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.
Wow. I had no idea there was so much hatred between non active addicts. If the disease model scares its believers into not using because they feel that using once will make them active again, how are they wrong? If you believe addiction is a choice and that you are no longer an addict then drink to that and go slam some dope, you can stop whenever you choose. I really don’t understand why addicts in recovery and addicts who no longer choose to be addicts are so creeped out by AA dogma. People can believe in a higher power if it keeps them sober. You all use to believe your own lies. I would rather have someone believe that an imaginary friend protects their sobriety rather then driving drunk? When did you junkies get so opinionated and self righteous? We normies don’t care how you got sober just please stay that way.
There is a thing called reality. It exists independent of what any of us a think about it. As human beings, we need to understand reality in order to make decisions that will help us to survive and thrive and continue to create better outcomes for ourselves. For example, if you understand the reality that fire destroys human skin, you’ll be sure to keep your skin away from fire. Make sense? You need to know the facts of reality in order to survive and thrive.
So, how are people who assert that addiction is a medical disease wrong? It is not, in objective reality, a disease. Bottom line.
It is not a condition caused by a physiological malfunction of some part of the body – it is not a disease. When we think that it is, we look for the wrong solutions to it. We look so far in the wrong direction that it leads us away from the truth and answers that would help people to deal with this problem in a way that works.
If you want to argue for scaring people into abstinence, that can be done without lying about the nature of addiction. We have a scare tactic called the war on drugs. Maybe you’ve heard of it?
I take issue with this part of your comment as well:
It seems you assume that because a choice is available (moderate use), that you should do it. It also seems that you assume the choice part is only about loss-of-control. So then, if you can use without loss of control, then you should use. I would just like to take this opportunity to point out to my readers that this is not logically implied by my assertion of a choice model, and I do not endorse such thinking. You should do what works best for you in your life – this may or may not include some sort of substance use. I can climb a jungle gym, and stop whenever I want – but I haven’t done so in too many years to count – because that activity doesn’t fit with how I prioritize my time and potential activities that will make me have a happy life.
“So, how are people who assert that addiction is a medical disease wrong? It is not, in objective reality, a disease. Bottom line”.
K smart guy….. then “WHAT” do you call the “condition” or “state” or “REALITY”…………of someone exhibiting these symptoms;
(by the way….these symptoms can and many times do “PERSIST” for months….even years and in some cases….”NEVER GO AWAY”)
Decreased coordination
Difficulty concentrating
Increased appetite
Slowed reaction time
Paranoid thinking
Drowsiness
Slurred speech
Memory problems
Confusion
Slowed breathing and decreased blood pressure
Dizziness
Depression
Euphoria
Decreased appetite
Rapid speech
Irritability
Restlessness
Nasal congestion and damage to the mucous membrane of the nose in users who snort drugs
Insomnia
Weight loss
Increased heart rate, blood pressure and temperature
Hallucinations
Greatly reduced perception of reality, for example, interpreting input from one of your senses as another, such as hearing colors
Permanent mental changes in perception
Rapid heart rate
High blood pressure
Tremors
Flashbacks, a re-experience of the hallucinations — even years later
Withdrawals
IF A PERSON IS SUFFERING FROM A COMBINATION OF ANY OF THESE SYMPTOMS AND THEY ARE NOT SUFFERING FROM A “DISEASE”………….. THEN WHAT THE HELL ARE THEY SUFFERING FROM MR. SLATE?????? TELL US THERE WISE GUY………… WHAT DO “YOU” CALL IT?????
YOU ARE A JOKE!!!!
Are you that thick? Or is your post a joke?
If you break your leg skiing, this doesn’t make skiing a disease.
If you walk among rattlesnakes and get bitten and poisoned, the medical condition isn’t “walking-among-rattlesnakeitis.”
As John Booth Davies, Professor of Psychology at the University of Strathclyde and Director of the Centre for Applied Social Psychology, said:
In case you’re unaware, the assertion is that addiction – which is usually described in some way as the act of taking drugs/alcohol past the point where they are causing considerable damage to a person’s life – is said to be a disease itself. The act, is supposedly the disease – the consequences aren’t the disease of addiction – the act of taking drugs/alcohol itself (or the imaginary “compulsion” to do so) is what is referred to as the “disease of addiction”. It is supposedly an unchosen behavior caused by some arrangement of neurons. However in reality it is no such thing.
As for these other conditions you raise, sure, they are diseases, medical conditions, illnesses, injuries OF THEIR OWN – I have no bone to pick with their status. However, the fact that many of them can be caused by heavy substance use says NOTHING about the habit of using substances itself being a disease. NOTHING, WISEGUY.
I cannot even believe I just replied to this comment.
Man….you have got to be the biggest F-ing moron ever!!!! Rattlesnakes? Skiing? Again you use the most idiotic, irrelevant, unrelated examples of life activities to somehow prove your ridiculous line of reasoning. As if somehow your analogies of breaking a leg and the act of getting bit by a snake are on the same par as a 20 year addiction to heroin!!! Dude….get your F-ing head out of your butt and at least “TRY” (I know that is hard for you to do) to stay within the realm of REALITY.
I HAVE NEVER ONCE SAID THAT THE HABIT (OR ACT) OF SMOKING THE CRACK PIPE OR SHOOTING THE METH WITH THE NEEDLE IS THE DISEASE!!!! If I take a hit of pot, or drink a beer, or smoke some meth….obviously I have NOT just contracted a disease. That is common sense. The disease model of addiction However, ….is when I continue smoking the meth or shooting heroin over a long period of time… and I then begin to make wholesale changes to the structure and chemistry of my brain. This is now when the “disease” or “condition” or what ever the hell you want to call it has set in. Because I now have DEVELOPED a host of symptoms that become my “EVERYDAY REALITY” …….. I now have the disease of addiction. WHY? Because now, my body has become dependent on the drug (heroin for example), my thinking patterns have become distorted and habituated to the point that I cannot focus on anything else except how I am going to get high for the day. I NO LONGER HAVE CONTROL of “the CHOICE” making areas of my brain and all I can do is repeat the vicious cycle over and over again day after day.
Dude, I am not discounting the FACT that many people DO quit using without treatment. But that is not what we are talking about. People have been cured of cancer by prayer for God’s sake!!!! It doesn’t matter the affliction or the cure. What matters is that a human being is suffering from an abnormal set of symptoms. And it doesn’t matter for how long the person suffers. Whether it is someone suffering from cancer for 10 years, diabetes there whole life, schizophrenia for 20 years, M.S….PTSD………………………….. OR SOMEONE REMAINING “ADDICTED” TO HEROIN FOR 10 YEARS….”UNABLE TO STOP USING” because they are now mentally incapable of doing so. NOT because in YOUR DELUDED MIND they should be able to simply use more will power. DUDE SOME PEOPLE SIMPLY “CAN’T” because of how their prolonged use has reinforced their “helpless” state.
You piss me off Bro honestly!!!
You seem to not only think you are so powerful and intelligent as to think you KNOW how “EVERYONE” should be “ABLE” to function. But yet obviously don’t know a “F%^&$#@-ing thing about what an addict “ACTUALLY GOES THROUGH”. To me…You appear cold-hearted, arrogant and display ZERO compassion, understanding and empathy. If we as addicts feel we are suffering with a disease and are struggling to quit…. Then give us that right to deal with our afflictions in that context and vein…..and leave people the hell alone bro!! FOR REAL!!! You (and other “choice” proponents) spouting to the world that “everyone” should be able to “just quit”….makes you people look like the most conceited, self-righteous people alive. Tell you what……….Why don’t you do an experiment tough guy and you put on a 20 year meth habit, or drink alcohol heavily for 40 years or shoot heroin for even 1 year and then come back to us and tell us how “easy” it was to just stop. That right there is what is so stupid about your argument.
