physiological malfunction that causes substance use/substance craving – it is at all times a fully voluntary condition, and voluntarily changed by the individual if they choose different thoughts about the value of substance use to them in their lives.
-Steven Slate
Are you saying our brains NEVER make us lose control ever, in any circumstance? Sorry that’s not true… there’s the “fight or flight response” that comes directly from our brains and we have no control over that. An even greater example is in the case of smoke inhalation or drowning… we know we cannot breathe, we know there is no air, we do everything in our power to hold our breath for as long as we can but our brain tells us it needs air and we must take a breath and no matter how hard we try not to eventually we inhale, because our brain MAKES US DO IT and that causes us to die by inhaling smoke or water.
You can’t make sweeping statements like our brains never control our actions anymore than you should say anyone can choose not to have a drug or drinking problem. Cirrhosis and Korsakoff’s syndrome are DISEASES caused by abuse of alcohol…. What is your advice for people suffering from those conditions and are struggling to not pick up the next drink? Just don’t do it is suppose to work?
Well said. Thanks for refuting the idiocy of this piece so thoroughly. Saved me the time of having to do it myself and i’m grateful.
Yes, this response is comprehensive and science-based – unlike that weird article. Substance use disorder leads to a lack of ability to make choices. I, like many other recovered addicts (my drug of choice was alcohol but I wasn’t choosy), was full of willpower. I accomplished many things but became, in time, completely incapable of not picking up the next drink (etc.). This miserable state of affairs is the life that we addicts know. Apparently the author of this “piece” (of s-t) has not studied the scientific literature, which supports what A.A. has been saying since 1935. Author, I do not know of anyone who sets out to be addicted. Once that happens, though, your willpower is pointless. Some kind of intervening activity must take place (jail, a breakdown, etc.). And once you have become an addict, I have to inform you: You can’t change a pickle back into a cucumber.
Autism, bipolar disorder and schizophrenia are not diseases. They are disorders.
Please be so kind and to point me to the research that you got this information from, because after years of research I still can’t find conclusive evidence that addiction is a disease, and there are many neuroscientists that would also say the same!
What’s that, you idiot. Oh, go to detox for three days and you’re good? You’re so full of shit I can smell you over the internet. You have no qualifications to speak on this subject, you have nothing but an idea that you ‘prove’ through evidence that only supports your claim. This is by no means a scholarly review and you shouldn’t present it as fact because your theory is flat wrong. I noticed you don’t deal with Heroin much, no doubt since all your theories go totally out the window when it comes to Heroin. It’s not just three days, jackass. The symptoms last for months, not days or weeks. After using Heroin for a while you’re brain won’t return to normal functioning for up to a year. This is proven science and what you’re doing is wrong. I hope you feel good about yourself. Does spreading lies out of some grudge make you a big man? You’re flat out wrong headed my friend and an obviously inferior intellect if you’re unable to grasp how your own argument about brain changes belies your very argument. My advice is this, go get a hobby, worry about your own self and get a life, Leave the big moves and big thoughts to the professionals and keep your vindictive, simple mind and mouth closed.
The symptoms don’t last for months, they last for days. As Dr Carl Hart, neuroscientist and researcher at Columbia University with 24 years of studying the effects of drugs put it “Heroin withdrawal is like the flu. If you’ve had the flu, you’ve had heroin withdrawal.” What he means is that it’s not as bad as we make it out to be, and it’s very temporary. Having detoxed from heroin too many times to remember myself, and having spent years in methadone programs, I agree. While you may continue to want heroin for months after detoxing, the actual detoxification/withdrawal period doesn’t last for months – it lasts for mere days. Your wanting of heroin is not withdrawal – it is desire based on your belief in the benefits of heroin.
I also think that a large portion of what people experience in heroin withdrawal is brought on by expectancy. In “Drug, Set, And Setting”, researcher Norman Zinberg layed out his work studying heroin users and found that detoxification becomes worse when heroin users are socialized into groups of other hardened users. The reason is that they learn that it’s going to be unbearable. This I also agree with. My detoxes became exponentially worse after I got into the recovery culture.
You might be talking about the supposed “Post Acute Withdrawal Syndrome” (or PAWS). I don’t know what there is to that – I’m still studying the issue. But for one, if it is a physical reality rather than run-of-the-mill craving (which is caused by one’s emotional investment in heroin as a cure-all/”only way to feel comfortable in my skin”), it’s not typical of heroin addiction – it’s extremely rarely reported even in the research literature I’ve read in which the authors take it very seriously. Second – an acquaintance who is a quite conscientious, caring, and medically innovative detox doctor scoffed at PAWS and said it’s nonsense.
Your claim that heroin withdrawal lasts for months flies in the face of not just my claims (and others on my side of the debate) – it also flies in the face of what mainstream addiction theorists who believe in addiction as a disease, loss-of-control, etc, believe and state about heroin withdrawal.
being a recovering heroin addict I can tell you that withdrawals feel nothing like the flu so how about you go out buy a bag and get addicted and tell me what it’s like and having been clean for 3 months and still not being back to normal I can tell you it takes way longer than days to recover the physical symptoms last days but the damage It does to your brain lasts much longer you ignorant prick until you know what it’s like don’t claim to be an expert, you people are the reason that this society is fucked up. Listen to the song what it’s like by everlasting, that’ll give you a good idea about not preaching what you don’t know so when you become a heroin addict for years then somehow beat it with simple choice and have a normal brain within days then come back and tell me your opinion is the same
How about you do the most basic ounce of investigation before you spout off like that. I am the author of this article and this entire website, and you can find in many places that I once had a very bad problem with heroin use. I’m the one who’s ignorant??? I’m the one preaching what I don’t know??? You’re here saying I don’t know what heroin “addiction” is like, and you can’t even bother to find out what I’ve been through first.
Do I deny in this article that changes to the brain are long-lasting? No, I don’t – and in fact I included a brain scan from the NIDA showing changes at one month, and then 14 months later coming back to normal. I don’t deny the existence of the brain changes. Most of this article is about understanding the significance of those brain changes.
They claim the brain changes rob us of free will, “hijack” our brain – basically, that we cannot choose because of the brain changes. Yet, people quit substances in the midst of having a changed brain….. they CHOOSE TO NOT USE. Using or not is a choice. Even with a changed brain. And yes the changes persist for some time – but they change back over time too – and if they weren’t causing you to use before, they won’t be able to cause you to use now. They are mostly irrelevant.
-Steven Slate
Sorry Steve, while I have a lot of respect for Carl Hart, as a 30 year opiate abuser, with 15 years in a medication assisted treatment facility, I’ve also had the flu several times in my life and withdrawal from opioid substances ain’t nuthin like the flu, believe it You might really consider applying your writing skills to something you’re more familiar with; bowling, gardening, etc. You’re WAY outta your league here and you’re doing a disservice to the progress we’ve made in reducing stigma and helping people enter into real recovery.
Steven Slate:
You seem to be intelligent, and your arguments seem to be sound.
Most of the people responding are doing so by using juvenile coping skills; such as name calling, swearing, and tantrum throwing. It does nothing to further, let alone establish, their credibility. Addicts love making excuses, and I am seeing them in rapid succession here.
Many individuals who are alcoholics and/or other types of addicts do not take into account that they may also have brain disorders. (Sheesh, I’ve read the posts of a few individuals that very well may have personality disorder – or two). That’s why some treatment facilities will offer dual-diagnosis treatment; for the purpose of facing the root(s) of the problem(s) which can be quite complex and oversimplified in their explanation(s). Treat the disorder, treat the addiction. It’s a long road to recovery, so people need to take some personal responsibility and be honest with themselves in order to make any real and lasting progress.
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I’ve enjoyed reading your information on the subject and wish nothing but the best for all who are serious about getting well.
Well said ! As a person who lived with an alcohol and drug problem person for too long, I so appreciate the personality disorder comments. After years of going to ALANON and to Rehab meetings to support my addict, I realized that the “disease” was an excuse to continue abusing and an excuse for abusive behavior. After 15+ long rehab stays, I also realized that the disease was a sick way of being the center of attention – no regard for the rubble left behind. I do think there is a strong case for dual-diagnosis disorders. Also if addiction is classified as a”disease” , insurance covers rehab. Some rehabs feed into the game by patting the addict on the head and selling the “disease” theory so the addict needs not to accept personal responsibility. The guilt that is put on the addicts support people is disgusting – yep, I did drink the cool-aid for quite some time before I dared to ask what about me and what about the children? From my perspective, I think it important to treat the addiction and the disorder and can only hope the approach to dual-diagnoses be taken seriously. I also think there needs to be much more information given to and about co-dependents instead of just passing guilt and blame. Thank you, once again for your comments,
Scott,
Why the explosion if you’re so steadfast in you’re belief in the disease/12 step model, and comfortable with the way you’re living? In one article on this site, it points out that real diseases don’t require a core of zealous minions to go around trying to convert people to the belief that they are, in fact, diseases. For example, you don’t hear people trying to push the fact that cancer is a disease on the general public because anyone above the age of two with most of their mental capacities functioning considers this obvious. Again, I’m just going to hope you were drunk and snorting cocaine while composing this post, because, if you were dead sober, god help the people that have to deal with you on a daily basis. I, personally, would rather throw in the towel and go back to drugs before I trudged through life “one day at a time” completely insecure and miserable. The defensiveness of the vast majority of the disease model fanatics is rather telling. Whatever you’re doing, you’re obviously “restless, irritable and discontent”. Im embarrassed for you…like naked in a dream embarrassed. Peace, god bless bro.
HAha I love your comment. There are so many great ones for this page for sure, but I love what you have said. I am an addict and I sure as shit did not choose this life and never would. I am smart and very talented, but when i chase my addiction it robs me of EVERYTHING I am worth. Just ask my family. Just ask the people that see value in me as a human being. Try getting raped and beaten as a 5 yr. old repeatedly for 5 years, and struggling through PTSD for 20 years and tell me that this shit you once used to escape isn’t something you feel you need anymore. I know the horrors of addiction. I know that it is bad and that it kills you and that it rips families apart. I’ve been there, still am sometimes, and I’m telling you the addiction is stronger than your need for food, stronger than your need for water. Even when you recognize it for what it is, you still can’t stop trying to get some before you worry about your need for food. The person who wrote this article clearly has no firsthand experience-you should be ashamed of yourself for writing on such an intense subject from such a limited perspective. Who do you think you are? You have never clearly struggled or torn things apart in your family, saying the things you say. You should be ashamed of yourself. Addicts only struggle while people like you sit on a perch and judge. I hope at some point you realize how demeaning and pointless your existence is.
Steve, don’t take the haters personally. They aren’t angry with you, but rather themselves.
Of course we all have brains that can become sick, but if one is not exposed to a substance then the brain cannot become addicted to that substance. If addiction is a disease, it is a disease of our own creation through learned behaviors. Sure there may be genetic predisposition to addiction. But the same can be said for music. The “disease” model of addiction overlooks the addicted brain can be controlled by ones “mind”, and any learned behavior can be unlearned. But to do so requires sacrifice, responsibility, patience and determination; things that are in short supply in today’s world, especially in the addicted brain and the medical profession.
I am a physician who has treated opioid addiction in myself and many patients in the last 10 years. I have found if there is a key to success in ending addiction it is in keeping one alive long enough to find the maturity to see this for themselves, if they are fortunate to avoid the punitive society that sees normal human behavior as criminal and immoral. The war on drugs is antithetical in offering those in need of help the proposition of first do no harm.
If “cure” is the only acceptable result, then the outcomes will continue to disappoint. More often than not we can only hope to reduce risk exposure and find constructive ways to fill the voids in our being when substance use has come to occupy this role in us.
Many chronic diseases are self inflicted: many types of cancer, type 2 diabetes, heart disease, anxiety/depression, kidney, liver, lung, obesity/ musculoskeletal deconditioning, addiction, etc. Many, if not most are preventable. We have such a need to blame something for our present condition and point the finger, rather than having a look in the mirror.
Keep up the good work of refusing to accept the status quo and asking questions.
The disease is that your weak, and your excuse is covering it up with a mask called addiction. Every 3 days it’s a choice to either say Yes or No, and when you say yes it becomes a disease again. Dude, the the coach says, get in the game or sit on the bench, but make a choice, stop using excuses…A disease is when you have a choice to say Yes or No to the fact that the doctor just diagnosed you with cancer, and neither one changes the condition…Everything outside of a real disease is a choice–bottom line… If disease starts with a “YES”, then all habits that started from that point should be categorized as one, from jogging to juggling–get it…
Coincidentally:
“Learning to juggle leads to changes in the white matter of the brain, an Oxford University study has shown.” http://www.ox.ac.uk/media/news_releases_for_journalists/091011.html
remember people who are associated with a clean slate
Must not understandthe difference between the factual basis of science and opinion based on theory.the American Medical Association acknowledges addiction and alcoholism not as a moral deficiency rather a pre genetic disposition..if you think someone would choose to be an addict or alcoholic, or for that matter choose To suffer the Consequences , dejection, prejudice, ridicule and the list goes onfrom just being an addict or alcoholicthat kinda seems insane.I see some of you spoke of the diseases of cancer, hypertension, hyperthyroidism, hypercholesteremia, and a few others even diabetes mellitus. From a medical professional let me explainwhere you are sadly mistaken.
1)diabetes mellitus is a disease proven by the scientific and medical community .this disease can be put at bay, and symptomatically one will not suffer at certain degree If Some behavioral components are followed.for instance diet, exercise, obesity,insulin regularity and consistency by use of injectableinsulin it backwhat you affects what’s your fa.here’s the point you have the disease and diabetes yet behavioral components can play major factors n the progression of such. So as it is with addiction and alcoholism,if you have the disease of addiction and alcoholism and you do not do the necessary things to keep it at bay, you have what they call a relapse. So from a medical standpoint using cancer and diabetes is actually a good analogy and can be proven below. Rats don’t have opinions, scientific studies are facts and do not lie. Do you think a rat would choose alcohol over water if he knew he would die? Please prove to mewhere there is choice in that study.
Addiction
THIQ and The Disease Concept of Alcoholism
T.H.I.Q. –Biochemical Culprit
T.H.I.Q. was discovered in brains of alcoholics in Houston, Texas by a scientist named Virginia Davis who was doing cancer research. For her study she needed fresh human brains and used bodies of homeless winos who had died.
She discovered in the brains of those chronic alcoholics a substance that is closely related to Heroin. This substance, known to scientists, is called Tetrahydrolsoqulnoline or THIQ. When a person shoots heroin into their body, some of it breaks down and turns into THIQ.
The Alcoholics studied had not been using heroin so how did the THIQ get there? When the normal adult drinker takes in alcohol, it is very rapidly eliminated at the rate of about one drink per hour. The body first converts the alcohol into something called Acetaldehyde. This chemical is VERY TOXIC and if it were to build up inside us, we would get VIOLENTLY SICK AND COULD DIE. But Mother Nature helps us to rid the body of acetaldehyde very quickly. She efficiently changes it a couple of more times – into carbon dioxide and water – which is eliminated through kidneys and lungs. That’s what happens to “normal drinkers.” It also happens with alcoholic drinkers, but with alcoholic drinkers something additional happens.
What Virginia discovered in Houston has been extensively confirmed since. In alcoholic drinkers, a very small amount of poisonous acetaldehyde is not eliminated; Instead it goes to the brain. Through a very complicated biochemical process, it winds up as THIQ. Research has found the following:
THIQ is manufactured in the brain and only occurs in the brain of the alcoholic drinker. It is not manufactured in the brain of the normal social drinker of alcohol.
THIQ has been found to be highly addictive. It was tried in experimental use with animals during the Second World War when we were looking for a painkiller less addicting than morphine. THIQ was a pretty good pain-killer but it couldn’t be used on humans. It turned out to be much more addicting than morphine.
Experiments have shown that certain kinds of rats cannot be made to drink alcohol. Put in a cage with very weak solution of vodka and water, these rats refuse to touch it. They will literally die of thirst before they agree to drink alcohol. However, if you take the same kind of rat and put a minute quantity of THIQ into the rat’s brain — one quick injection – the animal will immediately develop a preference for alcohol over water.
Studies done with monkeys, our close animal relative in medical terms, show the following:
Once the THIQ is injected into a monkey’s brain, it stays there.
You can keep the monkey dry, off alcohol, for 7 years. Brain studies show that THIQ remains in place in the brain.
The alcoholic’s body, like normal drinkers, changes the alcohol into acetaldehyde and then it changes most of it into carbon dioxide and water, which in the end kicks out through the kidneys and lungs. However, the alcoholic’s bodies won’t kick all these chemicals out. The Alcoholic’s brain holds a few bits back and transforms them into THIQ. As THIQ is accumulated in the brain of an alcoholic, at some point, maybe sooner, maybe later, the alcoholic will cross over a shadowy line into a whole new way of living.
It is not known by medical science, where this line is or how much THIQ an individual brain will pile up before one crosses this line. Some predisposed people cross the line while they’re teenagers, or earlier. Others cross in their 30′s or 40′s and others after retirement. But once this happens the alcoholic will be as hooked on alcohol, as he would have been hooked on heroin if he’d been shooting that instead.
With the loss of control, the complex symptoms have become chronic. All aspects of physiology have become progressive and incurable. Now it is clearly a disease.
GOOD NEWS:
Alcoholism is a disease.
Alcoholism is not the alcoholic’s fault.
Alcoholics can get proper treatment for the disease, which begins with learning the facts about remission.
The alcoholic can be relieved of guilt.
The alcoholic can take on responsibility for arresting their disease.
The alcoholic can refuse to put more THIQ in their brains and refuse to activate the THIQ that is already there.
Alcoholics can and do recover
If what you are saying about thiq is true then they can make a pill to dissolve this chemical to be passed out of the body ? If your saying the ” disease” can be cure with remission steps? Then how can it be a truly chemical disease or genetic it comes down to choice. Going through the program to achieve freedom of the alcoholism. Cancer is a disease you can’t take a remission course to cure this ailment , you need medicines , chemo, etc. other disorders like bipolar , autisum, schizophrenia would be a “psychological disorder” , a person can’t think away or choice to take a class to make huallutions go away or into remission. So where’s the THIQ drug, that will turn the disease brain that doesn’t break down the the alcohol to achdelthyde? If I have high blood pressure I take Crestor , if an infection anti-biotics . Alcoholism has many outside factors also , that might make you more compelled to drink . You can’t catch this by some sneezing on you, genetics might play a part , but how much ? 50%? So it’s 50/50 yes or no. Make the right choice
Dr. K,
I am interested in your theories, but I’m actually finding it difficult to read your post due to its utter lack of grammar, sentence structure, word spacing, punctuation, and capitalization. Were you tripping on acid when you wrote this, or did you have a chimpanzee serve as your ghost writer? I realize that forums like these are flexible on spelling and grammar, but you’re post is so poorly written that no one in their right mind could justify paying attention to the content. Have some respect for yourself, and present your arguments in a manner that wouldn’t be insulting to a three year old…if you want to be taken seriously that is.
I guess a person with schizophrenia, depression, bi-polar, or PTSD can just make the decision too. Find the facts before you run your mouth on a subject you no doubt no nothing about.
Tim,
Unlike addiction, the diseases you referenced were not brought about by years of poor choices made consciously by those who suffer from them. In other words, you’re comparing apples to oranges, and wasting our time as you simultaneously embarrass yourself.
Thanks
So to all those who call heroin addiction a disease…’ I ask…’when prey tell does the disease start…?”” I resisted the the idea of trying this toxic piece of crap poison substance because I KNEW I MIGHT just be unable to not continue using..When I thought about it did I have a DISEASE or not…????If I changed my mind would I then have the disease. For the sake of calling using this piece of garbage two bit high a disease the true believers call bad choices a form of disease. The arguments are ridiculous. You decided to try heroin and that’s your choice…so know you have disease and need treatment.
Ward – I’m sorry to tell you, but if you believe that people are unable to stop using heroin once they’ve started, which is what I got out of this sentence:
Then you essentially believe nearly same thing as is expressed in the disease concept of addiction.
The fact that someone could make a choice to kick off a disease process or expose themselves to pathogens, such as by having unprotected sex, or by smoking cigarettes until one develops lung cancer or emphysema does not change the status of HIV, Hepatitis, Lung Cancer, or Emphysema as bonafied diseases. They still progress beyond the will of the individual. The individual cannot directly stop the symptoms of those diseases as they can with the “symptoms” of “the disease of addiction” (i.e. by simply refraining from drinking/drugging, and/or by ceasing to romanticize substances – to stop the symptom of craving).
If exposure to heroin caused people to be unable to stop using heroin, then I’d have to say that heroin addiction is probably a disease. Thankfully, this isn’t the case. Everyone who uses heroin is fully capable of ceasing this habit at any given moment.
Your argument does no one any favors. You are unknowingly promoting the disease model of addiction while declaring it non-existent.
all you really did was prove the guys point.” i cant get clean because, yada,yada,yada.” no wonder your an addict. i used opiates and alcohol all day everyday for years. i quit cold turkey and have been clean for almost 8 years now. why? because i chose to. i made the decision and stuck to it.
your an idiot he said he was an addict did you not even read the whole thing. p.s. I doubt your 100 years old either
Nobody is “hating on you”. I submit that you possibly do have an organic brain disease, and possibly need some treatment. A tendency toward paranoia, feeling targeted, could be a symptom of something that can be helped by therapy and drug treatment. I say this because I DO have an organic brain disease, first and foremost. Using/abusing illicit drugs help mask the symptoms.
Sure, there’s no animosity at all towards addicts. <—-sarcasm, for those aware of Poe's law.
While I agree that AA is a scam, anyone claiming that addiction isn't really a disease is a scammer as well, and intentionally ignoring or misrepresenting the best medical and scientific evidence available. The taxi driver/movie ticket arguments above are frankly laughable and completely intellectually dishonest, and anyone partaking in an honest investigation of the subject would learn why in very short order. There's a strong component of narcissism and condescension in the 'alcoholism isn't a disease' argument that suggests that those advocating this viewpoint are simply doing so to address some need of their own to raise themselves through lowering others, which is a short step away from the sociopathic creation of an inferior 'them' which must be dismissed, reviled and ultimately hated for 'their' inferiority. It's fair to question why anyone would expend so much effort to prove that a disease that they do not have does not exist, and to assume that there must be some personal benefit secreted within their agenda.
You obviously have no understanding of what a “disease” is, so you are saying, that you would call a gambling addiction a disease? How about an addiction to cigarettes? Nicotine is a drug, it’s addictive, not have I ever EVER heard one person say smoking cigarettes a disease, because it’s not. So you’re saying, BECAUSE YOU CHOSE to use drugs/alcohol in the first place, and you are now addicted, that it is a disease? Your lack of intelligence of what a disease actually is baffles me. By the way, using the profound words in your comment just adds to your lack of intelligence.
How stupid are you, dude? You’re arguments are the ultimate straw man. You’re comparing apples to oranges. Tobacco addiction isn’t the same as a heroin addiction. If you need experimentation to prove that to you then no amount of science will prove anything to you, you prove only what you already think is true and you skew the evidence to support your claims. This is not science, it’s pseudo-science. Where’s your experimental results? Stop presenting your arguments as science because science has already proven you to be false and a liar to boot. Tobacco isn’t a psychotropic drug you dumbass. IT doesn’t apply. Sheesh. You are a real intellectual giant aren’t ya….
Bro…what we are saying….is that prolonged use eventually develops into the disease of addiction. We are not saying that a few times using or even a few years perhaps…”now you have a disease”. What we are saying is that prolonged use….does physiological damage, changes brain chemistry, causes uncontrollable cravings etc. Once this stage has set in…you now have a “disease” that almost always requires medical and psychological “TREATMENT” in order to heal. The definition of a what constitutes a “disease” can be subjective….. but any “condition” that requires treatment can be considered a disease. Ryan
Sooooo, what you’re saying is that the process is rooted in choice? I really don’t care if the result of prolonged use is labeled a disease or chemical dependency, though I favor the latter. My beef is with those who claim that they never chose to become an addict or never chose to hurt their families. Like they were just minding their own business and a nasty disease came along that forced them to put a needle in their arm?!?! While we likely didn’t intend to end up helpless, dysfunctional people who pissed on our loved ones, the choices we made put us at risk of ending up in a sorry state where we were capable of doing things we would have never dreamed of. Unless you were raised on Mars, we all deep down knew the risk of our choices, especially if you’re talking about coke, crack, meth, or heroin but we chose to roll the dice anyways. At a certain point, when I was starting to do coke almost every weekend, I knew that it would be wise to stop, but I chose not to because I was having fun and I told myself it will never happen to me. By the end, I was going on solo three day benders with alcohol and cocaine, and I landed in treatment. After all my rambling, my point is that I made the choice to try the substance, the choice to begin to use the substance more regularly, and the choice not to quit when I could have. Therefore, even if addiction is a disease, we are all responsible for the damage we caused, and to conveniently dodge that fact by placing the blame on a disease that took away our ability to chose is irrational, and, more importantly, cowardly. We made our own beds with our choices, bottom line.
Your right that we all clearly made to the choice to start using, and yes because of that choice alone makes it my fault for everything beyond my control as well, but there are people who die everyday from the their addiction, I don’t think they just chose to die. I knew drugs were bad because they were illegal, but I had never seen the effects that addiction have on a person before I became an addict, I really didn’t know what I was getting myself into, until I was there. Now with that being said, If I had this knowledge before hand, I would have chose not to go down that path of destruction, I wish to God , I had hindsight what I was getting myself into
Certainly there are those who’ve been prescribed narcotics for an injury which has led to addiction. It seems the euphoria from your very first use overpowered your otherwise good judgment. Should we be as hard on those who chose a high-cholesterol diet which led to heart disease?
I am a heroin addict and the first thing on my mind in the morning is how am I going to get high today.I will go to any length to get the drug and rob cheat and steal all to get that high.I don’t want to think like this it is just what I think and it is not a decision it is something I have to do and the only way I don’t feel like this is if I am somewhere that I no I cant get it like being locked up.If that is not a disease I don’t no what is it is not an option for me it is a task that I must do everyday until I get clean for a couple months in wich the thoughts are still there it is a life long battle it will get easier over time but it will always be in the back of my head trying to get out.The withdraws last for weeks physically and months mentally and you say you were on methadone I no it takes months physically and mentally so theres no way you had experience with that because you would no that is the worst drug to come off of because the it is government funded and they make tons of money of it.You need to get your facts straight before you go talking abouit something you have no idea about.
@Ryan: “Any condition that requires treatment can be considered a disease”? Really?
I had a “condition” (a bloody nose) that required “treatment” (tilting head and pinching nostrils) earlier today. Is that a disease?
I don’t mean to be patronizing, but it’s good to look at things from all angles before commenting or trying to make a point.
All the genuine best to you. I know it’s a touchy subject.
Are you implying that one’s choices can never lead to the development of a disease?
100% agreed dude….its not like we can just say “im just not going to do this anymore”, it LITERALLY becomes the number one survival instinct we have. And by the way there is more to the disease aspect than this guy realizes, all drug addicts also have whats referred to as “decreased hedonic tone” to where genetically we are predispositioned to produce less dopamine than the average person, therefore we do not feel as much “pleasure” out of normal daily activites as average people do, which in turn makes it so when we do that first drug we get a signifigantly larger response than average people so it makes it harder for us to say no in the first place. From there is where the diaease takes hold…
By the way my response is to Peter, not the poster… just want to clarify that.
Parker* sorry
I have been sober over 21½ years in AA and I agree that alcoholism is NOT a disease! In all the years I have attended meetings, I have NEVER bought into the “disease” theory or that ALL of the answers are in the Big Book. It explained A LOT about my OBSESSION with alcohol and the way to STOP alcohol addiction is very simple. STOP drinking! Despite what most AA’s might “think” they DO NOT have all of the answers. What they have is a lot of regurgitated drunkalogues that make them feel better about their miserable lives being stuck to meetings, meetings, meetings. Thank God I was able to realize that it is OK to “take what you need and leave the rest!” Once I realized that it was OK for me to take responsibility for my obsession with alcohol I could recover from alcoholism. I’m not stuck with the Buchmanite cult religion running my every thought or decision in MY life. I can get on with life with NO FEAR of being doomed to jails, institutions or death. If I go to a meeting it is because I choose to go NOT because I will drink and/or die if I don’t. I now have the freedom of a happy life instead of the bondage of an alcoholic obsession!
“its not like we can just say “im just not going to do this anymore”,”
Actually it is. You commit to change and then do what is required to change and the first step is continued refusal to use.
NO, it is very common knowledge that true addicts, who lose control in their addiction have to change people, places, and things that are an influence to their drug. And if you did not have to do that, then guess what? Good news for you, you were never a true addict, but ask one that is, they will tell you that they have to disassociate even their best friend, if they use drugs.
I do believe in the disease component of addiction and we do lose the ability to make our best choices when we are drinking or using…. especially the choice to drink or use more, the choice to drive or not drive, the choice to steal for more drugs or not to. I stopped drinking 14 1/2 years ago. I can go to a bar, party or a home where there is alcohol and have NO desire to drink. I thinks it’s because by the time I stopped alcohol was no fun, I was sick all the time, had blackouts during functions like parties and weddings, pissed all over myself, passed out, and then had to deal with the hangover and the shakes. The THOUGHT of drinking is repulsive. I love parties and weddings now, I dance, enjoy myself, stay up as late as I want. At dinner someone’s wine on the table affects me as much as their fork. It can’t hurt me as long as I don’t put it in me and I just don’t want it. On the other hand being clean from crack for 2 1/2 years is not the same mindset. I have changed people, places and things to protect myself from it. Thank God it’s not for sale at the corner store or sitting on the dinner table because I don’t trust myself to be around it. If I see anything that looks like crack on the bus, dropped in a sink, whatever, the first thing I do is reach for it. My husband has a drink now and then and I couldn’t care less but I wouldn’t trust myself around the people and places I used. Steven will say that’s more proof I don’t have a disease. Well when the judge told me “you wouldn’t be breaking the law if you didn’t have this DISEASE” he was 100% right. And if I had diabetes my blood sugar wouldn’t spike if I didn’t eat carbs or sugar and I’d certainly be able to choose how my body would react to those things…..riiiight. It’s a complex issue and I think the focus should be on what works for those who needs help regardless… not bashing one method over another or refusing to accept any method that might work over another.
…I’m sorry to tell you this, but the article you linked doesn’t offer conclusive proof..and it is from About.com, which isn’t exactly a major medical journal-I’ve been paid to write articles like this,for sites like that- and I promise you the barest of work is done. Notice some key words “this control is MARKEDLY DISRUPTED.( not destroyed, or nonexistent.) Imaging studies have shown specific abnormalities in the brains of SOME, but not all, addicted individuals. ” So not every addict is “infected”? Why did no one have sympathy for my smoking addiction?
Results weren’t conclusive, and needed much more work-like your reasoning and critical reading skills We haven’t even touched confirmation bias, or the fact that a disease is something an addict can suffer from, and get attention-not a selfish choice. There are many treatment options, but self-efficacy and agency are very important success factors.
If its a ‘ disease of choice ‘ then its your own bloody fault for making that choice in the first place isn’t it ? I believe the author is absolutely correct even if he ain’t had the hard experience himself.
I was a gambling addict for many years but i didn’t try to blame anybody or anything else for my self-induced problems. I never attended any GA meetings or submitted myself to the ‘ higher power ‘ and all that shit.
I just stopped doing it.
woooaa hostility there bro no need to get butt hurt because the “little research” the guy has done has shot down your weak mentality. Addiction is not a disease whatsoever; all addiction really is, is a mix up of priorities, combined with laziness, and neglect of responsibilities in your life. By claiming a disease all your doing is solidifying the victimized point of view, and ducking responsibility for your own actions. Shit you could call me an addict if you want, but despite the drugs I do habitually, I have never failed to accept responsibility for my own decision making. That is the biggest cop out in the world, you and others alike are the reason users are labeled with such judgmental discrediting perceptions from the rest of the public. Man up, accept control of your life, and quit allowing yourself to get manhandled by the existence of a NON-LIVING SUBSTANCE. You are a human freaking being for crying out loud! The notion of that is not only illogical, but completely retarded to determine one to be held captive by a drug. You hold yourself captive, and these AA NA and other rehab treatment facilities of course enable this fallacy of yours i.e. being a victim, for they are the ones capitalizing off your very own self pity! Of course you will say I am not an addict, but on the contrary addiction, falsified to the max, is defined as enslavement to a habit, practice, or substance to the point cessation causes severe trauma. Well lets see I have been a daily user for most of the past 6 years or so, numerous drugs. You could assume that I cannot go without. But amazingly in despite of such events, I still manage to maintain a 3.00 gpa while in school full time, and never allowed my habits to interfere with my job; these are possible for not only the fact I hold success above all else, top priority, and also I never let a drug decide its going to tell me what I can and can not do. A want is all it will ever be, never a need. By telling yourself you need this to get by, is an error, and the 1st destructive domino. In fact unlike you I have this thing called pride and respect for myself, along with of course a focused mind. I do not consider myself a drug addict in terms of how you picture it, or any one else for that matter. I choose to get high everyday, but no matter how long I stay consistent the fact is I am capable of going without, yeah breaking the monotony would create some discomfort, but it would not stop my heart from beating or my lungs from breathing.
The only people who can classify as an “addict” to some degree would be abusers of heroin, benzos, methadone, and other pharmaceuticals due to the fact they actually cause dope sickness. But if you use your rational mind Mr or Mrs. Victim you could clearly determine that even those users by utilizing every second of their life to do nothing but get high, to such an extreme degree, and neglecting all together the value of hard work as the pathway to success would be the sole cause of their own demise. In other words, they chose to use to such an extreme they tricked their body into believing it needed those chemicals to sustain homeostasis. A self inflicted wound entirely; had the user not got high just to get high as an “escape” grew up and took responsibility for what happens in their lives their story would be told much different. If Addiction, as you believe so strongly to hold true, takes control of you what automatically instills the notion of destruction following? Would you blame the user or the drug itself for the reckless behavior of some people? Your mentality I would assume would link responsibility to the drug; however, the drug doesn’t force anything, not even consumption. The user decides to consume, determines the value of its effects mentally, and then ultimately develops a certain thought process following use. The user then chooses what actions need be put forth. Drivers influenced by alcohol that crash and kill people are responsible for their actions; even if alcohol held some sort of devilish motives to destroy the lives of people, the user chose to get behind the wheel and drive. My point is the mental state, reasons for using, dosage levels, and all around mental evaluation of what it means/feels to get high, is the creator of your slave state disposition. In essence you are the one who holds the power as the slave owner, over your own body & mind. Furthermore, in my mind if i happened to ever become so gone to such an extreme I would utilize my addiction as motivation to work harder to support my own habit. Turn a negative into a strength, and still be successful. Getting high is mitigation, a get away to alleviate temporarily the negativity one may feel. It is by no means an essential substitute for reality, and if so happens to be used in such way the user depicts the outcome based on their actions. Going from casual use to chronic, and allowing your body to deteriorate, taking ones life with it, is by no means instant. All of that is one step-by-step process, and the user failed to notice or intentionally turned a blind eye to such destruction. That user well aware of the consequences but chose to enable such a detriment is by no means a victim, but simply a careless fool. They mentally, hold the value of their life at so little, imagine themselves pathetic and hopeless to such a degree, that living in torment, by escaping emotional judgement of their own egos holds the essence of life to them all together. Naive prospective, and easily turned around with a new process of taking advantage of the remarkable abilities of the human mind. One such remarkable strength of the mind is adaptability, capable of adapting to any said change in life, be it negative or positive. The mind will adapt and sustain, or possibly create a new level, of homeostasis. All in all Mind over matter, and the mind you possess is the battlefield of life, every thought, action, observation, prediction etc etc must first be processed by the mind before anything else. So therefore by failing to interpret in a positive way, you doomed yourself.
If you do not believe this persons article why don’t you read 2 of these articles I find quite interesting.
London General Practitioner by the name of Michael Fitzpatrick, well respected, views addiction as misleading. I cant post link because it wont allow me to share, not even on facebook.
Also Carl Hart, professor and psycho-pharmacologist from Columbia University ran a study challenging common beliefs of crack and meth addiction and found the original (government run studies) had purposely misconstrued data to hype public opinion. here is the link. check it out.
http://healthland.time.com/2011/11/21/why-the-myth-of-the-meth-damaged-brain-may-hinder-recovery/
Andre, I absolutely love your post, but I think it’s important to clarify that alcohol and benzos are the only drugs that can kill you in the withdrawal process. This may not be news to everyone, but I’ll risk losing addiction blog street credit for posting obvious information if it saves someone’s life. Obviously, you can overdose on heroin, opiates, and all forms of cocaine, but withdrawal from anything other than alcohol and/or benzos, while miserable, cannot possibly kill you. If you’re heavy into either of these and want to quit, do not do this cold turkey. Detox under supervision then go from there.
Alcohol, benzos, and opiates, Kevin B.
When doing the drug it turns you into a different person I would never do some of the things I have done if it wasn’t for heroin.It makes me feel numb like I don’t have any feelings or emotions and everyone around me sees it but I don’t.I have no empathy or compassion for anyone and it takes months for me to get feelings back .So how can that be some type of disease.Insanity is doing the same thing over and over expecting different results so am I insane that would be considered a disease.