Habits like brushing your teeth or other habits that you attempt to portray as the SAME as a drug habit are not in the same realm what so ever.
Once the disease of addiction is manifest in a persons life……….That is when the behavior and thinking becomes HABITUAL. The act of driving downtown and buying some crack is not a disease in and of itself. It is the “CONDITION” the body and brain are now in that forces the person to experience behave certain ways. It is not an “organic” disease that you claim is the only “KIND” that qualifies to be called a disease. But I don’t give a rats ass what smart asses like you think it should or shouldn’t be termed. It is STILL A PERPETUAL DYSFUNCTION OF THE BODY!!!!!!!!!! And so now in this example……it is nearly impossible to turn the car around and go home. I am driving down town to get my dope whether I like it or not. Trust me Bro….I have been there….where the cravings were so bad…. I HAD to get my dope in me to feel better and function. I could NOT simply say to myself…” yeah I think I’m done, forget it…. I don’t need this shit anymore, I think Ill go play some golf today”. HELL NO!!!!! Bottom line….I was suffering with the disease and I needed a major intervention, medical treatment and therapy. Now I have since been CURED of the Disease. I needed help. Some people can quit cold turkey. But we both…… had the disease. No matter what YOU say Slate!!!
It is absurd to deny that someone who doesn’t feel normal except when he has an opiate (or whatever) in his bloodstream, or who can’t stop thinking about cigarettes when he tries to quit smoking, has something wrong with him and the problem surely resides in his brain, rather than his pancreas to say that this state cannot be classified as a disease. What’s wrong with calling the condition a “brain disease,”? NOTHING!!!
That’s what makes this article and your “OPINIONS” useless and meaningless.
The only thing it accomplishes in my opinion is to expose you as being an arrogant person !!!
This site shows NO love, compassion as well as provides no HELP to those who SUFFER with addiction.
Try something else Slate. Really!!!! This article does nothing to help addicts or others understand addiction or provide hope or meaningful encouragement to those who suffer.
All it does is attempt to shine a light on “yourself”.
RYAN
Do we really have to do the skiing thing again, Steve??? It is absolute bullshit, and you know it! Come on, man…Do we really have to go over that shitty article you wrote aain? It was terrible! And now a rattlesnake…I know you can do better than that!
Do we have to go through this thing of you deliberately missing the point again Matt?
You can be outraged about the comparisons and analogies again, but it doesn’t disprove my point. All it does is make you sound like Crocodile Dundee saying “that’s not a knife!” But it is a knife. It has all of the essential attributes of a knife – it just happens to be small knife. But of course Crocodile Dundee isn’t being serious in that scene, he’s being colorful – he doesn’t really believe the smaller knife is not a knife.
You, on the other hand, really believe that non-essential attributes make for a different thing altogether. A voluntary behavior is a voluntary behavior – whether it results in negative consequences or positive consequences, or a mixture of both. Its outcome doesn’t determine its status as voluntary or involuntary.
A commenter presented a list of negative health consequences as some sort of proof that addiction is a disease/involuntary behavior. I presented other behaviors known as voluntary non-disease behaviors (skiing; walking among rattlesnakes; and missionary work) that can also result in negative health consequences, in order to show that a negative health outcome isn’t proof that the behavior that lead to the negative health outcome is itself a disease driven involuntary behavior.
Do you get how this works? It’s called abstracting and conceptualizing. It’s how human beings classify things and gain knowledge. You can be willfully ignorant about it, but you’re only making yourself look foolish.
But it’s not a knife…
He “can’t” do better than that!!!! He compares addiction to EVERYTHING UNDER THE SUN!!! It’s all he has!!! My question though is this. If ALL addicts should be able to make the choice to simply quit and be done with it………. How come Slate….in his testimony he states that he floundered around in different treatment programs for 5 years. Gee….. perhaps because he was in the same “mind frame” of confusion and mental instability (the disease of addiction causes) that most all addicts are in. Hmmmm…. I bet that never occurred to him before ehh? Addiction “hijacks” the brain and mind and prevents most addicts from simply “giving it up” and moving on. That is why most of us must go through the “PROCESS” of rehabilitation. That’s why most addiction experts and medical researchers have concluded that it is indeed A DISEASE!!! For some reason….. “choice proponents” can’t wrap their egotistical minds around the fact that addicts brains and minds have been altered structurally and chemically as well as psychologically (thinking) to a point where simply “choosing” to stop is nearly impossible. This is why people like Slate piss me off so bad. It’s not enough to be in the throws of addiction and suffering….but then we have to listen to people like him tell us “we are weak” and should be able to “just stop”. It’s not that easy for the majority of addicts. Teaching them that they do indeed have a medical condition that can be cured with proper treatment does a lot more toward providing hope and understanding of what they are going through than telling them the are simply….. “poor choice makers”. That just plunges a dagger right at their pride and self esteem….. telling them that there is something wrong with “THEM” personally…… and not that there is something wrong with the drugs themselves and the condition of their body that the drugs have put them in. God bless Ryan
Ryan,
You are exactly correct that my mind frame – i.e. my thoughts, beliefs, ideas related to substance use, my own abilities, etc – was what kept me having problems with substance use for so long.
However, I’m not sure why you think this implies disease. It would be great if you could explain that. Because, if the thinking that leads a person to a set of choices that ends poorly is indicative of a disease, then all thinking that leads to all unfavorable outcomes is disease. Wouldn’t that be diluting the term “disease” at least a little bit?
Diseases happen to you, regardless of what you think. You can’t reverse the growth of a tumor, or produce insulin by changing your mindset. But habitual behaviors can be changed by changing your mindset.
You said that I tell people with substance use problems that they are weak. I’d like to see you produce evidence of this claim, or retract it. I have never said any such thing. I go out of my way many times in my writings and the classes I teach to proclaim that such people are not weak, and are indeed quite strong, as evidenced by the stream of obstacles they clear in order to continue to do what they want to do. I go to great pains to say this is not a matter of strength and weakness of the will/willpower – it is a matter of what exactly you “will.”
While I have indeed referred to addiction as representing a poor set of choices in the past, I try not to use that language now, because I can’t judge whether substance use is a poor choice for someone else. However, I have never labeled people with substance use problems as “poor choice makers”, and that matters. I don’t believe that people are stuck in a state of being a “poor choice maker” no matter what their record of choices – I believe that people grow and change and learn and are always capable of making more beneficial choices.
I don’t know about you, but I was not born with all the knowledge needed for successful living. I’ve had to learn throughout life, and I have much more to learn. The fact that I’ve gone down some roads that haven’t worked out so well in the past didn’t mean that I was incapable of finding better roads for myself. I’m ok with learning from those choices, and improving my life. I wish everyone else could be ok with that. You don’t have to be perfect, and I don’t even know what perfect is. But I know that I can learn from my mistakes and try to improve.
I do not say that people are flawed personally because they’ve made some choices that haven’t worked out, and I don’t believe it. Again, none of us come into this world with the knowledge to make the best possible choice at all times. We have to earn that knowledge. It’s called being human.
Here we go with another fucked up Normy (someone who has never had an addiction and has no clue as to what he is talking about). You can bark, bitch and moan about what you THINK you know so it makes you sound like an utter idiot just like this article. Addiction is a fucking disease just like cancer. Fucking Idiot!!!!
Hi Joe,
I’m struggling to understand how calling me a “fucked up Normy” and asserting that “Addiction is a fucking disease just like cancer. Fucking Idiot!!!!” amounts to anything more than barking, bitching, and moaning. I’m also struggling to understand how it could do anything other than make you “sound like an utter idiot.”
Have a great life.
-Steven
Hear, Hear!!!
Your telling me people should do what works best for them to stay sober only if it is done in the context of the addiction model you argue for. How did you come to the conclusion that I prefer the disease model over the model you advocate? You could have just as easily concluded that I argue prayer works. But I did not argue in favor of any of them. War on Drugs? Who say’s that anymore? So you assrt that ambiguous campaign slogans don’t scare addicts into being sober? I don’t see how that discredits abstinence only. You won’t stick your hand in a fire because you know it would get burned. That leads me to believe that you would abstain from sticking your hand in the fire.
Allie/Jan
I argued against your subjectivism. Your comment (as Jan) basically amounted to everyone is correct it’s a disease, it’s a choice, it’s anything, why argue over it???
This is just insulting silliness subjectivism. Everyone isn’t correct, and it does matter. If you don’t care about it, then by all means, don’t come here to talk about it. I did not say you preferred the disease model – I explained why it’s silly to just take a subjectivist ‘everyone’s correct’ stance on it – by essentially presenting the idea that REALITY MATTERS.
It matters what addiction really is. The more strongly people believe the disease rhetoric, the more likely they are to relapse – and more likely to binge. It matters.
Your ignorance is really painful. The war on drugs is more than slogans – it is a bunch of laws and efforts aimed at putting drug dealers and drug users in jail as well. Avoiding the war on drugs is not so simple as changing the channel when a just say no commercial comes on. I mentioned it as an example of a scare tactic. Propaganda demonizing drugs, and big penalties for being caught with drugs. It’s a scare tactic. And rates of addiction have not gone down since it’s been implemented. The disease model, as you described it, is supposed to operate as a scare tactic (abstain, or you’ll drink uncontrollably until you die). I’m highlighting a commonality.
Also “who says that anymore?”
Are you really so obtuse?
I said no such thing as “people should do what works best for them to stay sober…” I said:
Try to maintain the focus of what your talking about. The low success rate of the war on drugs is unrelated to the fact that fear of relaspe causes some people to abstain from drugs. Addiction is unique to the individual that experiences it and what helps one may not help another. You can scream your black and white ideas all you want if your willing them to back them up. In doing so get your information from a website that challanges , rather than cherry picks arguments
Allie,
What exactly are the strong points of the disease concept? I’ll be happy to argue against them. Please let me know.
-Steven Slate [the author of this site]
I have been clean as they call it since 2010. I had a horrendous 12 year pain pill habit. Partly due to my own ignorance on the subject. The doctors should share some of the blame also. It did alter my chemistry. I suspect that I have had a chemical deficiency in some way before the habit and conclude I still have it . This is a very complex subject. After 4 years you still do not feel as wonderful as a person who had nothing wrong (no disease) should feel. It also takes a toll on your health that seems to have some permanent effects. At least for me. When my Mom died I had become used to thinking about things regarding her. My mind would just go there sometimes forgetting she was no longer around. The dependance and addiction differences are also blurred in recovery “science.” Unhappy or depressed people are known to be more suceptible to drug use. They try to self medicate away the discomfort. This might actually be the disease but the drug use is an attempt to compensate for it? I have accepted what happened and try to give myself the best diet and excircise to promote good health. And of course concentrate on growing away from all that with more interesting activities. It is fading away. But I still remember that extra good feeling. My cure is knowing what the situation really is what it leads to the next day and the next. At this point you know you simply can’t do it. And it is wise to be careful about it for the rest of your life, if you value it like I do. Many dead friends will let you know where this goes if you don’t make the change and keep it.
Sorry I somehow missed that this was a choice vs. no choice conversation. After reading these comments I wanted to add some more. I will leave the debate to those who know more than I do. My path was rehab and then meetings. Thousands of them by now. I was glad for something, anything to be there in my situation. The 12 steps commnunity did help me with acceptance and understanding that the outside world would never be able to provide. Even when I was at my worst low self esteem moments. I did see many who were in rehab due to the courts. Avoiding jail. They they sleep and you can spot them immediately. They don’t think they should be there and have decided it will do nothing for them. Also there are people forced to go by intervention. I saw some who had already relasped before ending treatment. Just waiting to go out and start whatever again. Also the rehabs and clinics are making money on return customers. In 12 steps it is ok to relapse as long as you come back. I do not agree with that unless it has already happened. It seems to me that you should never halfway decide to do something and plan to fail if needed. The right way should be to plan to succeed. My addiction was as serious as any. I tried to quit at home many times first before going to rehab. I lost my car and had no money left to live on. Some say the relapse rate is nearly 100 percent over time. I have not relapsed. I have to be honest and consider it may be a choice I made. That others did not? I seem to be an exception. Maybe I would have done this without the 12 steps program eventually. But I still know the support does help.
Forgot this. My first sponser. I specifically chose him for one reason. Unlike the others, that he was telling how a person would, after starting off powerless, become empowered through working the process. He could quote references in the book stating so. But after four years the meetings are a mixed blessing for me. Sometimes I feel like I am being dragged back to the old feelings when I hear a new person telling their thoughts. I know exactly what that felt like. And the new person is who we are supposed to be there for. I get a lot of inspiration from the old timers. They are great. But I do not feel this powerless situation should be life long. That can’t be right. Where is the getting better in that? I admit that I will continue to go and appreciate the recovery community always.
Thanks for your comments Jay.
I couldn’t blame you for missing the fact that this is about whether addiction is voluntary or involuntary – because without fail, most of the commenters who disagree with me make it into a debate between being a good person or a bad person; or between hating addicts and loving addicts; or between being “morally flawed” and a victim of a disease. It is rare that they ever attempt to delve with any substance into the issue of whether people with substance use problems are free to change or not.
Thank you for recognizing that that is what this is about.
-steven
Sure Steven. It’s a very worthy subject. I don’t know what the answer is. After about a month of missed sleep and meals I was not able to choose anything whenever other options became available. Powerless then. But after quitting I was free to choose anything pretty much. There is a lot of pressure from the recovery community whenever you get off track in their minds. I was expected to step aside and let others decide everything for me. Which I did for a while. I wanted the full advantage of my rehab. This was the worst situation I had ever been in and I was scared. To be out of control like that. But once thats over and you study all this. Then don’t you then have to choose never to do it again? So that must not be the problem. Because any sane person would at that point agree they have to stop. So for some something more is going on. My habit was equivelent to a strong heroin addiction but I do not have -overwhelming- cravings anymore. I have changed any patterns I could that seemed risky for relapse. That’s the part I don’t understand. I’m missing something.
Keep up the good work. Great site. – Jay
“However, I’m not sure why you think this implies disease. It would be great if you could explain that. Because, if the thinking that leads a person to a set of choices that ends poorly is indicative of a disease, then all thinking that leads to all unfavorable outcomes is disease. Wouldn’t that be diluting the term “disease” at least a little bit?
Thats the point!!! Dude…..you still don’t get it. YES all thinking CAN lead to bad consequences!! If I think I’m superman and can defy gravity and jump off a building I will die. But here is the thing……. Addiction involves MORE THAN JUST “THINKING”. Furthermore….. addiction “EFFECTS” THINKING!!! It influences thinking….. it controls thinking……it forces thinking….. it determines thinking!!!! DO YOU GET IT NOW??????????????? PROBABLY NOT!!!
But antyway…YOU JUST ADMITTED IT!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
AND I QUOTE…….
“You are exactly correct that my mind frame – i.e. my thoughts, beliefs, ideas related to substance use, my own abilities, etc – was what kept me having problems with substance use for so long”.