You were on drugs when you wrote this. So your irrational. If your irrational your not capable of rational thought or behaviors. Typical to doped up junkies. If you read the whole article, dumbass, you would have read the part where this individual states that the only treatment the author can “ethically” (google that, addicts seem to have no understanding of the word) recommend was detoxification treatments. You’re claiming you have a life long disease that only lasts 3 days to post using? And your offended because this individual isn’t making sense? Instead of writing a response to something you haven’t read, hence “know nothing about”, try writing a response to something you have intimate knowledge of. Like, “why I’m a short sighted illeterate asshole.” With in your oh so very thought out response, quite obviously with out realizing, you actually tipped the scale from the point you wanted to make, to the direction the author was actually trying to prove. Of course there is going to be some MINOR and TEMPORARY changes in the brain, your pumping vast amounts of poison into it genius. And based on the extensive research you’ve already done for us, that lasts how long? 3 days? So your permanently useless because of a 3 day slight brain malfunction brought on by the CHOICE to poison yourself. The amount of time between using is less than 3 days you say? Hmm, well once again the author suggested DETOXIFICATION TREATMENT.
Youre angry weak minded rant was clearly a direct reaction of your poor “choices”. Stop making these poor “decisions” and perhaps people with stop hating on you. But, if you’re going to continue to blast intellectuals with your doped up irrationalities than I would perhaps invest ear plugs instead.
Note: I’m personally offend by this guys stupidity.
i went to the methadone clinic for years. why, because i liked it. i got tired of it and quit cold turkey. had bad withdrawls for a long time. but i stayed clean because thats what i wanted to do. this is what i tell the acquaintances i know who still use and act like they dont have a choice, “quit being such a pussy.”
“You were on drugs when you wrote this.”
Prove that Steven was on drugs or admit that you’re a liar with no honor, whose words aren’t to be trusted.
“Note: I’m personally offend by this guys stupidity.”
I’m offended that you’re evidently constitutionally incapable of honesty.
The disease concept is exactly that- a concept- albeit useful for some people struggling with stopping chemical abuse; it’s a necessary illusion for people early in recovery that errs on the side of caution. The disease concept is a transitional object to help people develop- to move on to another place in their (psychological) development, which is not unlike a child and pacifier. A child’s pacifier brings comfort, helping a child calm down in discomfort & uncertain situations. Now the pacifier becomes a autistic object when it no longer promotes development or growth i.e. a 12 year old sucking on (needing) a pacifier. Some people due to the extent of their drug use- the long term consequences on the brain- compounded by personality organization, psychopathology, and pronounced difficulties to form healthy co-regulating attachments (failure to attach) seem to be the constitutionally incapable few to which the disease concepts must be reified dropping the concept portion and only considered a disease- as if their life depended on doing so. For others it is a necessary illusion that can help change their relationship with chemicals and promote psychological and even spiritual growth; at some point the notion of addiction as a disease can become dogmatic i.e. less about growth and more about excusing oneself, especially past motivations. Motivation is often complex and knowing without any room for doubt or uncertainty is autistic in that that type of knowing no longer promotes learning about oneself; when one Knows (in a static way) one stops the process of knowing i.e knowing means acKNOWledging oneself or others or any object in the immediacy- this pertinent to people recovering because they often relegate themselves to how they were. So knowing oneself is a continual process of reassessing and evaluating, especially if you acknowledge that our perceptions and interpretations are always partial, which 12 step programs offer (ample perspectives).
The disease concepts garners value depending on how one utilizes it. A lot of the people who responded to article, the extremely defensive responders, sound like they might always need a pacifier and I would rather them err on the side of caution. For those the necessary illusion commanded much benefit -at some-point but no longer does rather it keeps them in an insidious cycle highlights the biggest danger of the concept: a confirmation bias, a self-fulfilling prophecy . I heard a lot of Sally cry pants resentful about the article differing with their perspective, not wanting to dialogue but attack, which is reflective of addictive thinking, & deficits in self-regulation, which is usually underpinned by a dogmatic reactionary shame.
Thank you for your informed opinion. Worded like you have I can understand and respect the opinion that you offer. As a “Retired Addict” I can appreciate all that you have said and I know that you don’t have to remain an addict for the rest of your life as 12 Step Programs state. Thank you for an intelligent response.
“it’s a necessary illusion for people early in recovery that errs on the side of caution”…
With an exception for Santa Claus, etc. I think lying to people “for their own good” is almost always a bad thing. I’ve been under heavy family and social pressure to embrace AA/NA for the last fifteen years (on and off), and I am convinced that I’ve been seriously harmed by my indoctrination in those programs. If I hadn’t had so many people working for so long to convince me that I was powerless and that any substance use would inevitably lead me into a horrific downward spiral, then I wouldn’t have worked so hard to fulfill that prophecy.
The last time around the merry-go-round, after losing my family, I lashed out and did things that I knew would make my life worse, so that I would have to either kill myself, or hit bottom and get “the gift of desperation”. To me, the 12 steps clearly do not work. Some people gain a benefit from the social support, but I never was able to talk the talk convincingly enough to gain acceptance by the “winners”. I was under enormous pressure to buy into that program, but the internal contradictions and magical thinking were just too much. The discomfort of finding myself in that situation always led me back out. The longest stretch of clean time that I’ve had (by far – multiple years) was accomplished without a program.
AA and NA haven’t just prevented myself and others from receiving real psychological or medical help*; they have harmed me directly.
* which is de-emphasized on this site a little too much for my liking.
The first thing that I would like to say to you is that you have no clue. Don’t try to judge a man until you have walked in his shoes. Next, you need to try the thing that they call spell check. Finally, if you’re going to speak on someone being worthless and ignorant speak intelligently, you don’t have to use profanity.
I don’t profess to being an addict for the rest of my life, I am a retired addict with 18+ years without drugs. When I was out there I didn’t have a choice. I had to learn how to stop the cycle. NA & AA helped, but I had to grow past that. I learned over time how to walk on my own. No thanks to USELESS, IGNORANT people (I use the term lightly) like you. You should be offended by your own Stupidity.
You said when you were out there, “you didn’t have a choice” ultimately that was your choice to not have a choice because you CHOSE to start using drugs. Addiction being a “disease” is just a “way out” a poor pitty me excuse if you will. Secondly, does it really matter how people type?? Seems to me you are just picking apart his comment b/c you don’t have a legitimate argument lol YOU CHOSE to start using drugs nobody put a gun to your head and made you use. You had a choice and you blew it lol My entire family, with the exception of myself and 2-3 other of my cousins, is on pills, meth, coc, herione, crack you name a drug those dumbasses will use it some how some way. I refuse to be anywhere around them or near them and its a shame b/c their children are suffering,
Nicely said
I’ve been in NA for 2 years and 3 months 1 year in Na was spent still doing drugs. I didn’t need a study to know I was still doing drugs because I had a choice to or not to do the drug. I studed how drugs effected my thought process and came to the conclusion that it wasn’t a disease like the Na book said. Addiction is a choice I listened to people with a lot of clean time and heard the same thing over and over again, same stories, the same life troubles in their life even without drugs. Na and the people within the group of Na stay stuck on the phase I’m an addict for the rest of their life. If you keep saying the same thing over and over again you will be what you say you are. If you say what it’s a lousy day over and over again you are going to have a lousy day. That is what I hear in Na every meeting I go to the same problems different day. Na has turned into alot of members social group and it says in their own books that you need to associate with different types of people that don’t use drugs. I’m at that point in my recovery that I’m ready to have a normal life away from the daily pitty party and the foul language. The success rate of members are increditably low (fact) and that tells me volumes. It doesn’t work very well. My life will be sucessfull because I’ll do the work to make it sucessfull my choice. My be in 10 years I’ll go back and I’ll see the same people talking about the same things. Still saying I’m an addict after all that time and my life will be just fine away from all the stinken thinking.
Well said. Thank God everyone in 12-step programs doesn’t buy into this article. Surely it would kill us all.
I understand your fustration. If I bought into hopelessness too, then I would be totally pissed off if someone kicked my crutch rightout from under me. I started using drugs and alcohol at age 11 and turned away from a several hundered dollar a day habit and lucrative participation in a distribution scheme at age 23. I fully understand the grip of addiction, and of having something so overbearing that I ended up on the streets for two years and lived hand to mouth. I get it. I taught myself how to read at an adult level at age 20 and eventually put myself through lawschool and now I’m entering a PhD program. I am not a doctor, but I can read and I have personal knowledge of the addicted life and a post addictive reality. We choose our destiny, inanimate objects don’t choose it for us. The use of vulgar language and foul speech is simply a limbic response to your fear that the status quo of a “victim culture” that has permeated our society will no longer be available to you as a shield against the concept of a post-addicted state. BTW the 12 steps are great guidelines, but not moral absolutes, like the Big Bookers want to lean on, sincer their higher power is often of personal design so as to not offend or demand real change.
“I know what I’m talking about because I’m talking about myself”. So, Parker, you feel comfortable suggesting that your individual experience is irrefutably representative of anyone dealing with substance abuse? That’s like me saying, “I know pepperoni pizza is the best because I’ve tasted all of them and I like this one the most! I don’t care what you say, pepperoni is unquestionably the best kind of pizza” I mean, a century’s worth of experience is noteworthy, but basic statistics would argue that one iteration does not constitute a trend. Oh and some friendly advice…referencing the fact that you’ve been to numerous treatments doesn’t help your argument, in fact, it shows that you’ve put yourself through unnecessary hell by blindly devoting yourself to the disease model myth. A sheep comes to mind…
Parker,
Though I should be used to this babyish behavior from disease model Nazi’s, are you not intelligent enough to realize that being so defensive and vitriolic only makes yourself and your argument look weak? My favorite line of your childish tirade: “If you were a drug addict, you would know for a “FACT” that drug addiction is a disease of choice”. In the first place, the jury is still out on the science, so neither side can reference facts. The second part, that drug addiction is a disease of choice contradicts everything you are trying to say. A disease of choice? So it is a choice, but simultaneously a disease? If so, what are we arguing about? We are all right?!?! Believe what you want to believe and do whatever you can to live a happier life, but don’t be such an asshole when you are disastrously uninformed, and can’t even recognize your own contradictions.
PS Have fun holding hands with a bunch of grown men and chanting platitudes this afternoon like they were the brainchild of Socretes himself. Or, just don’t be a pussy, find some hobbies, stay clean, and stop wasting your time in those God awful rooms full of zombies. I’d personally rather be drunk.
All scientific claims are provisional in that scientists understand that newer, better information may be discovered at any time. But the scientific method is still the best method humans have ever developed to separate out what we would like to believe is true from what actually is most likely to be true. That method involves declaring what you will look for, and what qualifies as an answer in advance, making your data – from formulating the hypothesis to the conclusion of the experiment – open to the examination of the scientists of the world, and having one’s data and conclusions survive peer review publication and replication by other scientists who have no connection to the ones who originated the experiment.
So, as for the idea that “jury is still out” on whether addiction is a disease. I would say it’s not. Periodically, a claim of the discovery of a gene or brain “difference” that causes addiction is announced, but as of yet, none of these claims have stood up to peer review and replication. Also, our methods of detecting what goes on inside human bodies is incredibly detailed these days, compared to the 1930s when the “allergy to alcohol” was first floated, so the idea that medical science, as friendly as it is to the disease-of-addiction these days, is overlooking the mechanisms of this “disease” is unlikely.
As of now, there’s no virus, bacteria, prion, no missing or flawed chromosome or gene, no hormone or enzyme excess or deficiency, no organ malformation or malfunction or traumatic damage that can be used to separate those who “have an addiction” (or “an addictive personality”) and those who don’t. There is no way, in a doctor’s office or in a court of law, to refute the claim, or an accusation, that an individual is “an addict”. In fact, just attempting to refute the accusation is a symptom of the disease – denial. (To me, the “denial” thing is the most gigantic clue that we are dealing not with a disease but with a method of recruiting and retaining members into a group.)
So I would say, barring new information, the jury (provisional as it always is in matters of science) is in and addiction is not a disease.
Trish,
In the first place we agree…I think the disease theory is not only unproven, but also damaging to people trying to recover. As for the scientific method, it starts with a hypothesis (something someone(s)) believe may be true, is tested vigorously, considering every variable in the equation. After intensive experimentation typically keeping all variables but one at a time constant, if the results prove true in EVERY SINGLE ITERATION that can be substantiated by industry professionals, only then does it move from scientific theory to scientific fact. Maybe one day they will prove it to be a disease, but I highly doubt it. The only reason the disease model came into existence was to force insurance companies to pay for 30 day treatments. Since then, nothing has been proved.
Now, am I saying it is easy to quit when one is physically dependent? Of course not, nor am I questioning their character. Disease is just the wrong word, and provides too many people with an excuse.
Mental problems That lead to the drug……..
In many M ANY cases.
Very well said. Time to go to there90 min meeting (No brain don’t tell me I want a drug) they say what time for every step to take but our brain controls us….
Your arguments are completely laughable. You’re right: it’s not a disease, I was just being a bad person. If the medical community at large used this philosophy, the whole world would be in dire straits.
and I can still live a life beyond my wildest dreams as long as I put my drug into remission. So I’m sorry that you felt that the disease was an excuse to keep drinkin and all that shit, you should’ve just had someone take you to rehab dawg.
I accidentally posted a reply on another person’s thread (February responses) but I meant it for your post. I agree. After living a lifetime in a family with enablers and addicts a person gets tired of all the excuses and being used and abused when they suggest that the person quit and change their behavior. It can be tough to change it, but the people who help need their own lives too. They can’t constantly drop their lives for the addict and arrange everything around the addicts needs and wants. That’s not fair either.
To Kasey (11/18/13): My heart goes out to you. I got fed up with trying to put up with the irrational abusive behavior of both alcoholic parents and accidentally stumbled into Al-An0n Family Groups in my late twenties. They are the ‘sister group’ of those in AA and study an adjusted version of the same 12 Steps. Free, anonymous, found all over the world.
I learned about how I added to the enabling of their behavior by getting ‘addicted’ to their drinking behaviors…trying to force solutions, walking on eggshells, people pleasing, yadda, yadda. That clearly did not work. In Al-Anon, which I attended weekly (and more often) for 15 years, I learned so much about looking at and changing my OWN behavior. This slowly healed much hurt and resentment towards my parents and I had much less lingering anger when they passed, unlike most of my six siblings. I got my life back and became much more self-honest. I left when I had learned enough. I carry some of the principles with me, still. My trust in God sky-rocketed…leading, quite directly, to an awesome long term happy marriage. It’s not for everyone, but you might find some comfort there. Just like reading these comments: take what you like and leave the rest.
I am enjoying reading all of this page with discernment. What you are meant to know will come to you without any effort on your part. This is the promise that trust in a power greater than yourself can offer. Staying within the sly crafty ego mind will lead to many dead-ends. Choose again and listen within your own mind for the Right-Minded Voice. It is an individual path, you walk it by yourself but never alone.
You have no idea what you are talking about. AA saves peoples lives everyday. It saved mine. I have been fighting addiction for almost 10 years now. I went to rehab when I was 20 for an addiction to heroin, got clean and sober and stopped using everything for about a year and a half. Then I started drinking again but I was only a moderate drinker. Fast forward 5 years and I came across some Oxy’s at a buddies house and within 3 months I was just as bad I was when I was 18-19 yrs old. Tried to quit by myself time and time again but I never could. Thought the solution was to get off the oxys and go to a methadone clinic… BIG MISTAKE!!!!! Now im getting off that finally but I had started drinking viciously. Now I have almost 30 days sober from drinking and have been going to AA. The problem is not the drugs or alcohol it is our thinking. The way I think is fucked and I have to change that and my solution to do that is through AA and through GOD. AA doesn’t just teach you how to stop using, it teaches you how to live. How to be a better person. How to stop being a selfish, self-absorbed asshole who doesn’t care about anyone or anything unless im high. Im sorry for my rant here but you guys need to stop with this shit. There is but one solution and that is establishing a spiritual connection with your higher power and working the steps. Thru that true happiness can be achieved and you don’t ever have to worry about how am I gonna get my dope today so I can go to work, how can I catch a buzz before I meet my friends so I can be “normal”. This is the only way that I have found and I have tried them all.
Let me state that I have been sober 21½ years in AA. For the last few years I started seeing and hearing the same old same old differently. I began to wonder if going to meetings all of the time was any different than “doing the same thing over and over again …”
Check this Web site out and see what you think after you read about the “REAL” Bill Wilson and the Oxford Group (both cult religions that use mind control) …
It opened my eyes, that’s for sure! http://orange-papers.org
I agree with what you wrote about AA (because I lived it) but there is also a very DARK side to AA, as well. I have witnessed it and I eventually had to face the truth about it if I wanted to continue to stay sober and sane!
This is a trailer to a 90-minute documentary being produced RE: The 13th Step … http://www.youtube.com/watch?v=Z-jZ3NWI8uk
I don’t think anyone is doubting whether or not AA saves lives. Sure it does, and sure it messes just as many people up in the process. This article is about taking responsibility for your actions and dealing with it, which it sounds like your trying to do. Everyone’s different, there’s no textbook way to beat addiction (that and rational person will or could understand), I think this thread of rants proves that. But labeling something a disease, that has little characteristics of a disease is asinine, and clouds the already clouded judgment of people who are seeking help for their problem. I think it’s fair to call it a “problem”, I doubt anyone will argue that point. Calling addiction a disease simply gives the addict exactly what they want, a loop hole. An excuse to devert any and all responsibility of their own actions. There’s always that voice in the back of your head saying it’s not my fault i do this, or steal that, the disease is making me do it. The people who have labeled it a disease are making money off of it being called a disease. They’re not interested in you getting and staying clean. The more stints you do in rehab and the more scripts they write for methadone and all the other drugs keep they’re pockets full. Take these drugs so you can stop taking drugs?! Does no one else see that’s f-ing retarded?!? Stop go along with what the big wigs want you to do and start thinking for yourself.
Walk a mile in a junkie’s shoes and then tell me about control and choices. as the old saying goes, “It takes one to know one.” Also I might add, it takes one to help one. I’ve been in recovery from the DIS-ease of addiction for almost 10 years now and am very thankful for the 12-step recovery process which labels it as a disease. Unless we know what it is, we can’t treat it.
No one is saying it’s easy to make the choice to stop, just like it would not be easy to sit down and read a reasoned political essay from someone of the opposite political persuasion, and even harder to imagine that this person might be right about some of their points.
When you believe that IMMEDIATE RELIEF trumps DELAYED GRATIFICATION, and when you’ve tried drugs and your system seems to really respond pleasantly to them, indeed it’ll be hard to start considering that “maybe the normies have some good points too. It has led me to live on a razor’s edge-thin world seen only through blinders. My health is poor, my friends are all just as self involved… maybe I was wrong about drugs being the be all end all.”