But wait a minute….. I thought you said….. Ahhhhhhhhhh
But I thought you could just choose SLATE??????????? WHAT HAPPENED BUDDY?????????? WHAT WAS WRONG BRO?????????? Why didn’t you just make the “choice”……huh????:
See that’s the other thing……….. No one is arguing that a person needs to change their thinking. That is part of treatment and recovery. IT’S A PROCESS SLATE…..ITS A PROCESS….I REPEAT….ITS A PROCESS!!!! You can’t tell “EVERYONE” TO EMPLOY “IMMEDIATELY” WHAT TOOK YOU 5 YEARS (ALLEGEDLY) TO DISCOVER AND APPLY. That’s the whole problem with your reasoning. This is why the term “disease” is used. It’s used because a person is “AFFLICTED” and many aspects of their life have to go through a transformation. And in most cases…(dare I even say YOU) it takes TIME and treatment. You didn’t simply make the “choice” to stop and move on with your life did you?……….. You didn’t have ALL the answers and you needed treatment just like everyone else. Again, you need to allow the addict to deal with ALL the elements of what they are going through. And teach them the “truth” that they have a problem that is more than just “will power”. Bro….. this is why so much research has been done on the brain and behavior and the “disease” model makes more sense. Just like any other “disease”…….. it takes “treatment” + “time”……to find a cure!!! The “choice to quit” is one thing…… but the ability to make that choice and follow through is what addicts struggle with. And it’s because they are suffering with the “disease of addiction” or “chemical dependency”. Your whole argument that it’s “just like any other thinking flaw” is not justified. It actually is flawed on so many levels. If that were true…. I could accuse you of suffering with the disease of “pride”. And quite frankly, there can be an argument made that we all have certain “human drives” and tendencies that can ALL lead to bad behavior and consequences. But again….the reason addiction is a “disease” is because of HOW the drugs and alcohol change (hijack if you will) our brain and cause us to REPEAT the behavior. It’s fine Slate to instruct that our thinking needs to change….but you can’t change our thinking until the brain’s chemistry has returned to functioning normally, we begin to replace the behavior with NEW ones and like you said….we begin to implement new thoughts, beliefs and gain new direction and purpose. But I’m sorry there is a lot more to it than just “a thought”. That is why the term “disease” is used.
By the way….. what the hell is your beef with it anyway? Why do you have such an axe to grind with a “WORD”? An idea? A scientifically accepted model….with Tons of evidence? The model fits and you know it…so why don’t you just leave it. What are you trying to prove anyway?
RYAN
When did I tell everyone in the world with a substance use to just get up and quit today with no process of thought whatsoever going into it? That would be absurd, and it’s not what I’m advocating. It’s a big life change, and there is a lot of thought that goes into it – and you can’t just run through all those thoughts lightning speed in an instant upon someone else’s command and then arrive at the choice to quit. That’s not what I am suggesting.
Nevertheless, it is a choice. All those thoughts and beliefs that add up to the preference for heavy substance use over all other things – are held voluntarily by the individual, can only be re-examined by the individual voluntarily, and can only be changed voluntarily by the individual. Choice, choice, choice.
I’ve never denied that all of that is a process. But it’s a conscious volitional process – it’s not a matter that starts by re-arranging some neurons. It starts by choosing to consider new perspectives on what you think and believe.
You can shout that:
all you want, but you need to define what addiction is and how exactly it controls you, if you want to be taken seriously. That’s a large claim, and the burden of proof is on you with that. There is literally no published proof that some physical abnormality of the brain causes a preference for drug taking. None. I even recently added a quote from a 2013 paper by Gene Heyman PhD in which he says just that:
If you’ve got the proof of a causal link, I’d love to see it. If you have more baseless assertions though, I don’t care to hear them and I will no longer respond to them.
You ask:
The disease model is misinformation. If people believe it, they are more likely to “relapse”; more likely to binge; less likely to change long term; more likely to have this problem last longer in their lives than it would if they would just start seeing it as a freely chosen behavior based on freely chosen thoughts and beliefs that they can freely choose to reevaluate, rethink, etc and find better choices for themselves. I’m trying to prove that people are free because it is the truth, and truth will help people to get the best results for themselves. Misinformation hurts people.
-Steven Slate
“All those thoughts and beliefs that add up to the preference for heavy substance use over all other things – are held voluntarily by the individual, can only be re-examined by the individual voluntarily, and can only be changed voluntarily by the individual. Choice, choice, choice”.
Your stupid stupid stupid…..
Held “voluntarily” huh?? Where is your scientific evidence of that slate?? Your saying that a heroin addict each day needing their fix to feel better is voluntarily sticking the needle in their arm for the millionth time when he “COULD” OR “SHOULD” be tossing the needle in the trash instead. Research as well as experience shows the exact OPPOSITE!!! You didn’t read a damn thing I wrote did you!! Shocking!! People in the throes of addiction are NOT VOLUNTARILY THINKING THE WAY THEY ARE!!! They are thinking based on the condition their body and brain is in. Ever see a crack addict “fiend” for dope ALL DAY LONG…. MORNING…NOON …AND NIGHT?? Their like Robots dude!!!
Of course everyone should make the choice to stop using drugs….and ultimately (if they don’t die first) everyone will have had initially “made that choice” at some point, sought treatment and eventually recovered. But it is still a disease they must make the “choice” to heal and cure.
“The disease model is misinformation. If people believe it, they are more likely to “relapse”;” Oh yeah…where is your proof of that?? You got ant stats to back that absurd claim up? In my experience (and most of the REAL world of medicine any behavioral psychology)….when an addict is told that they have a medical and psychological condition that needs to be treated… they don’t feel so bad about “themselves” and they tend to approach treatment from ALL angles. Telling an addict…that “they simply don’t think right” hurts their self esteem and makes them believe that they have character flaws or they are weak or unintelligent.
Dude….your lost!!! I’m Done!!!
Good luck with your little “ego” driven quest to do whatever the F%^&* you think your doing!!!!
So much hate, it’s sad really. I feel refreshed after reading the author’s words of truth. Several years ago when my husband, who was too young to die, did, my world was turned upside down. I turned to consuming excessive amounts of alcohol and “zoning” out from the pain and everything else in my life. After two years of this hell and every day saying to myself, “tomorrow I will not drink”, while cursing my throbbing head, sore muscles and God for causing this pain and agony on me. One morning looking blurry eyed and groaning over having to drive my precious daughter to school so early, snapping at her and loathing myself again, I vowed no more! I exercised “my choice” to stop hurting myself once and for all. To say it was easy and that day was the last drop I swallowed, oh if only it were so easy. Yet, two years later, clear eyed, clean and sober and loving myself each day I wake up feeling stronger than the next day. I have always had an addictive personality whether it was drinking, diving, running, I had to be the best at it and I was the best alcoholic on the block! Is having a competitive or addictive personality a disease? I think not. We make choices every day of our lives, have another piece of cake, have an affair with that cute little blond, have another drink, our choice or decisions, our destinies.
The reason why it is termed a “disease” is illustrated by exactly what you stated………”I turned to consuming excessive amounts of alcohol and “zoning” out from the pain and everything else in my life”. Why did you do this Katherine? Why didn’t you make the choice to quit while you were in the throws of this state? Why not after a week? A month? 87.5 days? You then say…….”After two years of this hell and every day saying to myself, “tomorrow I will not drink”, while cursing my throbbing head, sore muscles and God for causing this pain and agony on me. One morning looking blurry eyed and groaning over having to drive my precious daughter to school so early, snapping at her and loathing myself again, I vowed no more”! REALLY? What took you so long????????????? Why two years of this “HELL”?????// See that is the point……..you were “caught up” in the “GRIP” of addiction!!! This is simply why it is deemed a disease. Why do you people not get this?????? Mind boggling!!! Of course at some point you made the choice and everyone does (unless they die first) to quit….but you still admit that you DID NOT QUIT COLD TURKEY AND THAT IT TOOK TWO YEARS TO RECOVER. Thats another component that justifies the disease model is the fact that we need treatment and various forms of assistance to recover fully. Again………………………………………….DISEASE….DISEASE…..DISEASE!!!! And what’s even more crazy….is that you admit that you have an “addictive personality”………..NO…you just happened to “SUCCUMB” to the “POWER” that drugs and alcohol have…..like most people do. THAT’S THE DISEASE!!! It changes you…physiologically and mentally until you are “powerless” to control it. Have you ever been around a crack addict or heroin addict and witnessed them crave the drug 24/7? Robots!!!! And why do you think you stated that over and over and over again for 2 years you vowed to quit time and time again but were unable to????? Again….that’s the disease aspect of it. And lastly, why do you people attempt to equate choices made (diving, running, eating cake etc…) while in a normal (non inebriated state) as being the same as choices made while under the throws of addiction where you are intoxicated and your mind is altered 24/7. Amazing!!! P.S….no hate here hun….just stating my opinion. God Bless…..
Ryan,
Another defensive lunatic, who I hope was under the influence of drugs and alcohol when they wrote this belligerent streak of verbal diarrhea because if this was composed by a sober person, then we are clearly confronted with a lost cause. I’ll say it a million times, it took a series of POOR CHOICES to produce the hopeless state you describe, Ryan. No matter how you spin it, it started with a series of choices, and, therefore, it all comes back to choice. You’re defensive posts suggest you have trouble facing facts, but allow me enlighten you on the fact that all the bad things you did, all the people you hurt, and all the things that still make you cringe were a product of your own choices. Does this mean you’re eternally evil? Of course not. But have the decency and courage to stop blaming you’re disease for your errors in judgment. It’s like a fat person blaming the spoon for their obesity.
I don’t even think my response will be read based on all the previous responses. What I love and what I believe based on my own addictions is that some May need the structure of a 12 step program and some May need to classify this as a disease.. The brain and body is plastic. There are many studies that support adaptation in neurotransmitter due to chronic use of any drug. Studies that support the heart protects itself to infarction with chronic users. Unfortunately, there are users that exceed their bodies abilities to absorb the assault. This will never be a deterrent. No addict thinks it will be them that dies from overdose even though every addict has cruised er’s or fire stations thinking a fatal reaction was around the corner. What I LOVED about this article was truth in the amazing ability for our brains to correct even many years of damage. I believe that many addicts fall into the belief that changes have occurred from their behavior that will result in lasting irrefutable changes.. That is not the case. I used cocaine for over 10 years after 20 years of abstinence. Non of it had to do with brain changes.. It was my choice. When I was done.. I was done.. I encourage those to realize you can just stop. It’s not an act of god or a decision that requires you to right all ur wrongs. Sometimes it just becomes a habit.. Move on..
If addiction ran in the genes then every human right now should be an alcoholic, considering how much people drank in the 1500s through 1800s.
People are more likely to become alcoholics when their parents were. The fact is, when AA meetings tell people it’s in the family, it vindicates alcoholics by letting them blame the fathers they hated so much.
Yet, most drugs weren’t around before the 1950s. The 20th century invented over a million drugs, some of course just variations of others. How did these drugs run in our genes all of a sudden? Why is cocaine entwined in an African person’s? Why would a family who knew nobody among them to ever have touched a drug suddenly see their teenagers using all kinds of hard shit?
Hmm, obviously, then, addiction is not genetic. The reason the family’s newest generation is using chemical substances is because most places in the world are now flooded with drugs. Humans have always strived to attain a higher reality away from the relative hell that is their lives. So drugs are the easiest way to break away from one’s emotional agony and boredom.
Second, addiction is a habit, only made tougher by a need to normalize one’s feelings/body by using regularly to avoid withdrawal symptoms. We take drugs (every one who has ever tried something or uses even rarely) to cope/escape reality. That is that.
Third, if addiction really was a disease, especially a progressive one, then why do addicts not consume themselves to death? If a heroin addict was given thousands of pounds of heroin, there would be quite a lot left, and the heroin user would probably still be using it a year after if an immediate overdose didn’t kill him/her first.
Addicts should be getting worse every single day, because that’s what diseases do when untreated. Unfortunately, for that line of thinking, many addicts maintain a constant level of use year in and year out. Some alcoholics can use two pints, the exact quantity taken by the average Russian every day, while others take in an extremely deadly amount around half a gallon of hard liquor. Same applies to every other drug addiction, opiates, meth, speed, marijuana, whatever.
The disease nonsense was that from the start, conjured up by a primitive doctor of the 1930s. It will gradually die away from here. Don’t waste your time arguing with those who’d rather be coddled over and not have to admit responsibility.
The theory will die, and drug addictions will continue to spread.
To Parker and the other cowardly, hostile defenders of the disease theory, which, conveniently excuses you from all wrongdoing in the past, please put down your guns and listen for one second. As this comment below shows:
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.
At one point, you, admittedly, had a choice. No one is disputing the fact that, once physically addicted, a person looses a large degree of choice in the fight against taking the next drug, but you’re completely overlooking the fact that it took a series of choices to get you to the point of chemical dependency. I don’t imagine too many people wake up one day with an insatiable desire to shoot drugs into their veins at the risk of jail, destroyed relationships, financial ruin, etc…and it’s hardly plausible that one use of even the strongest drugs could immediately trigger cravings and withdrawal symptoms. One gentlemen made a comment to the tune of “walk one day in the shoes of a junkie and tell me it’s a choice”…once again sir, you didn’t magically become a junkie as would be the case if addiction were a disease, you made a series of un coerced choices that landed you in the junkie shoes you reference. As an ex cocaine and alcohol abuser, I know what it’s like to crave and disregard the feelings of loved ones for my own selfish needs. Some of the things I’ve done make me cringe, but I’ll be damned before I dodge responsibility by claiming I never had a choice. Maybe I had little choice by the end, but this was a result of choices I had already made. I hate to be offensive, but to all those shamelessly attributing their past mistakes to a disease they couldn’t control, be a man, and accept the fact that some of your past choices had undesirable consequences. Thankfully, this doesn’t mean you’re forever an evil person, especially if you’re cleaning up now. Only, man to man, don’t be a complete coward and suggest to a bunch of people who’ve been right where you were that you had no choice in the matter. This wouldn’t pass the scrutiny of a three year old.
Thanks for the kind words jerk!!! Look smart guy…..OF COURSE CHOICES WERE MADE TO BECOME AN ADDICT!!!!! The thing is that once addiction takes a hold and your brain becomes changed chemically and physiologically…..the “disease” condition becomes set it. It is “THEN” when “CHOICE” becomes nearly impossible. Dude take your tired arrogant talking in circles ass somewhere else!!! NO ONE EVER SAID THAT CHOICES WERE NEVER MADE YOU MORON!!! BUT THE “CONDITION” OF CHEMICAL DEPENDENCY IS WHAT IS REFEREED TO AS THE “DISEASE OF ADDICTION”. MAKING THE INITIAL CHOICES TO TRY DRUGS OR ALCOHOL IS NOT THE DISEASE DUDE!!! IT’S “AFTER”CONTINUAL USE THAT THE DISEASE MANIFESTS!!!!!!!!!!!! KEEP YOUR SHALLOW OPINION IF YOU CHOOSE BUT STOP BAD-MOUTHING THOSE WHO HOLD TO THE SCIENTIFICALLY HELD MODEL.
Ryan,
It’s clear that you are still restless, irritable, and discontent. So I’m a jerk, a moron, shallow, and arrogant for having a different opinion? Ryan, be honest with the community, how much cocaine have you ingested tonight? No “serene” grown man would throw a cyber tantrum like that sober. I gave you the rope to hang yourself with, and, predictably, you reacted like an immature lunatic on a forum intended for mature debate. My point is proven and I genuinely don’t want you to have an aneurism, so I will refrain from further conversation with you in the future. I’m sorry that abstaining from substances did nothing for your peace of mind, and that you lack any semblance of spirituality. Thankfully, you can soon go hold hands with other like minded grown men and complain about how unfair your life is. Peace, god bless.