Sure, sometimes you’re going to feel as if you need that drug. As time passes, you see how life is livable and enjoyable without believing the worst about it and without believing you need drugs to get thru it. Convictions run deep and you might run back to it. Keep working on it, a DAY AT A TIME, or once and for all if you can.
you proved the point of the article.
Why yes, yes he did. Nice brainwashing there.
Sean,
Like your buddy Parker, you are suggesting that you’re own success in 12 step (all of 30 days at the time of the post) should automatically apply to everyone, and, even worse, if someone happens to disagree or has had a different experience in the rooms, you’re quick to imply that they just don’t get it. Because AA worked for you, when you couldn’t otherwise stop and you tried rehab and methadone clinics and you this and you that, this allows you to conclude that, and I quote:
“There is but one solution and that is establishing a spiritual connection with your higher power and working the steps.”
You can’t possible believe that the only way to get sober is by going to AA because it worked for you. While I actually admire you’re passion for working the steps and fundamentally agree with much of the logic behind the program, you have to recognize how dangerous it is to claim there is one way to heal from substance abuse. This is what all treatment centers preach, and it creates a huge dilemma. What if you go to enough meetings to get the gist, get a sponsor, and legitimately give it a shot, but can’t fundamentally give yourself to the program for whatever reason? If it’s the only way, I guess those of us who it doesn’t appeal to are forced to conclude that our situation is now truly hopeless? I suggest we all meet in the middle and say AA is a highly available option that has worked for many people, but other options exist as well and it’s highly unproductive for any methodology to claim lordship over all matters pertaining to sobriety. While addicts can relate on many topics, each human is unique and the nuances in our personalities, values, world views, life experiences, and history of substance abuse make the thought of forcing all of us into the same treatment program absurd, lazy and irresponsible. If it works for you, I’m honestly happy for you and genuinely wish you the best, but allow people to seek other options that may be better suited for them without being so defensive…please.
you hit on and are correct on some key issues. in “addiction and grace” by gerald may MD, he concurs insomuch that it is not an addictive personality but an addicted personality. to be alive IS to be addicted. you stated that flippantly but anything from crack to bubble gum can become an idol to someone. ANYTHING that supercedes a persons innate desire for God. attachments becomes desires becomes addictions become slavery.
the 12 step programs are NOT to get someone to stop the addiction. they are to choose a behavior change. to seek a Higher Power. this provides choice…and freedom.
while i agree that it is a choice, i disagree with your premise that man can rely on his own mind or will to accomplish that.
Adam willfully ate the apple. addiction is yet another by-product.
It might help someone like you, but it could do serious damage to someone who is drug addicted. I am not saying that you will have the disease for the rest of your life (theory of NA & AA), but it is a disease. For someone like me, it was not only a psychological addiction, but a physical one as well. It wasn’t a matter of just saying no, it was a matter of healing myself with the help of doctors and therapists. You spout this stuff with no expert opinion, just the word of journalists who paraphrase what they have read. I would challenge you to obtain the direct opinion of doctors and scientist worldwide to dispute the findings of the National Institute on Drug Abuse, The National Institutes of Health and The World Health Organization. I would further challenge you to prove that it is a matter of choice by experimenting with one of the addictive drugs, say crack cocaine, for a month and then just quitting, if you can. I am sure after that experience they would dispute the argument that addiction is not a disease it’s a choice. If you can, then maybe I would listen to you.
There are plenty of bonafide MDs and PhDs out there who disagree with the NIDA’s position that addiction is a brain disease. The program I work for, which is based on the position that addiction is not a disease, gets plenty of referrals from doctors. I have had several doctors as students. There are doctors such as Tom Horvath PhD who heads up SMART Recovery, and Sally Satel who strongly disagree with NIDA. There are plenty of PhDs like Stanton Peele, Gene Heyman from Harvard, Jeffrey Schaler, Peter Cohen from the drug research center in Amsterdam, etc who disagree with the NIDA et al’s position that addiction is a brain disease. They’re out there, and they’re making strong cases – I am not alone in this.
If Nora Volkow would have me, she can bring me up to Brookhaven laboratory, scan my brain, get me “addicted” to heroin, and watch me quit on my own, then scan my brain again. I’d gladly volunteer to show that it can be done. However, we don’t really need to do this, since there is tons of epidemiological evidence which shows that the vast majority of people quit these problems without professional assistance.
Also, you think I’m just quoting journalists? I directly analyzed the NIDA’s presentations, and the research papers published by Volkow on the meth addict brains she scanned that form the core “evidence” for NIDA’s claims. I’ve directly studied the research paper on the taxicab drivers mentioned above – even though I reference Jeffrey Schwartz PhD’s discussion of it (he’s a research psychologist – not a journalist). I’ve read the research papers on contingency management, even though I mention Gene Heyman PhD’s discussion of them (again, he’s a research psychologist, not a journalist). Etc, etc etc. The only journalist I quote here is Sharon Begley. Read more carefully before you take a ridiculously baseless potshot.
Steven,
I feel I need to commend you for both your article and your responses to so many of these defensive, foul-mouthed tirades. I personally don’t know if I’d have it in me to quantify many of them with a reply. I’d also like to say that I’ve done some research on Marc Lewis as we’ll and tend to agree with both you and him. My experiences with addiction stem largely from being on the receiving end, as my bother passed away from a heroine overdose at the age of 22, by father has battled alcoholism since as long as I can remember, and my husband a full-on I.V. opiate addict and alcoholic in “recovery”. However, I also have had a somewhat brief 2 year experience with addiction myself following my brother’s death. I used narcotics as what I deemed the best possible solution for me at the time, a way of masking my internal struggles and pain so to speak. Quitting was certainly not without a lot of pain and mental anguish, however once that part was over I honestly never looked back. I don’t believe for a moment that I have a diseased brain that could inevitably coerce me to becoming chemically dependent. I’ve had surgery since then and had no issue taking narcotics briefly and then stopping them. Many of my husband’s previous treatment programs have considered this to be an anomaly. In reality I believe it is and always has been fundamentally my choice. The lens I view my life from always has many positive reward alternatives to narcotics. At this point it has been so long that I don’t even consider narcotics in the realm of rewarding. My husband unfortunately struggles with this infinitely worse than me apparently. He now has no physical chemical dependency, yet he continues to fall back from time to time in spite of everything positive that he does have going for him . Knowing him better than anyone, I believe this to be due to his need to “quiet” his mind. That being said, I can say from this experience that I don’t think rejecting the disease model is in any way undermining the intensity by which addiction affects the individual. While I don’t believe it is a medical disease, I also don’t see an easy solution for the unquiet mind. No amount of “rewards” appear to have a comparable affect as drugs do to a brain that is wrought with constant anxiety…whether the neural pathways have corrected themselves or not. I think this is where many people express defensiveness over their actions being a choice. In spite of possibly having phenomenal positive rewards, ie; career, children, exercise, hobbies, etc., I would think a lot of addicts view the choice model as a direct attack on themselves. For example, who in their right mind would choose drugs at the detriment of their own career/children? I think the choice mistake lies in the nature of the reward. While their children/loved ones undoubtedly provide happiness, and their career a sense of accomplishment and financial well-being, the drugs/alcohol provide the release of pressure and the “quiet” like nothing else. To effectively reroute this sort of need into something else is undoubtedly one of the highest forms of internal struggle we must face. Adopting a completely different way of processing our thoughts and emotions may be easy to write about, but worlds of seemingly miraculous effort to produce. The complexity of the individual human thought pattern is beyond my capacity to dissect, so I suppose all we can do is hope for the best in the addict’s ability to truly self-reflect.
Gene Heyman, PhD, in a recent journal paper published in Frontiers in Psychiatry:
Here’s a link to the full paper – Addiction and Choice: Theory and New Data
I work servicing the disabled and the only reason why drug addicts are recognized as a disability is
because they are con artists who could ace any interview and hence are sucessful closures.
The disease model if inherently flawed. It traps people even if they manage to abstain from drinking for years on end. I have friends and relatives in AA. They can excuse nearly any behavior on their part as long as they attribute it to ‘the disease’. One they’ve eliminated the alcohol they don’t really progress or grow as human beings. Some people’s defense of AA is how could you be against anything that helps so many people? Because it isn’t true, I’d say and doesn’t. Anything that shuts down rational argument and debate. That accuses the other side of simply not understanding and expects you to accept their subjective experience as fact without argument is not good for anyone. Two cents.
The idea that poisonous chemicals such as methamphetamine put into the body over a long period of time does not cause damage–is ridiculous.
I’ve seen first hand, people who have permanent damage from long term drug use. (Uncontrollable motor control problems–physical ticks, for instance) Naturally its depends on various factors—the individual’s personal anatomy and DNA, the length of time and the amounts the person has used, etc.
This is a presumptuous and pompous article. The brain scans currently being used may look simplistic and foolish in 20 years time. There are scores of medical tests and theories that have been thrown out as antiquated–as we now know there where things which simply DID NOT APPEAR.
Saying that putting poisonous chemicals such as meth into the body–cannot cause permanent damage is like saying that swallowing a bottle of Draino–even if you DO live doesn’t possibly cause permanent damage to the internal organs.
Its been proven that the human brain can be PROGRAMED under hypnosis to perform certain functions on certain cues. (The CIA is documented to have used these techniques!)That is the problem the addict deals with–when certain promptings come up–chemicals in their brain are programed to take certain actions in order to gain relief. It’s damned difficult.
In the end–yes–it is a choice to pick up and use–but it is not the same as a normal person deciding whether or not to eat a chocolate chip cookie!
This is a manipulative comment:
You make it seem as if my argument is that drugs don’t possibly do any damage to the body. They can and do. And this can result in various HEALTH problems. However, it has not been demonstrated that the neural adaptations correlated with drug use actually cause the behavior of continued drug use, or involuntary drug use. And these neural adaptations which are represented by NIDA and others as causing continued drug use have also been shown in the same research to adapt back over time with prolonged abstinence.
To say all of that is not the same as saying that meth can’t physically damage you. You have tried to pull a fast one on my readers, and I do not appreciate such sleazy tactics. I call them out for what they are.
-Steven
I really enjoyed your article and thank you for bringing some points to light that are often overlooked. My only concern is by stating that addiction is only an issue of choice you fall into the same black and white thinking many proponents of the disease theory do. The answer to what drives addiction just isn’t so simple as what drives one person might not drive another. I also believe the disorder is fluid and not static. It might start out with choice but doesn’t necessarily end there. I can use myself as a good example. I used heroin for 21 years. In the end I used despite the fact it didn’t increase pleasure anymore, what drove me was the fact I only felt normal, or okay in my own skin when I was on heroin. I didn’t get high for years, I had a drive to feel normal. Then it got to the point where I didn’t even feel normal. My use always ended in misery and yet I had the compulsion to use despite the plethora of negative consequences. So choice was kind od clouded here as I don’t think I would choose to be miserable or many others would.
While it’s regrettable that we sometimes make decisions that don’t work out well, their outcome doesn’t change the fact that they were freely chosen actions. That’s ex post reasoning, and doesn’t hold up.
I’m going to speak generally here to my audience regarding some points you’ve raised, so if it doesn’t apply exactly to your case, please don’t take offense.
If you continue to make the same choice that repeatedly doesn’t work out well, then I think that means that you saw that action as your best available option at the time.
When I hear people say that they repeated a choice that didn’t make them happy or give them pleasure, and when I hear it said that it only provided a feeling of normalcy, or relief, et cetera, then I think one of two things are going on (and possibly both things):
1. They’re looking only at the consequences and not at the initial effects. So, for example, when I wake up monday morning in regret thinking that I don’t like that I spent my whole paycheck, and I don’t know how I’ll explain myself to my wife or pay the rent or whatever I think at that moment that I don’t like crack. Then I go a step further and think that if I don’t like it, why would I have smoked it? Meanwhile, I overlook that at the time, I enjoyed the high of crack. Or I enjoyed the first hour or two of drunkenness even though I hated blacking out and then being hung over and throwing up all day the next day, or whatever. It doesn’t change the fact that I liked it at first.
Yes, I don’t like it now, but I liked it then – and then was when I made the choice to do it – not now.
2. They’ve set their bar that low. If you repeatedly reach for temporary relief, then you must not believe a permanent solution is available. If all of your efforts are directed at feeling normal, then you must think normal is the best you can feel. If you invest in activities that you believe to bring you misery, then you must believe that level of misery is the highest level of satisfaction available to you.
Also, let’s not forget the fact that the relief seeking user obviously believes the drug provides adequate relief, or else they wouldn’t do it.
If I knew that another employer would give me a job doing the same work, but triple my salary – I would take that job in a second! And if an “addict” believed that they truly had a better more attractive way to live, then they would live it. They don’t believe that though, and that is their problem. Portray their lifestyle however you want – happy, enjoyable, okay, one of cycles of pain and relief, comfort in one’s own skin with little else, unsustainable, reckless, miserable, whatever. At the end of the day, that’s how high they believe their bar can be set – or else they’d be living differently. It is sad and tragic sometimes. That I don’t deny. But that doesn’t mean it isn’t amenable to choice.
-Steven
While I agree with Steven’s reply, I wouldn’t say Bruce’s comment was manipulative, as much as it was rude and entirely uninformative, given how astoundingly obvious and not worth the keystrokes his main point actually was. So prolonged abuse of hard drugs can have a detrimental impact on the human body that is potentially there for life? I think all the three year old’s on this thread are probably waiting for their mom’s to leave the room so they can say out loud “NO SHIT”. The accusation of presumption and pompousness strikes me as odd, to put it lightly, hypocritical and embarrassing when we really get down to it. What could be more pompous than leading off a post with that insult, then countering it with an argument that was already self evident even in the slowest of minds. As an aside, marijuana and moderate consumption of alcohol should not be included in this discussion…
The disease model fanatics on this site have a couple of disturbing traits that seem to rear their ugly heads over and over again. First, they are hostile, rude, and insulting to anyone who disagrees. As we all know, this is a telltale sign of defensiveness, and comes across as rather childish and pitiful. Second, they tend to use it as an excuse for their previous misdeeds. I’ve heard things like, “Do you think I would chose to rob my mother? I have a disease man, I couldn’t help it”. I’ll grant that once in the throws of full blown physical addiction, some people do lose their capacity to do anything but find more drugs at any cost, but they got to this point because they made a series of bad choices to get themselves there. You don’t wake up one day fiending to put a needle in your arm…this results from a series of choices. Finally, they make an illogical, unfounded leap by suggesting that those of us who don’t think it’s a disease are saying it’s not a very serious situation that is simple to overcome. Saying I don’t believe it is most appropriately labeled a disease does not mean I’m saying beating addiction is not one of the hardest things anyone can do. I know from experience. There is simply a major difference in having a physical addiction to a harmful substance that can be subdued with a few days of detox and a 30 day treatment program, and having a disease that is with you for life. AGAIN, this doesn’t mean the stressors, cravings, environmental factors and unresolved emotional and psychological issues that lead to relapse are not powerful and real. It just means that they are personal, environmental factors rather than fundamental malfunctions in the body like diabetes, heart disease, cancer, ebola, Parkinsons, MS, etc…
“You don’t wake up one day fiending to put a needle in your arm…this results from a series of choices.”
But a sometimes series of mini choices, which leads to an illusion of choice for some who think they don’t know how they are using again, and so they say, Hey I had No Choice!
It’s often hard to see the little choices
Tony,
With all due respect, I can’t follow your point. Certainly, many choices in life lead to unintended consequences that leave us in bad spots, but, when it comes to drugs and alcohol, I would assert that we all knew this could eventually land us in a tough spot. If not at first, assuming you were very young, I believe everyone has a brief moment where they look themselves in the mirror and realize they better be careful with whatever it is that floats their boat, but decide to roll the dice anyways. I am only challenging you on the notion that any sane grown up should know that a “series of mini choices” involving drugs/alcohol could very well lead us back to the badlands, and to assert that an individual with a drug problem had no idea of where starting back up again could lead them as if under some sort of spell doesn’t stand up to logic and reality. Certain mini choices have unforeseeable outcomes, such as choosing to cancel your flight before the plane crashes, deciding to attend school A when school B would have been a better fit. When it comes to drugs, however, most of us realize that flirting with this “mini choice” has a rather predictable and unfortunate outcome. In other words, there is no illusion when it comes to this, unless, of course, someone is using it as an excuse. Many of us are well aware of the consequences but chose to get our fix anyways because it is fun, provides an escape from anxiety or pain, allows us to feel more comfortable in a crowd, makes us better in bed, etc…I’m only saying that any adult who has been through struggles with addiction should be under no illusion when it comes to the worst case scenario of these mini choices.
My son and my daughter are both drug abusers. Their father died with a syringe in his arm after I had divorced him for being a drug addict. I never used drugs and my kids did not grow up in a drug environment.
My son cleaned himself up and has been doing fine for years. My daughter is currently in prison for committing numerous felonies to get money for drugs. We spent thousands of dollars putting her in detox and rehab, tried suboxone only to have her go right back at it.
She stole just about everything from us that was worth more than $10.
I have no compassion for her whatsoever and never will. She went too far and drugs have made her a monster. I believe when she gets out of prison she will return to her same behavior.
Not sure if it’s something that my kids inherited from their father or whatnot. All I know is all I have done all my life is try to get people clean and I have washed my hands of it. Help is out there for those who want it. She knows right from wrong so she will have to live with the consequences.
Kay, Thank you for sharing your story. My son is in prison for the third time for drug related offenses. Heroin is his choice, although I’m certain he’s done it all. He’ll be released to a half way house next week, thankfully still on parole. There is no home plan from his family…this time. This cycle of addiction baffles me and reading disease or no disease makes it all the more complicated to figure it out. All I know is he has caused more pain and conflict in the family that I no longer want anything to do with him. Then, I start feeling guilty. Reading messages as yours helps knowing I’m not alone. I tell myself over and over if money and love could have saved him, then he’d be ‘cured’. It sucks like having a boat anchor around my neck.
People keep trying to use “disease” and dependency interchangeably. It doesn’t work.
You obviously do not understand the program of AA. AA promises that we can recover and be recovered from alcoholism. This does mean the alcoholic is cured it means that they; if they are willing to follow the program of AA; will find a way of living which will empower them to live life under the full realization that alcohol is not their problem. READ THE BOOK!!
I am utterly committed to not using the 12 step fellowships as a tool for recovery. I am not impressed at all with the limited disease model and the limited recovery on offer in any of them. I am 25 years clean and left them all after 8 years. I had done NA, CODA and SLAA. I never believed I had a disease. I did like CODA and SLAA for shining a light on deeper emotional problems and providing some tools to enhance my self worth. At 10 years I had a complete emotional breakdown/breakthrough when my emotional history that I had buried from my childhood came flooding out like a burst dam. But not before some seriously self-destructive behaviour (although I did not drink or take drugs) had tried to protect me from all that buried pain.
I would say that my desire to truly recover precipitated this holocaust in my soul, as once my fractured self came out and grief was my only option, I very quickly unfroze and lost much of my compulsive and self destructive nature. In between these huge wells of grief and I won’t sugar coat it, they were intense and long and many years of work, I started to really feel connected to myself and happy and at peace in a way I never had before.
I just wonder where this fits in with all the cognitive models. I like cognitive therapy and there is definitely a place for it in my life, but I am also a trauma survivor and my experience of this burst dam, which was quite the surprise to me, indicates that the psyche buries much that needs to be released in the emotional sphere. I have known many people who were sexually abused, coming from abusive, loveless and neglectful family homes whose self hatred and self destructive behaviour escalates the closer they get to the place where the trauma resides.
What are your thoughts and feelings about this? I am loving all these alternatives on the net and researching everything in an attempt to figure out what I would do when faced with trying to help an addict now that I would not send them to AA, NA, SLAA,etc…
Thank you very much.
Holly
Hi Holly,
There are a plethora of resources available to people with addictions. Just because some people struggle with the disease model does not mean 12 step programs are ineffective. This type of support has been around longer than I have and it has saved countless lives. I am glad that you found ways to beat your addiction, but I would not be so quick to throw out other alternatives for others with the same issues. It is a cookie cutter way of thinking and everyone is different.
There is one good thing about the disease model, and that is taking away some of the shame that many addicts feel and allowing them to finally open up about their burdens. Not to mention the court systems providing more treatment to addicts rather than punishment.
I wish you the best in your recovery and hope you fine the best that life has to offer.
Sincerely,
Ashley
Really? The court systems have done way more harm than good! http://www.youtube.com/watch?v=Z-jZ3NWI8uk
As a person who is in long-term recovery and is a counselor specializing in co-occurring disorders, I see way better success from clients in treatment courts than the ones who only go through inpatient or outpatient treatment. The treatment courts are changing lives!
Holly,
Great post. I am a fan of whatever works for each individual to make them a better citizen of planet earth. I’ve tried AA, and, for many reasons, it simply wasn’t for me. If there is one overriding complaint I have, it is the downright lie pushed by nearly every treatment center and AA itself that it is literally the only way to recover from substance abuse. Some will even go as far to to suggest, if not downright state out loud, that if you don’t follow this program, quite frankly, you will die. I know plenty of people who have gotten better without it, myself included. The steps are useful for human life in general, albeit intuitive and no more profound nor worthy of philosophical deification than The Seven Habits of Highly Effective People. In summary, accept the notion of a higher power who can and will help you out, take inventory of your character flaws, admit them to someone else, be willing to improve upon them, say sorry to those who deserve an apology, continue to check your actions moving forward, and help others. Again, all good things, but nothing we couldn’t probably figure out on our own. Another issue I have is the idea which is pushed heavily in that organization that the second you stop going to meetings, you’re going to drink and it’s all over. The thought of being sober for 10 years and still needing to go to a meeting everyday because I would have no other choice but to drink does not sound like a happy and joyous existence; as a matter of fact, I would absolutely rather be a drunk than live like that. AA is a good start for some people, but the thought of them trying to keep you in the baby pool for the rest of your life is unnerving to me.
My advice, look at it as one option for self help, give it a shot with an open mind, and don’t waste one time worrying about it if it’s not for you. It’s not for many people, and other options exist. After all, their success rate hovers around or below 10%, so let’s just pray it’s not the only option.
At the time Dr Benjamin Rush first proposed that alcoholism was a disease rather than a character flaw, people also believed that a slave’s desire to escape enslavement was a disease, “drapetomania”. At that time, “fever” was considered to be a single disease. At that time, doctors didn’t even wash their hands before touching patients. At that time, the idea that invisible organisms with their own interests might consider human bodies to be a source of food, shelter & reproductive resources would have seemed ridiculous.
It might have been forgivable, with the state of medical science at the time, to assume that liver failure in people known to drink copious amounts might be a disease that developed slowly over a long period of time. But we now know that it’s possible that overuse of alcohol might make the liver more susceptible to hepatitis, but that hepatitis doesn’t happen to everyone who overdrinks. We also know that people who never had a drop can catch hepatitis. It’s the infection, not the drinking – or desire to drink – that is the disease.
But, today, over a century after germ theory, disease can be defined as a physical form of dysfunction caused by:
infectious agents: bacteria, viruses, prions
poisons: mainly heavy metals like arsenic & lead
chromosome malformations, defective genes, malfunctions in epigenetic switches
organ malformation or malfunction
hormone levels over or below optimum
malnutrition, especially insufficinet nutrients like iodine or vitamins [& I mean diseases like pellagra & rickets, not feeling a bit tired & gobbling vitamins]
noninherited birth defects: low levels of poison or infections during pregnancy, malnutrition of mother, accidents during gestation, malformations of fetal organs of causes that can’t always be determined after the fact
The thing is, in all the above cases, it is possible to use physical measures to divide the population into two groups, those suffering disease X & those who don’t
And yet, even though the AMA originally panned The Big Book, doctors, especially American doctors, are heavily involved in promoting the disease concept of addiction/alcoholism. It could be that some aren’t versed enough in science to understand the weakness of the arguments in favor of alcoholism/addiction-as-disease as created/promoted by a failed stock swindler, some see the disease model as a useful way to scare people into better behavior, & some are making money running clinics that promote a theory that sets people up to be repeat customers. And, nowadays, the concept is so popular that some doctors who know full well that addiction/alcoholism is a bunch of hogwash have been intimidated by their employers to go along with the disease “theory”.
But what makes disease theory such an incredibly ridiculous proposition is that it’s now claimed that pretty much anything anyone wants to do more than once is an “addiction.” I’ve seen FBI profilers on TV saying that serial killers are addicted to killing.
I used to be a firm believer in the disease theory, but I’m kinda on the fence now. Your points are based on physical. What about mental illness and gentic disposition?
Why would you stop believing in germ theory? Has there been new evidence to demonstrate that bacteria are just adjacent to infections, not causing them?
Some “mental” illnesses involve actual physically measurable phenomena – schizophrenic brains show differences in size, and shape, that reliably change over time (the areas smaller than normal people get smaller over time). Most of what we now label as “mental illnesses” are about behavior & self-reporting of internal states. I’m not saying the people identified as “mentally ill” aren’t suffering, but suffering and disease, while they may overlap in a venn diagram, are not the same thing.
Do you know anyone who made a choice to become a schizophrenic? Do they have the ability to ditch their stymptoms after a few short days? Choices. That’s what the difference between addiction and disease are. I think we can all agree something drives people to habitually use hard drugs, but dressing it up and calling it something it’s not gets us no closer to understanding it than ignoring it all together will.
i personally believe that most addicts that cant seem to stop have a learning disability, they dont learn lessons like normal people. that may be the real disease.
I agree and basically said the same exact things stated here i.e. not a disease, but ones own decision along with reflect interest for positive gain theory behind addiction clinics, as a possibility. I feel its more then that though, or a mix of all your notions. My post was the ^^^^ giant paragraph above, though well written I still forgot to break it up a bit. However, I make some valid points, and I agree with you here. Something needs to change in this world, doctors and other people with creditable power are capitalizing, manipulating public views
“Specialists” can call things an addiction, as long as they recognize that addictions can be broken. Moral responsibility is still a part of the solution. NA allows for moral responsibility more than AA in my neck of the woods. I often go to AA and NA meetings to challenge some of the long held beliefs. I watch people go in to these meetings, stay awhile, then leave, come back, or never show up again. Something’s not working. My “sponsor” (he’s more of a friend, really, as we don’t officially work the “steps” and never pressures me to do so) always tells me “take what works and leave the rest”.
Also, I am learning that people are at different stages in their lives. Maybe they need the structure…for now. But even my therapist who is a die hard 12 stepper, tells me that I need to seek out a plethora of social support orgs.
Creating new synaptic connections takes time!! It is hard work too!!
But the “specialists” claim “addiction” is a lifelong, unbreakable condition that can be managed but not cured.
Of course it can be difficult to change behavior and habits, but that doesn’t mean the behaviors & habits one wants to change are a disease.
I believe Trish comment on disease theory that “some are making money running clinics” . I have a heroin addicted 21 yr.old daughter that has been to 3 rehabs, outpatient etc…Insurance covered most, but I had a lot of co-pays, medicine bills etc… They all taught my daughter that she had a “disease” and was “powerless” over it! After the insurance was up, and I wasnt waving a check in their face, none of them could have cared less about her, and thats the truth. After going through countless therepist, doctors, all advised after rehab stints, I’m convinced this is all about the money. If she truly has a disease, why doe’s this “disease ”
disapear when you are entertaining her?. Seems when she is entertained 24/7 , and your spending money on her ( taken shopping, lunches, parks, beach, etc..)
shes fine, happy and drug free. But once the money for entertainment runs out, she is suddenly back on drugs and has the “I have a disease” cry again.
I love my daughter more than anything in the world, but my view on this is the return to drug abuse is there when plain old boredom sets in. What happened to the tough love good old days where they just told people “get your &**^&## together? nowadays drug rehabs will have you running your loved one to every counselor in town for the rest of their life.
Disease? or Money racket
Maybe I just have a spoiled brat?
Disease can refer to a condition that causes pain, dysfunction, distress, social problems, and/or death to the person afflicted. Drug or alcohol addiction can be viewed as a mental disease that was brought on by choices in the beginning, paving the way for harmful abnormal behaviors during its reign(20 weeks to 20 years), and by choices end the cycle. Overt stress can have a negative effect on our psyche. We may choose to salve our feelings in many healthy ways: exercising, reading a book, communing with nature, cooking, having a glass of wine, etc. We may also choose to salve our feelings in unhealthy damaging ways: having five glasses of wine, smoking a joint or a pack of cigarettes per day, indulging in cocaine, meth, hard liquor, heroine, etc. Addiction is a disease curable by the level of determination behind the choices to turn the downward spiral around. The physical evidence proves it’s a brain disease, the cure proves that it is not.
Alcoholics Anonymous and other such Anonymous groups do nothing but preach you were born addict and try to act like it’s a disability. When you put a chemical in your body- that’s a choice not a disability. A disability is in everyway involuntary – there’s nothing free will about it. You drink alcohol or ingest a drug in any other way- that’s a choice. Doctors will say a so called addict’s brain is different from everyone elses just so they the doctors can get money to fund such pseudoscience studies and/or collect money from insurance carriers or Medicare, or maybe it’s to hide their own abuse. Statistics prove that those who abuse alcohol or other drugs (past or present), are at their core self-centered liars. Alcohol and drug abuse is a telltale sign of that and nothing more. But thanks to groups like Alcoholics Anonymous they’ll keep on cheating, lying, stealing, and using because these groups support that kind of behavior as long as the abuser comes to their meetings. As long as they aren’t inebriated at the meetings and recite the twelve steps along with the Serenity Prayer they can still lie, cheat, and steal and remain anonymous. Don’t let these abusers be anonymous anymore. Instead expose them publicly in every way for what they truly are – self-centered liars. Do not donate time or money to any organization that supports so called addiction recovery or abusers in any way. Remember these abusers are far from powerless or helpless because they CHOOSE to lie to, cheat, and steal from anyone to continue their selfish ways.
You are very uneducated and ignorant. how pathetic and sad. Just wait until someone close to you goes through a disease like this. WOW
This guy who wrote this knows nothing about AA. I am an addict and am not a bad person. I have suffered terribly from addiction. I have always felt different, separate, and apart from the rest of humanity. I am a college graduate and achieved great successes in my life. I am now sober and it is very very hard. I thank God everyday I’m sober and hope and pray I can continue on in my journey of sobriety. This individual is very ignorant and I would love to have you walk in my shoes and deal with the thoughts I deal with on a daily basis. You wouldn’t last. So rude and disrespectful.
But I would. Be rude and disrespectful. You have a big stake in being a victim, I’M HERE TO TELL YOU THAT IT ISN’T WORTH IT. I always felt different, separate, and apart from the rest of humanity. BUT SO WHAT? You mean you’re telling me that you feel anxious? Maybe you should check into psych meds. In AA they will tell you to use your higher power. That’s why you are suffering now, because you listen to laymen at AA. Being an alky doesn’t make you an expert on addiction. They are lucky to have any valid insights into their own condition. AA will make you slip sooner or later. You’re suffering because you are listening to the wrong message. You do not have a cunning, baffling, incurable disease. I’m not blaming you for the choices you made but it is time to take responsibility. LIfe is difficult and sometimes brings pain. Just take it.
For everyone who wants to criticize some for calling addicts selfish think back to the many things you did to your loved ones. You are self-centered thieves that lie so much that it seems to become a “disease” of its own. As you may be able to tell I ha e dealt with an addict in my life for a long time and he made stealing medication from me a habit vrom the time became disabled and started receiving prescription narcotics. He would steal from me and I didn’t die or have any compulsion to go and steal from anyone else. Since other family that’s we lived with told me I would be unwelcome in our home if I turned him in I was held hostage for three years and two failed attempts at traditional its everyone else’s fault rehab. My family even blamed me for him stealing my narc. He always had family protecting him giving him the freedom to do whatever he wanted. Happy to report my family after over three years and a refusal to change have allowed me to turn him in and he has been charged. For everyone that says walk in the poor helpless addicts shoes try walking in mine.
Your full of shit
Yes there are other ways to be sober but I saw a guy take his 43 years a couple weeks ago and he hasn’t slipped like you said people would.
Nice work Expose. In addition to all you say, there are predators and child sexual offenders mandated to these meetings. The meetings were started from a con man, narcissistic, womanizing liar and they were made for the same. Stay away people.
Anyone who thinks disease is a choice and not a disease is an idiot and obviously not a true addict. I would have never done the things i’ve done had I had a CHOICE.. THE ONLY CHOICE I HAD WAS CHOOSING TO DO THAT FIRST DRUG AT TWELVE YEARS OLD THAT SHIFTED MY BRAIN TO THE FRONTAL CORTEX TO THE MID WHICH MADE ME A DRUG ADDICT.
To say you don’t have a choice is just not true. I know. People need to face the fact that they DO have a choice . No one forced me to take that first drink/ drug- I knew in my heart I could have said no. I knew that the alcohol and drugs had addictive properties but I did it anyhow. That was my choice. When I finally stopped listening to people telling me that I didn’t have a choice- that’s when I was empowered enough to get clean. Telling someone they don’t have a choice because they have a ” disease” only helps to keep them addicted. Great article! Bravo! We need to tell the truth and stop hiding behind excuses. That’s what I did and now, finally, I’m free.
I could argue that rageaholics need to be “exposed” and called out as well.
No, you don’t get to decide what is or is not a disease, just because you want to get the kind of sympathy that society rightly offers to people who actually suffer physical conditions that are no fault of their own & make life painful, difficult or shorter.
you think when i was a little girl i thought ” im going to be an alcoholic addict t\when i grow up” no. you have no idea what your talking about. addiction is a disease called chemical dependency. for all you people who think that alcoholics and addicts are just low life people and use it as an excuse not to quit, you better dig deeper.
Hi Lexie,
Of course I don’t think that you decided as a life goal to be an alcoholic. But I do happen to think that you’re making a choice every time you consume a drink. Drinking and drugging are purpose driven behaviors – the purpose being personal happiness (or relief from unhappiness, which is still a form of pursuing happiness). I make no judgment about drinking or drugging (or even “excessive” drinking and drugging) in and of itself as a behavior for lowlifes.
While some people may deliberately use the disease theory as an excuse when explaining their behavior to others, I’m more concerned that many more will sincerely believe and embrace the disease rhetoric, and learn to be helpless as a result – becoming a self-fulfilling prophecy, living up to the lifelong disease view (as I did, once upon a time).
The disease theory has mainly gained acceptance because it allows our loved ones to explain behavior which they otherwise cannot understand – they see what we do, and the only thing that makes sense to them is that we must be sick, insane, out of control – diseased. The truth – that from our perspective, we believe that the feeling provided by drugs and alcohol is the most happiness available to us – is too simple, too obvious, and at the same time too incomprehensible for them to even realize. Likewise, it’s apparently too simple for counselors and other so-called addiction experts to realize.
When you realize that it’s simply a choice made in the pursuit of happiness, and yet you also get a glimmer that it might not be worth the price, or that there might be greater levels of happiness available to you – then you can change the behavior. From there, it’s all about exploring your options and making bold new decisions.
Best Regards,
Steven Slate
Author, The Clean Slate Addiction Site
Addicts might have the choice to pick up their first drink or drug, or return to it, but in the cycle of using after months or years of being physically and mentally addicted, there is no choice. No matter how much you want to stop, you are going to use if you are in that cycle. Maybe you swear you will not, lock yourself in a room to abstain- but once that craving hits, you will do everything possible to get out and use regardless of your prior promises.
Other than that i agree that addiction is not a disease. I currently struggle with using after months sober.
I agree it’s very difficult to change a habit, and to see that there is a choice. I really believe I just couldn’t see my choices, or I was afraid to change. I didn’t have the courage to do something different. That’s why education about choices/habits in school is so important, and we should teach that instead of scaring kids about drugs.
It was important for me to look at why I used drugs. Why I wanted them. What was I avoiding? Every thought of drug use comes down to avoiding/escaping something, I think. But I’m no psychiatrist, just a gal who has reflected a lot on why I did it. It took me almost one year to be completely emotionally back to where I was before I started the addiction. I think it was just my brain normalizing, forming new habits, gaining more strength from my activities, getting used to facing situations without substances. What kept me going was “don’t pick up no matter what’, and “take the next indicated step”. That kept me focused on what I had to do to move forward, instead of glamorizing the past.
I’m just grateful to both of you for sharing what you have learned, and are continuing to learn about the journey. It helps us all develop in our belief that the change we hope about ourselves is not only possible, but likely. Little by little…It’s process that takes as long as it takes.
Stay forward focused, Jen. You’re getting there:0) And, Kelly…Thanks for the inspiration you give above. I shared the link to your comments above with someone I know and care about. It resonated in them deeply. Both of these comments did.
“This” is the kind of stuff that we oughta’ make sure we are all doing in forums like this. It’s such a friggin’ awesome opportunity to share information regarding substance use disorder/addiction…but, as importantly to serve hope, health and well being in a compassionate spirit of humanity. That’s ‘evolution’, baby!