You end that arrogant self-righteous ATTACK with……….Peace, god bless!!! Your laughable!!! P.S….your “opinion” is NOT PROVEN!!! And to accuse someone of being high just because I tell it like it is (YOU ARE A MORON)…..is also laughable. You didn’t read a FUCKING thing I said…..all you can do is defend your bullshit with attacks. You are shallow because you cant even acknowledge the endless amount or research and science backing the disease model. Also, we who hold to the model have every right to adhere to it and just because we blast back at ego-maniac PUNKS LIKE YOU……………all you can come back with is “how much cocaine have you smoked today”. And then you play the “mature adult forum” card. What a fucking loser you are!!!!!!!!!!!!!!!!!! You are a pathetic jerk because you have NO IDEA who I am how “spiritual” I am and you make accusations with NO PROOF OR EVIDENCE…………………and lastly you are a hypocrite…….claiming to be spiritual while doing nothing but spewing insults!! People like you SUCK!!! You have NO FUCKING CLUE WHAT I WENT THROUGH AS AN ADDICT OR MILLIONS OF OTHERS WHO SUFFER OR ANYTHING ABOUT IT!!! AND YOU HAVE THE NERVE TO TELL ME AND APPARENTLY EVERY ONE ELSE THAT WE “CHOSE” TO HURT OUR FAMILIES….ETC…………..YEAH LIKE I WOKE UP EVERY DAY CONSCIOUSLY SAYING TO MYSELF….”I THINK I WANT TO HURT THE ONES I LOVE TODAY…..YA KNOW FUCK EM…..I WANT TO GET HIGH”. AND I MADE THAT “CONSCIOUS” “CHOICE” “DECISION” EVERY DAY FOR OVER A DECADE!!! I THOROUGHLY THOUGHT IT OUT IN DETAIL EVERY TIME…..RIGHT BUB??????? AGAIN………………YOU ARE A FUCKING IDIOT!!!~!
Ryan,
If I even closely resemble the litany of unprovoked insults you launched at me, why are you concerned about the opinions I’m suggesting? Ryan…you are categorically insane, sober or otherwise. Want proof? Read your own hysterical, effeminate post:
You have NO FUCKING CLUE WHAT I WENT THROUGH AS AN ADDICT OR MILLIONS OF OTHERS WHO SUFFER OR ANYTHING ABOUT IT!!! AND YOU HAVE THE NERVE TO TELL ME AND APPARENTLY EVERY ONE ELSE THAT WE “CHOSE” TO HURT OUR FAMILIES….ETC…………..YEAH LIKE I WOKE UP EVERY DAY CONSCIOUSLY SAYING TO MYSELF….”I THINK I WANT TO HURT THE ONES I LOVE TODAY…..YA KNOW FUCK EM…..I WANT TO GET HIGH”. AND I MADE THAT “CONSCIOUS” “CHOICE” “DECISION” EVERY DAY FOR OVER A DECADE!!! I THOROUGHLY THOUGHT IT OUT IN DETAIL EVERY TIME…..RIGHT BUB??????? AGAIN………………YOU ARE A FUCKING IDIOT!!
You are right on one thing…you didn’t wake up consciously considering whether you would hurt a loved one because you didn’t give a damn. Me a punk…interesting. I’m not the one blaming an unproven disease for the sins of my past so I can feel better about the fact that I’m am ignorant, useless, crybaby with a backbone made of swiss cheese. Ryan, I would never mention this, but, since you have called me an idiot so many times, I guess it’s worth mentioning that I made a 1540 on my SAT, have an MBA, and am about to start my second non-profit organization devoted to those suffering from substance abuse. You wouldn’t understand spirituality if it shook your hand and told you to keep coming back because it will work if you work it, and I can only pray that my harsh responses will jolt you into real action.
I do know what you went through, I’ve had upwards of ten friends or family members die as a direct result of drug/alcohol abuse, and how fucking dare you claim to know who is an addict and who isn’t…You chose to hurt yourself and your family, but keep lying to yourself if that’s what gets you through. You’re a coward of the worst degree…one that can’t even look himself in the mirror.
PS Yes, I attacked Dr. K’s article based on grammar. Those of us who are educated tend to believe that the manner of delivery can be equally as important as the content. Have fun being a finger pointing female today, Ryan. I’m about ready for a beer.
Blah Blah Blah dee dah!!! LMFAO………………. “I scored a 1,345,000,856 on my SAT”……………… Your still a F@#$%$^%^& LOSER!!!! There…. was that better for ya!!! What a Chode………..
Boy…… don’t we all love “know-it-alls”….EHH
By the way………..if addiction was simply a matter of choice…….why did all these friends and family of yours not make the choice to quit before addiction took their lives?? I’m guessing they didn’t make the “choice” to die did they?? They were suffering from a debilitating “disease”…..that’s why. And you say I lie to myself?? LOL………..Dude……………..if everyone could simply “choose” to quit….there wouldn’t be anyone using until it killed them now would there? And there would be no need for treatment centers either….now would there?
I would absolutely love to see you make comments about my dead friends and family members to my face Ryan. Go ahead and get down on your knees and thank god for the fact that we live in a nation of laws where spineless punks like you can spout off at the mouth with no recourse.
“You wouldn’t understand spirituality if it shook your hand and told you to keep coming back because it will work if you work it, and I can only pray that my harsh responses will jolt you into real action”.
P.S…..You do know that this is a completely irrational run on sentence don’t you?
Oh and there is no need for the comma after “it” because you use “and” right afterward…..
Just saying…..since you are so into grammar and such…..
LOL
I just read your response to Dr k above…..and all you did was attack his grammar????????? Spelling????? And “were you on LSD” when you wrote this???? Wow….no wonder you have nothing meaningful to say………….YOUR A TIRED BROKEN RECORD!! What a joke you are Bub…………and you actually think you are intelligent. Ask any psychologist what it means when someone finds the “tiniest” little things to insult someone with. That’s right………..you guessed it….”immature” and “insecure”!!! In other words…………….LOST!!!!
Hi Steve,
I guess it’s been awhile…I like the new digs. Pretty slick. Who is this new guy Kevin B? He is fun to read! Well, that’s it for me now…I guess???
Love,
Matt
For me, the uncertain relationship between freedom and choice is at the heart of whether anyone, addict or not, can just choose to change. “In Freedom Evolves,” (2004), Daniel Dennett does a reasonable job of covering the idea that our perception of choosing freely (whether or not we actually are) may be an evolutionary necessity which allows the Self to take ownership of its actions. Older studies by Benjamin Libet indicate that conscious awareness of an action may come after the electrical impulse governing that action has already been unleashed—although whether this is an artifact of the experimental conditions is still uncertain.