But you still DO have a choice. I know- I was addicted and I made the choice to do whatever it took to get clean!
lexi, I too never thought that when I grew up I wanted to become a drug addict but I did. Like my two brothers before me I fell into addiction. My brother just died two months ago, OD. I saw what it did to them but still CHOOSE to do it. No one made me no one forced me. We all have a choice in life, to pick up, not to pick up, to call our drug dealer or not call our drug dealer. Its not a disease its a choice, we may be chemically dependent on drugs because we chose to do them time after time, day after day after day, no one forced us. Us as addicts say we have a disease so we can blame the disease for us being addicts and not out choices to pick up the drug.
No, you made the choice. No one denies that you make the choice, but there is also an element of chemical dependency, which is called addiction. I think this site is confusing people about the two. You yourself, said it. “Us as addicts, say we have a disease so we can blame the disease for us being addicts and not our choices to pick up the drug.” Well, no. You should be blaming yourself. You made the choice to start doing drugs and you made the choice to become chemically dependent on them. HOWEVER, no one can sit there and seriously tell me that there is nothing addictive about crack or heroin or even cocaine. This site shows pictures of brain scans and tries to confuse people that this is the same as people who drive taxis. Great, but driving a taxi won’t make you lose your family or rob a store. Playing the piano won’t lead you to prostitution. Just because your brain changes doesn’t mean that the change is good or bad. It depends on how the change occurred. If your change is from drug use, that’s probably bad. What this site is telling us is that everyone just lacks willpower. That could account for a lot of people, but statistically speaking, that could not possibly account for every single addict in the world. It’s just impossible. The statistics involved would literally be impossible. The whole world would be lacking in willpower. The most recent study said there were over 6 million children living with one parent who was a drug addict at least. So, that’s six million weak-willed parents, minimum. Not counting single people. Also, in 2009, the United Nations Office on Drug and Crime released their report on drugs, which said over 1.3% of the world’s population was addicted to amphetamines. Last time I checked, the current population of the world was 7 billion people. That means 91 million people are weak-willed, just from amphetamines? That is not statistically possible. That sounds more like addiction.
Yes, I agree with everyone that putting the blame on a disease is bull. Everyone needs to take their own share of the blame. Classifying addiction as a disease does not mean that the addicted person is a helpless victim who is innocent. On the contrary, is is their choice. Even 12-step programs teach responsibility first. When you hear them get up there and they say “Oh, I don’t have a problem”. You’re thinking it’s BS. Everyone else is thinking the same thing, but AT LEAST HE GOT UP THERE. Making the decision to step in the meeting is a huge step for some people. At least they got off the bar stool or out of the shooting gallery. I think your comments are all a little naive. My wife struggled with addiction for a while and she needed help to get clean. Myself, I did drugs and when I got bored, I quit. Two different people from two different backgrounds. She has lots of emotional issues and extensive trauma in her childhood. I understand why she did drugs. I don’t excuse it. Neither does she. She constantly admits it’s her fault. Those who put the blame on the disease aren’t fooling anyone. I have to say this site is kind of insulting, to be quite honest. What if an addict were looking for help and this was the first thing they found? They would think they were just too weak and just keep drinking. If hitting bottom and coming back up was a choice, then explain all the homeless people who are out there who have hit rock bottom and still stay there because they are addicted to alcohol or drugs? They have definitely hit rock bottom. I have heard it from hundreds of them that they would choose to pull themselves out if they could. When given the chance, they reverted to their old ways. That’s not a chance, that’s an addiction.
“chemical dependency”…..as long as the drug is in your body. Once it is out of your body, you need to rely and apply scientific principles as outlined in neuroplasticity to ensure you never use again, or at least, greatly increase the chances that you won’t.
I refuse to say…”and I am an addict/alcoholic” at 12 step meetings. I will not reinforce a self fulfilling prophecy by repeating these words. I am a human being, with the propensity to do destructive things to myself and others.
To some extent, I agree with you that addictions should not be classified as a disease like cancer, meningitis or other diseases over which a person has no control. Where I disagree with you, however, is in your argument that addictions cannot be addressed through the medical model used to treat disease. Many clusters of behavioral symptoms that the medical and psychological fields classify as mental disorders vary in their cause and are usually attributed to a combination of physiological, psychological and environmental conditions. In fact, for many (or maybe most) of them, science has not been able to identify a cause. Lack of an identifiable cause for any specific disorder, however, does not prevent the disorder from responding to medical and psychological treatment. Thus, things like depression or addiction can respond to medical interventions that target symptoms both physiologically and psychologically. So, for example, the treatment for someone with an addiction might involve both medicine (although I think that’s often given to address comorbid psychiatric disorders) and therapy to help the person manage and reduce symptomatic thinking and behavior.
I disagree that classifying addiction as disease necessarily implies that the addicted person is helpless. This simply isn’t true. And it isn’t true even in some other conditions in which science has identified a physiological cause, like diabetes. The reality is that there are many diseases and disorders for which behavioral change is the key treatment (like addiction) or a major component of treatment (like diabetes or heart disease). Simply classifying a cluster of symptoms as a disease doesn’t remove responsibility for management of the disorder from the affected person. Even within the confines of medical disease (and especially chronic disease), people are required to make choices, every day, with regard to how they are going to manage their condition. For some, the only choice is whether to take their medicine. For others, it involves many more behavioral choices that determine whether their disease becomes better, gets worse, or simply remains manageable. Addictions are disorders that fall in this latter category.
Finally, I also disagree with you that 12-step programs teach helplessness. Which 12-step programs do encompass the concept of powerlessness, it does not involve an absence of choice. The third step talks specifically about making a decision to turn your life over to the care of God. The remaining steps also encompass many concepts of choice and require taking action – in making an inventory, making amends, etc.
Where you are right, is in refusing to let people with addictions get a free pass on their behavior. People with addictions have a definite choice regarding whether they will make the behavioral changes needed to manage and improve their disorders.
I do not speak from a scientific standpoint at all. I speak from experience. I am ambivalent to the idea that addiction is not a brain disease. There is one component of addiction that I want to comment on. That would be compulsive behavior. You say that compulsion is voluntary It is my experience that it is not. I was compelled, without relief or any forethought that I had a choice whether to seek out or use drugs. I could not stop. My brain was telling me not to stop until I had procurred drugs. I had to hit bottom before I found the courage to stop……I have been sober 2 years now. I still have cravings, but I know now I do have a choice. Before, I did not. And almost every addict is in the same boat.
I’m a bit confused Clayton. Do you think that at one time, you literally were incapable of choosing to stop, and that at a later time you became capable of choice?
Or – is it that you were capable of choosing differently all along, but you simply didn’t believe (or know) it before?
I did not make myself clear. I believe that I did not have a choice to stop. I think addiction is more mental then physical, although the physical need was overwhelming. It never became clear to me that I could live another way until a medical intervention from my physician and friends took place. Willpower plays a small role here, but it too cannot work if one has a malfunctioning brain. I speak for myself here……I could not stop. Period. Now, I have stopped. Not just because of the intervention, but because I have turned my life and my will over the God of my understanding. That is something 12 step programs have taught me.
Congratulations on turning things around.
I believe that you believed that. I also believe that you believed you had the right to treat yourself however you saw fit, even if that included seriously self destructive behavior. You may have believed it so strongly that no one else had the right to tell you otherwise, and you then had the right to lie, cheat, steal, conceal, whatever it took because no one could take that most basic right to destroy yourself away.
Perhaps a belief in a higher power helped you realize how not alright it was to abuse yourself. Perhaps for some it is deciding they have enough self worth that it is no longer acceptable to abuse themselves any longer. Perhaps removing that choice to choose addictive behavior is the critical difference which allowed to choose something different, and made the real change happen.
Repeatedly I hear addicts must ‘hit bottom’ and then change happens. Hitting bottom seems to mean that the addict decides the addiction is no longer acceptable. Something about the addiction hits them hard and they have to face the real consequences. They no longer believe it is OK to treat themselves, others, or whatever, with that kind of abuse. That is a choice.
I think the entier premise of ‘hitting bottom’ shows just how much of a choice and allowing themselves to abuse whatever they abuse demonstrates this completely. If that suddenly puts someone in a position to choose to not use/abuse, then it shows the choice was there all along, but they believed in their core that doing that abuse was Ok for them.
A choice.
Compulsion to use and abuse IS voluntary… it’s your “beast” that gains control of your body. It’s that voice that keeps telling you, “come on, it’s ok this time” – the beast is a heartless faithless lover that will always suck you in and do it again and again until you decide (choice) to say NO to it. and NO you won’t die>you also will not hurt anyone else physically, mentally or spiritually by using one more time. I had a real recent experience “letting down” a friend by my stinking thinking that I could have a couple of beers. WRONG. No real harm tho’, apology accepted and back on track. Thanks for listening.
but you can change your brain’s tendency to be OCD. I think the science of neuroplasticity is very exciting. I always felt like the moral component of addiction was the prevalent one that needed to be addressed. Why would the emphasis be so much on relying on a higher power? Who helps a person to adjust their moral behavior, historically? A higher power. So, whether you acknowledge it or not, the 12 step programs are using “moral methods” to change a person. Predominately, so, I would say. How about step 4: moral housecleaning. Making right (moral) choices is replete throughout the 12 step literature.
I have to say that I work in radiology and have had scans of my brain., heart, etc…..I don’t think it proves anything about addiction problem. Medical science is constantly changing and unfortunately not an exact science. I think people put too much emphasis on what one person says vs another as we r all different and wired differently. Even in utero, you can clearly see that each baby has. Different personality , as I am medical sonographer and in close relations to other imaging modalities. I completely disagree with the fact that it is a choice…maybe at first, to stay away, but I have seen people who have never had addicyion problems with cigarettes, alcohol, etc….and then. Been prescribed opiates (up to 77 yrs. old) over trauma, cellulitis, and become addicted in a matter of 3 days! That was not their choice, it was for pain and prescribed by dr
Thanks for the input Karen, but I have serious problems with the diabetes comparison:
A cellular malfunction is the root problem in diabetes. The symptoms are all caused by the cellular malfunction. The behavioral changes are all about regulating the amount of sugar intake so that those cells don’t get more work than they can handle (and thus symptoms are minimized).
Substance use is a behavior. If behavioral change is the treatment – then doesn’t that mean that you just choose to stop using the substance? It’s very direct, whereas the diabetes thing is indirect, and wholly different.
You can’t choose, as a behavior, for your body to handle sugar and insulin differently. You can only choose to use medicines which make up for the deficit, or choose to regulate your sugar intake so there won’t be so much malfunction. From there, symptoms may subside as a result. The cause is cellular malfunction. But in addiction, symptom and cause are one in the same – the symptom is using to much – and if the treatment is to change your behavior, then the cause of the behavior is chosen behavior. Do you see the circle you’ve sent me in?
Now, I know you didn’t say this, but your diabetes example makes me feel the same way I do when hear people say that “abstinence is the best treatment for addiction.” Huh? How is it a treatment? If addiction is using substances, and abstinence is not using substances – how is anything being treated? How is a disease or medical treatment involved? It’s just do it, or don’t do it.
I didn’t eat lunch yet today. I guess the best “treatment” for that is to eat lunch. I’m gonna go treat myself behaviorally now.
I know that certain ethnic groups are more susceptible to diabetes and alcoholism…does it really matter if you have destroyed your pancreas and liver by overindulging in your favorite substances that are pre disposed genetically to cause poor health? I know plenty of borderline (not on insulin yet) diabetics that will eat themselves into their graves because apparently they have NO voluntary control of what they put in their mouths and swallow. RIGHT!. Does anyone see my point?
It really does not matter if you are fighting for your physical survival. Maintaining your social status and personal relationships is ENTIRELY choice. Expecting others to make excuses for your PTSD or childhood trauma (oh you have to love me no matter what – NOT) is NOT acceptable. If you are driving impaired, I have serious issues with that. Sorry, that’s my morality. If you want to be miserable and punish yourself for the rest of your life, please don’t take me out with you. I am HAPPY!
Steven and Karen-
I would like to offer the following to help explain the differences and relationships between disease, addiction, symptoms, behaviors and causes.
The nutritional and psychological literature that I have consulted seems to be pretty much in agreement that addiction is a biological state in which our body has become acclimated to, or adapts to, the presence of a noxious or toxic agent (alcohol, drugs, unhealthy food) such that the toxin no longer has the same effect; this is known as tolerance.
Addiction is not, as Steven states, “using substances”; using substances is a behavior. A symptom and a cause are also not, as Steven states “one in the same – the symptom is using to much”. Again, using too much is a behavior. The behavior is imbibing the toxic agent in quantities and frequencies sufficient to create the biological state defined above as addiction. I think it’s important to distinguish between chosen behaviors(using substances, abstinence) that we are trying to change, the biological state caused by those behaviors(addiction), and finally the chronic diseases that may result from maintaining this toxic biological state at a cellular level(liver disease, diabetes, respiratory disease, etc). I believe that making these distinctions actually supports the model that addiction is not a disease and that the root-cause of the whole thing is changeable behaviors.
While addiction has it’s own symptoms(physical dependence, tolerance, withdrawal) and can be extremely difficult to eliminate, it isn’t necessarily a disease, which also has symptoms. The word “cause” could be used in many areas. Our behaviors may cause a change in our biological state, which may then cause certain chronic diseases, which may then cause certain symptoms. We might even say then that our chosen behavior is the root-cause of our liver disease.
Finally, I would say that this same model could be applied to a disease such as type-II diabetes. Our eating habits(behaviors) may contribute to a biological state(addiction), which may lead to diabetes(disease).
I hope this is helpful and I welcome your thoughts and any feedback.
-Don
Hi Don,
I appreciate your contribution to the conversation. But I must note that tolerance and withdrawal are not the same as what is known today as addiction. Specifically, the NIDA says that they are not one in the same, and that “addiction” as they define it needn’t include tolerance or withdrawal. When addressing the difference they state that addiction, or “compulsive drug use despite harmful consequences—is characterized by an inability to stop using a drug; failure to meet work, social, or family obligations; and, sometimes (depending on the drug), tolerance and withdrawal.”
Since this has come up several times in comments, I have decided to put up a page dedicated to this issue. It doesn’t necessarily address every point of your post, but you will find it relevant. It covers some of the problems I see most often when the issue of physical dependence is raised. You can see the page here: http://www.thecleanslate.org/dont-you-know-about-physical-tolerance-and-withdrawal-aka-physical-addiction/
To your points about causes and symptoms, I maintain that in many of the definitions and diagnostic criteria they are one in the same. The use of drugs is considered both a symptom and a cause of addiction. I promise you I didn’t create this circular logic, the various organizations who claim to be the authorities on addiction came up with this. Perhaps you misunderstand me – I like to point out the absurdity of it.
Thanks,
Steven
im not smart, logical, or a scientist by any means here,
i think at times, well the article starts off by say they are shouting from the roof tops that its a disease right? and a need for medical treatment(something insurance companies hope never have to deal with lol)
most of the article weather the arguing is for the diseas model or not a disease are looking at pictures that represent damage caused by a particular substance.
for the most part but not always in regards to emotions and behavior alcohol and different drugs are used sometimes to make a person feel completely numb especially in regards to emotions, and after certain people live that way long enough they have learned to become extreme in a way to not take anything seriously at all even consequences that come from making decisions based on self neglect and self harm that are probably hurting also the people around them,,, somewhere along time ago the word disease was used as a tool for someone like this to try to start learning how to take things seriously and how to learn to think about consequences before making decisions in order to make a healthy choice,, something else well known is that when people start getting better,, no matter what kind of recovery method they have used they tend to use that as club to beat over other people all the time and become demanding that everyone must be needing the same type of tool as a way to be happy as well in their own lives too,(which is not true) sometimes i feel this article might be showing anger towards those type of people that might have become demanding, and ya the reason they probably became demanding is that they might be in a new place of living without the slavery of substances and when a person experiences that type of freedom especially when it is new its possible that they go out and start shouting it from the roof tops! and sometimes for those same people if they continue on not picking up substances and continue to learn how to make healthy choices they can understand that shouting from the rooftops was perhaps thinking without the ability to have humility but still over all just a part of the recovery process of what sometimes is going on when substances start leaving a persons system. The scary part of this type of situation is that many people will use the word disease as a way to avoid making decisions and yes i can understand your anger as well.
No im still not a scientist but words like habit, addiction, disorders, syndroms, dependancy are thrown all over the place and yes all these words do have there own meaning, some say these words cannot be interchangable but they certaily can be very connected to each other, thats why even for legal substances such as cigarettes, caffeine, or alcahol they are called drugs because every individual is different and we will never know for sure exactly how someones own body chemistry will react once a drug is introduced into that individuals body?
im still learning alot these days and wonder if using logic to find one way to treat everyone (although i would like that myself) im not sure if that is really going to hold TRUE either.
I myself have been interested in all the words being used when it comes to drugs, im very interested in the word adapting as well, its okay btw if people don’t like the term disease although alot of diseases can get passed through genes and child birth even if that isn’t completely understood yet. Cancer they don’t know why through genes,, children of the same parents why one child can have a genetic dispostion for cancer while another child can avoid that gene, and i bring that up because especially with alcahol your body starts to adapt to that particular drug the moment a person starts using it and it can adapt to a point where a persons body cannot function properly without it, they can even die from stopping it
I disagree, these people need help and compassion….they did not ask to be in this situation, and that goes for others who may have decided to, either way, it’s a huge problem and being unsupportive is not the key. It would save many much money and pain, both physically and mentally. I had multiple brain scans of the type u r referring to, on and off meds and only a small percent were close to being correct dx
This is an important claim:
It’s wrong. Addiction does not respond to medical interventions. I have tried to find evidence that it does, but I just can’t. Treated addicts don’t do any better than untreated addicts. Epidemiological studies have shown this to be the case again and again. Gene Heyman lays out a whole list of such studies in his book “Addiction: A Disorder Of Choice.” I list one of my favorites here: http://www.thecleanslate.org/self-change/substance-dependence-recovery-rates-with-and-without-treatment/ This is from data collected in 2002, and is a follow up to a study done from data collected in 1992 – and the results are nearly identical! The point is, that when treatment centers claim any success, they’re only taking credit for self-change which would’ve taken place anyways without treatment.
And I’d like to know r these MRI with contrast which is what I did. As well as CT
The scan of the 2 brains (http://www.thecleanslate.org/wp-content/uploads/2010/09/volkow-brain-scan-300×224.png) is actually a scan of a normal brain and a person sleeping.
NIDA falsified their research dealing with marijuana.
Yes I agree it is a choice if used for other purpose, but not after the fact…and has anyone heard of the addictive gene? Not everyone has it so the lucky ones, I praise you, but for others,it’s not that easy!
And maybe disease is not the correct word, but more like a condition?
Thank you for this post Steven. I can see the trolls are at it again. Maybe they need something to talk about for the upcoming Christmas alchothon. Nothing new. I wonder if excessively clinging to 12 Step mythology and fellow indoctrinees is a disease too?
I found this site while doing research for an English paper. Before I started to access this kind of information, and after I had been going to 12 step meetings for 2 years, I did not really have a belief either way as to whether addiction is a brain disease or not. Never really gave it much thought, even though it is described as a disease by AA and the like. I read the text in this site pertaining to this subject, and was enlightened to say the least. I was compelled to write something about my experience in recovery. What I have expressed here is just that, my experience….nobody else. Now while medical intervention and 12 step programs don’t work for some, it has helped countless millions over the years. I am not a scientist, nor am I well versed on addiction. I am however, an addict who has had the obsession to use arrested. What has worked for me is mine, and I own that. I just wanted to share experience where I thought maybe someone would appreciate it. Chastising someone for putting themselves out there is unkind and inappropriate. As is with the name calling (trolls? really?) I stopped that behavior when I stopped using. I respect your right to express your opinion, have some respect for me as well.
Sanctimonious lately? I do find it fascinating that Steppers comment on blantly contradictory approaches to addiction as if their input hasn’t been heard 7 million times before. I respect that you had an experience in “recovery.” Some people, such as myself, who have left AA are angry. Sites like this provide many with validation who cannot find it elsewhere. And here you come along to bless the world with your “spiritual awakening” that, to put it frankly, many are sick and tired of hearing about. You don’t have a disease. You choose to believe that a supernatural entity removed your “obsession” just as you chose to retort to a post I made that didn’t care for what you had to contribute. I do think however that since you did find this site, some doubt must be lurking somewhere in your mind. Just remember: “your best thinking got you here.” Have a nice day 🙂
Not once did I say I had a disease. I did say that that was what AA suggests to its members. I am not convinced either way that addiction is a disease or not. So yes, I guess that means I have doubt. I think addiction should aptly be called a disorder, not a disease. I was not being righteous at all. I don’t think that just because I found help through 12 step programs that I am better than anyone else. But it worked for me, and that is all I really was trying to say here. I suppose that does make me a little biased, my bad.
I am not a religious person all, but finding some solace in a “supernatural entity”, as you call it, is for me, my God. I in no way believe in God as Christian religions believe. It’s just something for me to believe in, a “false God” of sorts. Look, I in no way meant to point fingers, or put myself up on a pedestal. I just know what has worked for me. That is my belief and opinion. And we all know what they say about opinions. Let’s just agree to disagree. I’m done.
Though I admire your more liberal stance as an AA member (and I am assuming you are), I loathe it at the same time. I think it’s really what pulls a lot of people in the Program, including myself. I knew a lot of people in AA like that. Traveling around to different meetings, telling jokes, going to baseball games, “fellowshiping,” etc… I was part of it too. Say one thing contrary to AA dogma and you instantly become the elephant in the room. The comportment of these “friends” changes faster than you can say the serenity prayer. I think it was this that bothered me the most. Of course, there are the obviously “crazies” in AA like the Big Book “thumpers.” But I think the real danger exists in exactly the more milder “we’ll love you until you can love yourself” cunning niceness that ever so slightly hardens at the faintest indication of dissention. It’s cruelty at its finest simply because it’s practically invisible to non-members. The loneliest feeling in the world. It’s infuriating just detecting this tone in your writing (oozing with sanctimony and Step-speak by the way).
Ryan, you sound like a jerk. I think AA has a flawed approach, but to to downplay someone’s good experience just because you had a bad one is simply being a jerk. It is okay for some people to make changes in a way that doesn’t work for you. And it is also okay to share that on a forum like this. Drug addiction is a problem whether you subscribe to the philosophy on this website or to the disease rhetoric – and people making positive changes is really what is important. If you don’t agree with AA, that is fine, and obviously many people would agree with you. But there is no common sense in being a jerk and trivializing someone else’s success, even it it came via a path you find wrong. Being a jerk doesn’t do you or your viewpoint any favors.
Joe, you’ve completely defeated your own argument by calling Ryan a jerk. His anger is as valid as your need to scold him.
Ryan,
Resentment much?
Paps
Hey Ryan, I agree with you I just left AA after almost 5 years when I realized how harmful it was to my psychological health and then realized it was a cult, and I was one of those people who would talk about praying to goddess or telling people you don’t need to believe in god at all, and basically was able to retain some sort of my own identity, but I still mixed it with telling people its a fatal incurable progressive disease and I wholeheartedly believed the stories that if I stopped going to meetings I would go crazy and die. since I stopped going to meetings I feel better than in my whole life, much safer, I got sober when I was 21 and didn’t believe it was a disease at all until I went to meeting after and meeting while I was in a desperate and vulnerable state and believed the bullshit message which I then carried for years. I feel better in some ways but now I am dealing with the fallout of realizing I was in a cult for years and feeling somewhat guilty of participating in it and roping others into it. but in the end I was vulnerable, I was sucked in and either people will leave or stay and it doesn’t really matter, as long as I have my self back and know who I am. I guess the last thing I want to say is AA really really really badly hurt me in a number of ways and that’s just as valid as AA helping another person. It deeply hurt me and terrorized me for years with stories of how if I left I would go crazy drink and die, but had no answer for the fact that meetings are full of predators. I was always told try different meetings. I tried so hard to make it work, but the healthier I got over the years the more horrible and pointless and depressing AA seemed to me, but now I am not chained to it and I don’t have to believe I have a disease.
I came across this site quite by accident, while doing research on Neurological diseases. I have had several memebers of my family afflicted with Neurological diseases. Specifically Parkinson’s and Alzheimer’s. Neither of these diseases is completely understood and neither is curable. I do not believe alcohol is a disease per se. It is still a baffling and strange affliction that isdifficult to vercome. I do believe I am powerless over alcohol. I am an alcoholic and have had success in straightening my life up with AA. I am also pragmatic about the program. It is not for everyone. It is certainly not the ticket for the many 17 year old alcholics and crackheads trying to stay out of jail that the court system has dumped on AA. Likewise, there are certainly a large number of folks in AA that have problems greater than alcohol. A good number choose to use it as a substitute for professional counceling. Alcohol merely exacerbates these problems But, there are also plenty of sincere and kind people that are willing to help a newcomer. AA has helped me.
@John S.
I am glad you find AA helpful and have remained abstinent for so long. I have to pick away at a couple aspects of your post however because I think it is very crucial. You say: “there are also plenty of sincere and kind people that are willing to help a newcomer. AA has helped me.”
Your last sentence clearly states that you were helped by AA. Correct? Before it however, you say that there are people willing to help ‘newcomers’ after stating that “AA is not for everyone.” My question is, what are the criteria for determining whether a ‘newcomer’ can be ‘helped’ by AA? If not met, would you ‘help’ the ‘newcomer’ find an appropriate alternative? What if the ‘newcomer’ expresses disdain for AA? Is he in ‘denial’ or on a ‘slippery slope?’ Is he told to ‘go to different meetings,’ thus undermining his own judgement? These are very important points for me as someone who has left.
You also expressed some disdain for ’17 year old’ ‘crackheads’/’alcoholics’ and their presense in AA, which, if I remember correctly, is a violation of AA’s fifth tradition (Each group has but one primary purpose—to carry its message to the alcoholic who still suffers). It also seems like a 4th Step may be forthcoming: see Chapter 5 of ‘Alcoholics Anonymous,’ page 417 might be great supplemental material.
Another question for you personally: As a person who, I imagine, ‘helps’ people with potential ‘diseases,’ I am curious as to what your credentials would be for involving yourself with the ‘treatment’ of a ‘disease,’ if they were?
You also say that some AA members have ‘problems more than alcohol.’ Are these particular AA members drinking alcohol as they attend AA meetings, so that it could be postulated that they may have other problems as well?
I think questions like these are very, very important. A lot of blanket, unclear statements, I find, are made in the promotion of AA. Hope I didn’t pick away at your comment too much.
Let me sum up what John said for you:
– AA isn’t for everyone.
– Alcohol addiction is a conundrum, but is different than other traditional diseases
– Alcohol addiction is difficult to overcome
– John bought into the idea that he is powerless over it
– AA may not be the right program for multiple issues beyond alcohol abuse, though it can clearly help some people (including himself)
– AA should not be used as a substitute for professional counseling, as there might be deeper issues that alcohol only magnifies
– People in AA are not villains – just because they subscribe to a questionable method of treatment does not make them evildoers. There are good people who put in the time to help those with addiction. Qualified or not, volunteers and “recovering” alcoholics are probably just trying to help.
My own point might be – clearly AA was not the right thing for you, and I agree that it is not the “right thing” in general. But it has/does help some people make better CHOICES, even if it is through that poor method. For those people, it has done good. Maybe they are brainwashed. But it is not your job to try to trump their happiness with your own feelings of contempt for AA.
Hope this helps clear things up.
It is challenging not to dip into passive-agression when responding to AA members. It is doubtful a comment here would change the beliefs of one. Critisicim of AA is very tricky to engage in. Your accusation of me ‘being a jerk’ and not a simple acknowledgement of ‘behaving passive-agressively’ is, in itself, quite irritiating. Whether AA ‘helps’ someone is not my concern. I expressed frustration with ‘blanket, unclear’ statements being made in its promotion that I believe are harmfully misleading.
One of your responses, for instance, I take issue with: ‘Alcohol addiction is a conundrum, but is different than other traditional diseases.’ I don’t believe it was deliberately calculated this way, but you first (perhaps having noticed that I don’t believe in the ‘disease’ concept) equate ‘alcohol addiction’ with being a ‘conundrum’ (a relationship I might find more palatable) then, at the end of your sentence, you re-introduce, now a bit buffered, the conept that ‘addiction’ IS a ‘disease,’ before generalizing and softening the equation by making reference to ‘other traditional diseases.’
I think this maneuver is, though not deliberately, unnecessarily mendacious and indicative of ‘disease’ proponents’ awareness that no one is REALLY going to believe that ‘addiction’ is a ‘disease,’ so it is tempting to obscure their contention in hopes that it will be accepted, at last.
As far as sites that promote AA doctrine, there are millions and millions. A comment on one of the far fewer quantity of more critical sites is doubtless going to deter any attendees from attending to make ‘good choices.’ Moreover, I have never, nor ever will, visit an AA sympathetic site to introduce ‘my views.’
I am all too pessimistically aware that AA ideology is truly beyond criticism and I think that is sad.
One last thing: your contention that ‘alcohol addiction is difficult to overcome’ is, in my opinion, a belief that ought to be challenged, as the moderater of this site has, I believe, quite admirably done. I can imagine people who are drinking ‘alcoholically’ already have that belief ingrained in them to varying degrees. I don’t think further proselytation of it is helpful to such people in the long run.
One last thing Joe, after having reviewed some of your other comments. You say, ‘i hate junkies and i hate how they are carefully babied and enabled by people with no balls,’ and recieved no response or charge of ‘being a jerk.’ While I do not wish to finger-point, I find it quite fascinating the double-standards that pervade addiction debates, mostly leaving criticism of ‘treatment’ virtually impossible (with ad hominem attacks), and far more vulgar admonishments of ‘addicts’ as seemingly welcomed and permissible.
I have to say that I totally agree having going thru pain and addiction for years ….and I work in medical field as a licensed professional, not a dr. But I have seen the med industry become hardened when I believe that compassion is key. Not one person I’ve met is proud of their issue and have enough of a difficult time trying to get help to overcome it. No one and I mean no one is perfect, and has no right to judge anyone else, . The sad state of healthcare and limited resources makes it even harder…I feel that this is one of the largest problems facing us and yet either money, shame, or being treated like less than the human beings that we are is unacceptable! Esp when md. And ers are prescribing traditional painkillers to all ages for all reasons and no follow up when left high and dry.
Obviously responses and forums like this allow feathers to be ruffled, but I appreciate interesting dialogue. And I can admit my too-quick reaction in saying “jerk” – I honestly do apoligize. (The veil of the internet can cloud my judgement to be insulting.) My point is simply that helping people make better choices, overcome an addiction, be productive members of society, etc. etc. (however you define it) should be the end goal. Changing the worldview on addiction can and should be a part of that, but not the only consideration. If someone actually did have success with AA, and found it beneficial, it is their right to feel that way, to be proud of overcoming an obstacle. The way I view an AA success story is not that a person is in remission/recovery from a disease, but that AA did likely influence that person to make different choices – which is not all bad. Even if their philosophy is flawed, this is a success (to that person). And if that person lives in fear of that “one drink that could send them spiraling,” then that fear is continuing to simply affect their choices, and the stance of this website is still intact as to why that person has changed. (Even if that person thinks they are powerless, you and I and others know differently.)
You and I seem to agree that this site’s message is generally correct, and that the “disease” idea is incorrect. I was paraphrasing John by calling it a conundrum – but if it was so simple, there wouldn’t be this site and countless others with varying ideas on how to find soultions to what is clearly a problem for many people. The topic is confusing, and though the answer may seem incredibly simple (choose different), it is difficult for many to not only accept, but to put into action that answer. Further, I was again paraphrasing for John by saying that “alcoholism is difficult to overcome.” Keep in mind, that whole post was in response to yours claiming that his statements were unclear. (And, if I misinterpereted John, I apologize – though he seemed clear enough to me for a web blog reply.) But how can you say it is not difficult to overcome? That, I am unclear on. If the belief is that it is all choice as this site suggests, then it is alarming to think that you, the site moderator, or anyone else believes that some choices are not more difficult than others. Addiction may not be a disease, but habits and lifestyles are simply that – habits and lifestyles. Lifestyle change is difficult, be it someone trying to diet, drink less, study more, take care of a baby, balance a busy work schedule, etc. Just because you make the “right” decision to do something (ie: stop drinking excessively) doesn’t mean that it is easy. To convince someone that making huge changes in their lifestyle choices is easy would be doing them a disservice.
Looking at your other post, that may have been another “Joe.” I just found this site yesterday, and never posted about hating junkies, etc. So, please strike that from the record!
Very good Joe, and I certainly can agree with you that forums like this allow feathers to be ruffled. I will not delve into my personal reasons for having so much contempt for AA, but will try to answer some of your questions:
‘But how can you say it [addiction] is not difficult to overcome?’
‘To convince someone that making huge changes in their lifestyle choices is easy would be doing them a disservice.’
I base my opinion on my conviction that alcohol and other chemicals contain no inherent ‘addictive’ properties and that it is mostly the belief that they do that can make the process excruciatingly difficult. Also, I have a bias towards Stanton Peele, and his general approach that addiction (to whatever) serves a very important part of an ‘addict’s’ life and is, in many ways, a function of mostly psychological and environmental factors. He has, for instance, brought attention to the fact that many US soldiers used heroin ‘addictively’ in Vietnam, for instance, but not upon return to the US. Sure not using heroin might have been a healthier and more moral lifestyle for them at the time, but ignoring the atrocious environment and its devastating psychological imprint and encouraging or coercing abstinence, would, in my mind, have been doing them a disservice. I find the general practice of disregarding these and less extreme factors, and mandating or pursuading permanent abstinence to be too reductionistic and due mainly to the predominant temperate and stringently moral climate of this country that has, perhaps, paradoxically led to higher addiction rates.
I have my own ideas about why addiction is so prevelant today and especially in this country, and so perhaps differ in some of my views. However, I do sense you have quite a bit more empathy for such individuals and insight into the phenomenon than the other Joe, for instance (my apologies), and so appreciate your consideration of my comments.
Ryan – At some point individual opinions prevail, and for all I know mine are hogwash. I cannot say that I have personally had a substance abuse or otherwise addiction problem. I have never been to AA. And, to that end, I credit my choices and actions for avoiding such things. I however and very interested in this topic. I have family members who have abused both drugs and calories, detrimental to their lives in various ways. I have been to fundraising events that openly use the words “disease” and “predisposed,” which simply rubbed me the wrong way. I have a level of empathy because some people are not educated enough to make better choices. Or, they make one bad choice and quickly fall into a negative pattern because they lack the will or succumb to external pressures (still, through their own choices). I feel sorry for them, and agree that if they “feel powerless,” their chances of making changes do not increase. I also have a level of disdain because, doesn’t everyone know “drugs are bad”? (Obesity is bad, too much alcohol is bad, etc.) So, part of me resents them for wasting the life they have as well as money, resources, charitable programs, etc. In short, my opinion wavers.
But no matter my level of empathy, I am a firm believer that will power can conquer it all, but I guess I just have a hard time believing that it is easy. Whether it is a choice, a chemical addiction, a lifestyle, a means to escape, or anything else, people sure seem to struggle with it. Maybe they struggle because society and the “disease rhetoric” tell them to struggle. Nonetheless, it seems that for many it is easier to continue using, and more difficult to stop. Whatever that reason for being more difficult, to me it stands to reason that it is in fact difficult.
Understood and well said. For myself, having drank heavily in college and experimented with drugs, catupulted into the ‘treatment’ culture (family coercion) and then getting demonstrably worse, was a horrible experience. It was like I never got to learn that drinking excessively doesn’t make me all that happy anyways and I won’t do it anymore. Instead it was psychiatriy, 12 Step Groups, a life-long battle, yadayadayada. All of which, I have had to ‘deprogram’ myself from and reconsider now. Hence all the independent research I have been doing (including this site). Since leaving, I’ve gotten a lot less judgemental on people who use drugs, behave irresponsibly, immorally, etc… I have come to understand that there are probably reasons for such self-destructive behavior that I am not the one to deduce or comment on (no more than Bill Wilson). For that reason Harm Reduction seems like the most ethical approach, but if anyone, like me, was interested in abstinece alternatives to AA, I would point them to this site or the works of Stanton Peele.
I will mention I was stuck for awhile in AA because I always felt the compulsive need to ‘help’ such people. Now that I understand that a lot of it is strong, culturally re-inforced beliefs and emotional difficulties beyond my control, I no longer feel that compulsion. The only thing I am vocal about (if only on forums, and then again only occasionally) are the publically hidden inadequacies and indecencies that I have witnessed occur in AA, behind all the ‘serenity’ talk. While, of course, I have met many pleasant people in AA, it wasn’t them that was driving me nuts, but the inextricable aspects of powerlessness, self-condemnation, and deceptive religiosity that drove me to leave, which, unfortunately cannot be divorced from the organization, despite any presense of ‘kind’ or ‘caring’ people. Moreover, I have witnessed too many people collect Time and grow even more insufferable to be around, into ‘spiritual’ parrots, or into ticking time bombs. I’ve seen more than a couple smart, creative, empathetic individuals lose those very precious qualities in ‘service to the Program.’