An honest debate about whether addiction is voluntary or involuntary prompts all of us to re-evaluate how much any of our actions are voluntary or involuntary, which may be why we react with such vigor when our viewpoints on this subject are challenged. Addiction is a wagging finger that mocks our humanity. Regardless of the certainty displayed by many on this topic, it is far from a settled issue. A few pieces of kindling to throw onto the fire:
“The person who asserts his freedom by saying ‘I determine what I do next,’ is speaking in and from a current situation: the ‘I’ who thus seems to have an option is the product of a history from which it is not free, and in fact determines what it will do now.” B. F. Skinner, About Behaviorism. 1976
“I say, do not choose, but that is a figure of speech by which I would distinguish what is commonly called choice among men, and which is a partial act, the choice of the hands, of the eyes, of the appetites, and not a whole act of man.” Ralph Waldo Emerson, 1847
“But what we ordinarily mean by choice is not freedom. Choices are usually decisions motivated by pleasure and pain, and the divided mind acts with the sole purpose of getting ‘I’ into pleasure and out of pain.” Alan Watts, 1951
“Neither blindness nor ignorance corrupts people and governments. They soon realize the path they have taken is leading them. But there is an impulse within them, favored by their natures and reinforced by their habits, which they do not resist; it continues to propel them forward as long as they have a remnant of strength. He who overcomes himself is divine. Most see their ruin before their eyes; but they go on into it. Leopold von Ranke
“Freedom is not a reaction; freedom is not a choice. It is man’s pretense that because he has choice he is free. Freedom is pure observation without direction, without fear of punishment and reward. Freedom is without motive; freedom is not at the end of the evolution of man but lies in the first step of his existence. In observation one begins to discover the lack of freedom. Freedom is found in the choiceless awareness of our daily existence and activity.” J. Krishnamurti, 1980
Author….Ryan
Michael….thank you for shedding some light on the reality that much of our behavior is involuntary and that the reality of actually being able to choose moment to moment is really impossible since we are perpetually moving forward in the realm of time and space and hindered by limited ability. It clearly is impossible with our limited minds to consciously “decide” or “choose” everything we think and in turn act at every possible moment. Much of our existence is driven by habitual processes. And this is why the state of severe addiction is clearly a case of involuntary action. A severe addict cannot simply “choose” to halt the momentum of the path they are on anymore than a driver of a car can stop the vehicle that the brakes have gone out on. Sure…the thought can “occur” to them that this “pattern” of behavior needs to stop and that something needs to be done to “change” their present forward momentum in a different direction. And this usually means seeking treatment in which the persons brain can begin to function in a different way. And this is why the disease model fits. An addicts brain becomes driven and controlled by a developed “condition” that directs thoughts and behavior “in a specific direction”…..continual use!! Ultimately….a “choice” is made to quit using….but most of the time…..a “process” of change will need to occur in order to cause our momentum to go in a different direction. If some people are able to quit cold turkey….more power to them, but to then in turn claim that “EVERYONE” should be able to accomplish this same momentum shift immediately just simply does not make any sense what so ever. The addict is still suffering from a “DISEASE” (perpetual involuntary condition) no matter how one is able to accomplish lasting change. And even then…..as you have pointed out…..much of our ability to choose is limited.
Ryan…Your thoughtful response is much appreciated, although I suspect that an opponent of the disease model could find something in my post to support their position also. Tabling that debate for now, your multiple uses of the word “momentum” with regard to choice were quite intriguing, and could serve as a key clarifying concept if we can tether it to a measurable, biochemical quantity. The idea would go like this: stripped down to our volitional skeletons, human beings choose, experience and remember the results of those choices, and then choose again. Choices accumulate; memories accumulate. Do addicts remember differently than non-addicts? —And how does the accumulation effect how each chooses?
I checked my files (I have been fortunate enough to serve as an R &D Chemist, Biologist, and Scientific Historian for the last 25 years) and found research starting around 2002-2003 and continuing to this day that suggests that learning & memory and drug addiction are modulated by the same neurotrophic factors, share certain intracellular signaling “cascades,” and depend on activating the same transcription factors. The “cascades” in particular may indicate a real “biochemical momentum” associated with addiction and memory. A better understanding of these molecular and cellular adaptations could lead to novel interventions that improve memory and combat addiction in humans. Imagine discovering that addiction is actually a severe learning disorder!
My personal preference is to call addiction a Disorder of the Volitional Self, even MORE serious than what we would normally call a disease. But that is just my preference. In a landmark 1980 compendium, “Theories on Drug Abuse,” the National Institute on Drug Abuse compiled 43(!) etiologically distinct explanations of addiction from a variety of sources. There is a lot of room on the field between the opposing goalposts of “choice” & “disease.” Clarifying concepts like “momentum” and “memory” can go a long way towards reminding us that we are on the same field.
I am not a scholar or scientist by any stretch….in fact I am a humble garage door repair man and construction worker….so I am not in the same league as you are when it comes to research and scientific knowledge. All I DO know however, is my own experience combined with my witness of other addicts as well as what I have learned and it has led me to unequivocally assert that addiction when it is in full blown mode so to speak is a “condition” that completely “paralyzes” its victims. I cant tell you how many times (hundreds) that I told myself that “I need to stop”…”God why?”…”I can’t do this anymore” etc…..to find myself back downtown the next moment. It then turned into “I CAN’T STOP”….”I need help BADLY”. But the state of mind that developed over time that began to seemingly take over control of my every thought and action is the state that causes us to experience what feels like a perpetual and hopeless disease. These yahoos on this site want to split hairs and claim that in order for a condition to be deemed a disease it must be “cellular” or organic or something that afflicts us with out any doing on our part. But the problem with that is that there is plenty of scientific evidence as well as experiential proof to show that an addict in the throws of severe addiction has marked changes in the brain as well as chemical imbalances occurring. So why cant this be termed a disease??? In my opinion….the writer of this site and others who think they are so intelligent and are in FULL control of their thoughts and lives and want to push their “choice” BS…. are simply ego-maniacs who have ZERO humility or compassion for others who are legitimately suffering from a hopeless situation in many cases. People need help….they need treatment…they need love and support. They don’t need ASSHOLES like these self-righteous “KNOW-IT-ALLS” telling people they are weak and should be able to simply make better “choices”. I finally got clean…….but it took several years of struggling!!! And it was not as simple as making a choice to quit and that was it!!! It took a series of events to start that ball of change rolling…..and it then took a lot of hard work to reverse the “momentum” that had taken over. By the grace of God….I was able to recover. But there was a DEFINITE AFFLICTION….CONDITION….”DISEASE”………….whatever you want to call it ……..that had deeply set in!!! And this is the reality of addiction. It is a medical, physiological as well as a psychological issue!! It is not a philosophical one!!!! God Bless
Ryan… I am not sure whether or not your comment was directed at me, but I would never tell an addict that they “should be able to simply make better choices.” I would also never tell them that they have a disease that robs them of their ability to choose. Framing the discussion as simply “choice” vs “disease”—and that is nothing new in the history of addiction—is a wobbly dichotomy that leaves out alternative explanations that might better account for why an addict’s ability to choose “appears,” for them, to disappear. You actually said it: “the state that causes us to experience what feels like a perpetual and hopeless disease.”
So why can’t we call it a disease? Because the ways things appear to us, the way we feel things, are not necessarily the way they exist—and that applies equally to the extremes of full agency and total helplessness, the extreme explanations of choice & disease. For me, it is not a settled issue, so I continue to look for better models to explain the reality of addiction. As a human being I tend to look for comforting explanations that reinforce my pre-existing worldview. As a scientist, I look forward to those paradigm-shifting moments when my worldview is turned upside down. Hopefully, my internal dichotomy never blinds me to the immediate suffering of those who do not have the luxury engaging in philosophical discussions.
Ryan,
I’m 100% stooping to your level, but, ironically, I have lost choice in the matter…at this point, I’m addicted to fundamentally dismantling anything that comes out of your mouth.
Your quote:
In my opinion….the writer of this site and others who think they are so intelligent and are in FULL control of their thoughts and lives and want to push their “choice” BS…. are simply ego-maniacs who have ZERO humility or compassion for others who are legitimately suffering from a hopeless situation in many cases. People need help….they need treatment…they need love and support. They don’t need ASSHOLES like these self-righteous “KNOW-IT-ALLS” telling people they are weak and should be able to simply make better “choices”
There are so many problems in this comment, but I’ll try to address the most glaring items succinctly.