Thanks for this excellent site. Some years ago I was scared straight after waking up in ER strapped to a gurney convinced I had been kidnapped by a religious cult. I even asked the doctor to call the police so I could affirm otherwise, elliciting chuckles all around. I topped the leader board that morning, attaining a .35. So horrific (and expensive) was it that I had no problem fooling around with choice or not: My life at that time had been plainly revealed. I had got myself knee deep in hell and was not going that way again. I still smoked my pack a day, however, and had no thought about quitting. Until a friend of mine contracted viral pneumonia and spent a week in hospital. “I haven’t smoked in a week and I don’t even miss it.” I was happy for him. I thought this was the start of something new for him, and I considered my own situation in that light. But–only a few days back home, breathing from an oxygen bottle, reporting weekly to a lung specialist to whom he lied about quitting–he was back again on the usual smokes. That did something to me. A window opened and I stepped through it. I let go of the smokes. There might have been a couple days of discomfort, don’t remember for sure; but whatever discomfort may have been was not enough to drive me back into the fold. I reiterate: I just let them go.
Suffice it to say, I am again back in the fold. With yet significant behavioural and salutory differences. Not all has been lost from that morning in ER. One thing for sure: I keep it at home. (My buddy, Kerouac: “Try never get drunk outside your own house.”)
The point I’m trying to make is: it is not the substance used. It is the person using it.
We addicts are not just zombies. We are human beings. Just like the restive you.
I had an interesting conversation with a friend who has struggled with a food addiction. She weighed 250 lbs. She lost 80 lbs. She said addiction is not a choice. It is a disease. She said she has to really watch her sugar intake or it sets off uncontrollable cravings. She says she is in recovery now so her weight is normal. I ave watched a close relative struggle with this same sugar issue over many years. He has to work out relentlessly and is on an Atkins diet to stay fit. Whenever he ingests any sugar (which is even in bread), he just gets these extreme cravings that he says he cannot control, and every few months he will go on a binge, until he again decides to go back on the diet. Without that diet he would be a blimp. I have seen it. Is there any evidence to show these people have just not realized their power of choosing healthier habits/values instead?
Uh…. clinical studies have proven addiction to be a disease, the brain functions differently. It’s a disposition. As a recovering addict, who has been one year clean after ten years of abuse, I believe that in order to get clean, you have to treat the disease as a disease. Anyone who believes it’s a choice will eventually make the wrong decision. I’m insulted by this article. If addiction is a choice, then so is being gay or falling out of love with someone. Good luck with anyone who fails to admit powerlessness because if you can’t do that, there’s no way in hell you can get past the first step of recovery. If you think you can beat it and fail to respect how tricky the sickness is, then you’re bound to relapse.
To my knowledge, no research has ever proven addiction to be a disease. If you would read Steven’s article a little more carefully you might better understand what he’s so well explained (not only here, but all throughout this site) – – that there is nothing abnormal about the biological adaptation of the brain to drug use; it’s nothing more than the brain’s process of learning. The presence of a neurobiological correlate to a particular behavior does not mean one is powerless to control that behavior – unless you believe that free will is an illusion and humans are essentially robots, predestined to act out the dictates of their brain’s wayward neurochemistry. There is nothing abnormal about the pathology underlying “addiction” – the process is conceptually identical to any other form of learning.
To classify problematic drug use as an illness is to disregard the major distinction between drug-associated biological changes and the deliberate act of seeking, obtaining, and using substances. If I may quote Jeffrey Schaler – “drinking is a behavior, while cirrhosis of the liver is a disease; smoking is a behavior, while lung cancer is a disease. Drinking is not cirrhosis and smoking is not lung cancer”
When people reprogram themselves to understand that drug or alcohol use is a choice, they’ll become empowered to make their own decisions, rather than living down to the expectations of the recovery culture. Admitting powerlessness, and passively surrendering one’s will to an external source to fix one’s life, it all leads nowhere.
This is spot-on Derek, and you’ve said it far more succinctly then I ever have.
I thought addiction is always a choice, until I spent a couple hours this weekend with a friend who was an overeater for decades. She said it is harmful for me to tell people addiction is a choice, not a disease because it could make someone relapse. She does not go to meetings anymore, but she says she has, after 20 years, only now reached a point where she can eat a candy bar and be satisfied. She used to steal food and eat out of trash cans, hide food, etc. So my question is: To what then do you attribute the cravings that some get to alcohol or sugar, once they start eating, these uncontrollable cravings that don’t go away even after years,and that remain a lifetime struggle. Thoughts?
I think claiming to have an “addiction” to food is a totally different thing – mostly because a person can’t decide to not eat food any more.
But if we’re talking about people engaging in behaviors that they claim are not a choice, I have to ask – if someone has no control over their use of, say, an illegal drug, why do they do their using in secret – why does their “out of control” behavior not include, say, sparking up a joint at their desk in view of the boss? Obviously, they know there would be negative repercussions. So if they can control behavior enough to try to not get fired or arrested, they can control over their behavior.
As for this person who used to eat out of garbage cans and can now eat a single candy bar & feel satisfied – how could that be possible if that person has no choice in behavior? How did the ability to control the behavior in question come about if being more in control isn’t possible?
As for sugar, all primates find sugars very attractive. We are hard-wired to prefer foods that are concentrated forms of energy, so sugar, fats, honey, fruit are more attractive than lettuce leaves or celery or tubers that require a series of steps to process out dangerous compounds. Since in the wild food is not always reliable, creatures that could quickly identify and strongly prefer concentrated sources of energy would have an advantage that would be passed to the next generation.
I also don’t understand why, if a person who believes that s/he has an addiction and that this belief helps him/her to have enough self-control to not engage in behaviors that s/he doesn’t want to do, hearing someone saying, “I disagree” would be enough to make this person chuck a belief & behavior that works for him/her & go on a bender.
All good points, thank you for your response. For some, disease theory is easier to live with than taking responsibility, which is probably why she felt so defensive.
I still struggle to understand whether these people who cannot refrain from eating the entire gallon of ice cream are really overtaken by extremely strong cravings, or if they ate that first bowl of ice cream with the expectation that it would be okay to finish the entire gallon. But then again, who am I to judge what they are experiencing and if they want to label themselves as different from other people?
Wait. Is the use of drugs and alcohol a choice? Or is the abuse of drugs and alcohol a choice? It seems to me that if it were a choice, “alcoholics” should be able to control their alcohol consumption, even when drinking. Is that what’s being proposed here?
Yes, that is exactly what is being proposed here. People are in control of their substance use consumption at all times, even when we call them “addicted”, and even while they’re already intoxicated. They can always choose. I understand this sounds radical, but the science backs it up.
Here’s a link to an article on this site which gives references to several studies that show alcoholics don’t lose control of their drinking even after having ingested alcohol: Do Alcoholics Lose Control? The Results of priming dose experiments say no
Here’s a link to a recent article in the New York Times about Dr Carl Hart of Columbia University, who has shown the same to be true with several drugs such as methamphetamine and crack cocaine: The Rational Choices of Crack Addicts
It”s not radical…You just sound like a psychopath, that’s all.
Happy Holidays!
Matt
You only ‘sound like a psychopath’ Steven to those who have been indoctrinated into the cult religion known as the 12 steps.
Are you saying you were born an addict? Born addicted? I don’t think you were. If it weren’t a choice, then NO ONE would EVER be able to get CLEAN. You would ALWAYS use. If you were once addicted, and now you are sober, what made your disease ‘go away’? It just vanished? Into thin air? No…you stopped using. You made a choice to stop. We are not talking about tourette’s syndrome here…swallowing a pill or booze is not involuntary. It may be harder for some people to muster up the will power, and I think the more you use the harder it is, but it is not impossible. Don’t let these 12 step programs tell you that you’re an addict for life. It’s BS. You’re an addict when you’re an addict. When you’re clean, you used to be an addict. Don’t buy into the crutch and get labeled and set up to fail again and again. It started with one pill. One drink. Somewhere between THERE and ADDICTION you made millions of choices. You are not robots. You’re people. Use your beautiful minds and make good choices to be beautiful people. I think it’s incredibly awesome that anyone who was once addicted is now sober. INCREDIBLY AWESOME. I can’t say enough how incredibly awesome it is….Now go and be even more awesome by refusing to wear an ‘addicted for life’ label and refusing to be labeled ‘diseased’. Go on…do it…you know you want too 😉 Peace and love…
Jerri, that is awesome!
Amen, i particularly enjoyed the Tourettes reference as I have Tourettes, and what i find irony in is the fact that i can control my tourettes 90% and it is a REAL neurological disorder I don’t choose to “tic” but i can choose not to, it has taken years and a lot of will power but i can control and overcome it for the most part.
That being said it infuriates me when addicts claim they have a disease that they have no control over while i genuinely “suffer” from something that truly is involuntary, if i can overcome my tourettes they sure as hell can choose to NOT pour a drink or eat a pill.
Be strong people, most everything in life is a CHOICE, happiness is a choice as well, and i believe most “addiction” stems from not choosing to be happy.
If you do not choose to be happy with what you have right now, you will never be happy in the future.
There is more to life than drugs, and you TRULY CAN Experience a greater happiness and high than drugs provide, you just cannot be too afraid to be willing to try and experience it!
Amen Jerri!!
“Those who decide they need help to stop smoking tend to lack self-efficacy”, so their results are not indicative of all who quit smoking. 2/3 – 3/4 of smokers quit on their own! LOVE IT!
http://www.cnn.com/2012/07/11/health/diet-fitness/quitting-smoking-weight-gain/index.html?hpt=hp_bn12
“The data in the study include only those smokers who volunteered for clinical trials and attended smoking-cessation clinics, a “self-selecting minority of smokers who may differ in important respects from those who quit without professional assistance,” the authors write.
Those who decide they need help to stop smoking tend to lack self-efficacy. They might have similar problems with the dietary and physical activity behaviors important in weight control. So these results may not be generalizable to all smokers who quit because two-thirds to three-quarters of ex-smokers stop smoking without professional help or interventions.”
If AA and NA really worked, people would heal and 1. never have to go again, and 2. be able to drink normally.
If you are AFRAID of alcohol, if you think that having one drink will either bring you back to drugs or into a spiral of drunkenness, then you have not moved on from your addiction issues, you are stuck. A program that works will include teaching people to drink normally again. It’s fine if someone LIKES to be a teetotaler, but it’s not fine if they do it out of FEAR.
Just my 2 cents.
Ding, Ding, Ding! We have a winner! Kelly in a knock out.
Your nuts. I have been sober for 14+ years. I know that 1 drink will not happen. It will be a bender. My Grandfather was an abusive drunk, cirrhosis of the liver on his death certificate. My mother was a loving drunk, sober 6 years before she died and I have several cousins and a niece who are recovering alcoholics. Its in the DNA. I am a grateful recovering Alcoholic. If you study the mechanics of alcohol on your brain, you may understand why I use the term recovering rather than recovered. I have recovered from my compulsion, how every I still have the disease. If you are a heavy drinker and can alter that behavior and still drink, then you are not an alcoholic. Hats off to you!
Steven, I listened to that radio interview and I like what you said to the interviewer about your early rehab experience, when asked why you took the drugs. You said you liked it, and the counselor ridiculed you. When I stopped using drugs, and my husband and counselor asked why I did it, the same thing happened to me. They wouldn’t believe me when I said I liked it. So I had to keep searching about why I did it. Did you have to search about why you did it? Did you think that was necessary for you?
I lost my understanding of why I was using drugs for a few years. I began to believe the hype – that substance use, for an “addict” like me, is completely divorced from any sense of purpose, that it’s a mystery, that it’s driven by an elusive disease. As long as I “didn’t know why” I was doing it, my problems became worse. An integral part of change, for me, was getting back to basics, and knowing that I was using simply for the pleasure (and I also needed to make sure to disconnect the usage from any other “underlying issues” – more on that in another post, at another time).
I have a request for an article called “Why choose addiction”, or “why do they do it?”. I watched “30 on 30: Unguarded”, a documentary about basketball star Chris Herren and his oxy and heroin addiction. It is very good and brought tears to my eyes in places. The movie intersperses his story telling in front of groups of people with footage from his career and home videos. His addiction got even worse after he married (around age 20 I think), and had several children.
Steven, you often write addicts will stop when they find more meaningful activities, like work, family, etc. . But there is more to it! There are people who choose addiction when they do have a meaningful life already! Like Chris Herren, I had meaningful work and that same perfect family. He had home movie going on outings with the kids while high, I did that too. He had a double life, I had that too. He was good looking, athletic, I had that too. However, I didn’t go into those dark places of deep addiction after I had my kids. My husband watched the movie and he says I wasn’t that much different from Chris, that i’s just a matter of degree.
So watch the movie and think about it – the question really is, why does someone choose addiction? I’ve come to believe it’s a lack of knowledge of where it can lead. What are some thoughts on this?
This is good from the Time magazine article
“Surprisingly little research is conducted on the positive effects sought by drug users and what they actually achieve via their drug consumption; the assumption is that alcohol and other drugs are always bad and their users are irrational.”
Read more: http://healthland.time.com/2012/08/20/why-college-binge-drinkers-are-happier-have-high-status/#ixzz24JLNzaSH
I get to think about what I achieved with my drug consumption, and I get to put away the assumption drugs were bad and I was irrational. Wow, a great light went on. It’s true that I did exactly what I wanted and I only beat myself up over “why I did it” because I feel guilty about my husband and kids. For myself, I have no guilt at all, because I did not cause any damage, and the financial stuff I don’t mind because I wanted to do it and I can easily pay if off by working today. What a freedom this gives me.
Interesting that the writer complains about people not seeing that addiction is a disease, but the writer FAILED to state that sex addicts and likely other addicts also have the addicts disease!! Talk about unfair!
Wow. What a useful post and comments. I’m torn both as a addict and as a person seeking truth whether from a scientific view or spiritual view. What I do know is in the beginning for me I was “unbalanced” and CHOSE to self medicate. It was a CHOICE not a disease 100%. However, what I know now, is physically I can’t stop. There is NO CHOICE. If I stop I could hurt myself. Sure feels like a disease. We can all chime in with our smart debates but the fact of the matter is I’m a decent person who loves my children and can’t seem to find the way to FIX my life. I can’t WILL my way to getting over a cold nor can I WILL my way to quitting drugs. I could at the beginning had I “looked into my future” but I can’t NOW. So I’ll say it again it sure feels like a DISEASE but it also gets old feeling WRONG all the time. Whether it is or not only the atoms know for sure, right?
“Whether you think you can or you can’t, you’re right.” – Henry Ford
This pretty well sums up why feeling “powerless” is counterproductive. Apply this saying to your drug habit, and you might see that will power and choice are strong enough forces to do many things.
I have been to rehab and can tell youthe disease concept is complete crap. “They”-that is, usually councelors that have not one iota of what it is like to live with an addiction- brainwash you into beleiving this concept. Usually with a VERY high relapse rate. However, while I can tell you first hand that I believe most rehabs are just another business to prey on those who may be able to be swayed to follow the disease concept I truly do believe that it IS a genuiine mental illness and therefore we with this diisorder are ijdeed sick and can benefit from somw sort of therapy whether it be aa/na, spirituality, conventional therapy etc. But a disease? Sorry. No bueno. That is an excuse. I am a good person who has made bad choices. I now choose my family and Jesus Christ over alcohol and pills and as long as I put them first, I will be alright.
Mental illness is a disease. A disease of the brain. Just sayin.
Thanks,
I needed to read this today after a tedious and annoying day at the office, being disrespected by a single minded society follower of the disease model. Of course I was told I was the outsider after giving a referral for a non-12 step program, which ultimately helps the individual learn skills, make goals, and achieve accomplishments through changing and implementing new activities. So sorry for wanting to empower an individual! Naughty me! But yey to the pharmaceutical companies who will have another person groomed for a life of addiction in and out of treatment due to relapse (which is part of recovery remember!) – I’m being passive aggressive if you didn’t notice. Oh and the money they get for all those medications that they will end up getting. Whatever happened to ‘get your shit together’ and to taking responsibility for actions. Is smoking cigarettes a disease? No, but it causes diseases, so stop or get lung cancer, your choice. Alright, how about this then…do we send cancer suffers to jail? Oh, well if drug addiction is a disease, why do they all go to jail? Erm…okay, so what about personality disorders. I have been told in treatment clinics that a person should not only have a personality diagnosis because ‘there is no cure’ and that ‘they cannot bill for that diagnosis alone’. However, personality disordered people have significant differences in their brains…so why don’t they have direct treatment ‘cures’–because they are just like addiction–they can be changed with re-wiring like CBT, DBT and can change through personal improvements and hard work, (most cases I imagine). Oh malarky, what a mess this society is in. Bottom line, it’s all about money…if someone has a ‘disease’ they are in treatment, they ‘relapse’ because it’s ‘part of recovery’ and then the pharmaceutical and insurance companies get money up the yinyang for ever. Suprise suprise. And the longer we sit arguing about whether addiction is a disease or not, the longer they get to scoop up peoples lives and money. We all know addiction is not a disease, you are not a disease, you have choices and you can take responsibility for your actions. Yes, it might be hard, you need to re-wire your brain to feel happy about things that might just not feel so good at first, but it takes time and self-empowerment. I know it’s possible – I’ve done it myself.
Thank you! Couldn’t have said it better myself. Your passive aggressive sense of humor is a disease. Careful now.
Im so sick of hearing addiction is a disease. No its a choice, you did it to yourself. All it is is a cop out, a way to pass the blame and not take responsibility. Its pathetic. I used to be addicted to several things for years. I had the willpower to quit myself, so if I can just choose to quit, how is it a disease? People with real diseases can’t just decide to “cure” themselves. even brain diseases, people can’t cure themselves. When people claim addiction as a disease, it slaps people with a real disease in the face. Its a selfish move, and sickens me. Grow up, take some fucking responsibility, and face it. dont act like a little kid and pass the buck.
i too believe addiction is not a disease and I stay away from “voodoo” 12-step cults. I will go so far as to say addiciton is a habit formed as a maladaptive coping-skill. I see addiction as always coming from one or more underlying causes (it is not primary as disease-concept theorists like to say). Read “The Alcoholism and Addiction Cure” by Chris and Pax Prentiss from Passages Malibu.
Passages is very expensive. You can get the same stuff by reading The Forgotten Five Steps and working with a counselor in a few sessions. Underlying issues like depression, anxiety would require other work, I am not sure of what is involved. Or read the stuff on this site. Steven recommends St. Jude’s. How much does that cost? My friend needs rehab, and his family can afford the $18k for one month but don’t want to spend it so he’s going outpatient. I don’t see why changing a habit should cost tens of thousands of dollars. That’s just a scam.
Yes, very expensive (I know a couple of people who went there). I didn’t mean go to Passages, just get the book. On Amazon, it is less than $11 for the paperback. The book explains the philosophy used at passages so that you can apply the same principles to yourself.