1) You describe the situation as hopeless, though people recover from addiction every day. If an undesirable situation can be bested, it cannot be described as hopeless. A hopeless situation is one without an answer or a way out, so that terminology is illogical. Let’s meet in the middle…it’s a difficult situation.
2) To your point about people needing love and support, are we supposed to believe that a person as angry and unstable as you is capable of being loving or supportive? If you were my last line of defense in a desperate situation, I’d prefer a handgun and a bottle of scotch.
3) No one arguing the choice model has ever even remotely insinuated that struggling addicts are “weak”. This is just a bold faced lie.
4) The people you are unnecessarily bashing in this piece are only guilty of having a different opinion than you on a debatable issue. So because I happen to believe that, in the absence of true physical addiction (a state of mind and body that is the product of a series of poor choices), we always have a choice, I’m an ego maniac, know it all asshole with no humility or compassion?!?! That’s quite a leap. I believe it’s empowering and encouraging to know that each of us can chose to engage in behaviors that are destructive or beneficial. As for humility, doesn’t it stand to reason that a person who owns up to the misdeeds of their past instead of blaming a condition they couldn’t help should be considered more humble, more mature, more responsible? Just because I feel that substance abuse and everything that comes with it boils down to a series of bad choices doesn’t mean I’m numb to the suffering of people in that struggle. Nor does it mean that I’m judging them…how could I, I’ve been there. I take responsibility for the sins of my past, and I try to do better moving forward…please explain how this mindset is arrogant, cruel, egotistical, and/or apathetic to the suffering of those around me.
One final item, stop putting God bless at the end of your belligerent posts. God doesn’t bless unproductive, maniacal outbursts of anger, and, more importantly, you’re pissing on the core nature of spirituality.
good onya Ryan,
to the rest, after you have had some real life experience with addiction maybe a good decade of heroin use, then by all means offer an opinion about choice.
I, the author of this article, have the experience of using heroin from the ages of 18-26 years old – spending five of those years sincerely feeling “addicted” and out of control. Is that good enough? Is 8 years of use, and 5 years of struggle enough? Is it enough that I went homeless for a few months, was arrested many times, and spent a month in jail for shoplifting to support my drug use enough? What’s enough? When I do I get to give my opinion? Are several stints in treatment and several years in 12 step programs enough? What do I have to do for my opinion to be valid?
My opinion is that all substance use is fully freely chosen, and that the mindset that creates the desire to use is freely chosen, and can be freely abandoned.
-Steven Slate
It’s too bad so many of the determinists hang there argument on those experiments by Libet, since they’ve been seriously challenged in the past few years. It appears that we’re just finding background noise in that experiment – that there is a constant wave of readiness potential going up and down, and indeed it is there often, and yet not followed by a flick of the wrist. Too bad.
Here’s a quote I’m fond of:
That last sentence is the best. I hope Nora Volkow reads it someday, and seriously ponders that idea.
Steve:
This is not a reply to your post; I just positioned it here to address you directly.
First of all, I applaud your site and defend your right to run it any way you want – not that you need my applause and support. As someone who has been fighting the good fight against the “Addiction Industry – AA -disease” juggernaut for thirty years, I know how difficult and thankless a task it can be. Someday I would very much like to start a meaningful exchange on what strategies and tactics you think work best in this ongoing battle, and which strategies and tactics just backfire.
But for now my question is this: is it really serving any purpose posting Ryan’s rants? (his last one included the word “chode” – I had to look it up!) I can respect a no censorship policy, but sometimes we need to protect people from their own lunacy.
Anyway, its more of a rhetorical question tacked on to my much overdue kudos to you for being in the game and not standing on the sidelines.
Sincerely,
Michael V.
Michael,
Having been on the receiving end of numerous insults and rants from our boy Ryan, I have to say that I support his continued participation and I have actually learned a lot from him. His childishness and obsession with capital letters aside, he embodies the dry drunk concept, and, though annoying at times, his behavior serves as a daily reminder of how not to be. Ironically, he has a spot on my grateful list…despite all my faults, I’m grateful that I’m not as bad off as him. I imagine his day today will look something like this…wake up, be really mad, eat breakfast, be really mad, go to an aa meeting, be really mad and confused, then spend the rest of the day being mad, insecure and scared until bed time. Personally, I’d rather go ahead and get drunk than live like that, but, assuming he has been sober while composing his comments, I can’t imagine how hysterical, irrational, emotional, and needy that dude would be drunk.
I feel a tinge of guilt for being so harsh, but I’ve determined that, at the end of the day, Ryan is a net negative for the world at large. Put differently, the sum of his words, actions, interactions, etc…will result in the world being just a little bit worse. The vast majority of moronic behavior falls on a very simple spectrum…asshole or dumbass? The asshole knowingly cuts you off and feels absolutely no remorse…the dumbass cuts you off unintentionally and doesn’t even realize he’s done anything wrong. Occasionally, someone comes along that is both simple minded and cruel hearted. It’s never too late, but, as of today, that person is you Ryan. Respond however you see fit, but you know I’m right. All I have done is give my opinion on a site designed for mature debate. You, on the other hand, have insulted anyone who doesn’t agree with you, and have shamelessly exposed yourself for the simple minded coward that you are.
Anyways….I’m about to go check on the ladies I work with who have recovered from years of homelessness, addiction, incarceration, and all other forms of abuse. Then I’m going to puff some weed, watch the UGA game, and decide whether or not I want to go out and get laid tonight. Have a good one Ryan.
I’m in total agreement of the creator of this website…i see someone like him as using tough love to help people in a dysfunctional recovery culture….he will get mocked..bashed..accused of anything from triggering..or killing people who die from their addiction. it’s pretty simple for me to see..on websites like this that are for free thought and aren’t AA based or disease model based…the AA disease camp will feel the need to come out squash an opposing view..in a disrespectful way.. If their program or philosophy was so good they would never feel the need to do that..in the way that they do..I’ve done the research myself and this man Slate..is correct..it’s amazing it’s like he is stuck inside my head…i drank to give myself liver damage….got sober..did my own research for 2 years..keep in mind i have a good BS detector…the vast majority of people grow out of addiction…some small percentage feel they have a lifelong disease that they are powerless too….our recovery culuture and business caters to those people and controls them…they really think..they are the only “real addicts” recoveryism becomes their life….In my experience substance is the not the real problem for people in “long term” recovery and I’m glad someone is brave enough to tell it like it is..
thank you for your courage and honesty
Addiction is not a “lifelong disease”………..it is a temporary one. The disease model applies to a person who is in the throws of addiction (currently using) because of the chemical imbalance in the brain and so forth. Once a person has recovered completely and in not using any longer….the disease is cured. Wow people!!! Get with reality……..Slate is NOT correct in his assertion that addiction is merely a matter of choices. Come on….you really think that is all addiction boils down to?????????? You people crack me up!!!
So are you saying addiction is a lifelong disease or not? your post wasn’t clear..well I think it’s neither because it’s not in any way a disease..and it’s definatley not lifelong. I knew the truth about this phenomena “addiction” long before i found this website. Slate didn’t change my mind but I do agree with him. i base my conclusions on logic..statistics and social science…thats all we really have with addiction. the science of genetics..brain scans..neurotransmitters contrary to published articles in the New York Times or what Nora Volka says conclude absolutely nothing about addiction..the are useless,,bugus…made up conclusions..I also don’t base my assertions of addiction on “feelings” like I really feel alcoholism runs in my family..or I feel I’m powerless to alcohol..I certainly don’t use the “feelings” of the small minortiy that addiction is a lifelong disease as a fact..even if they are screaming at me using profanities
somebody asked on an earlier post that if there is somebody who was abusing alcohol..that now can moderate…
well I am such a person…i drank because I liked getting drunk for 3 years very hard…up to 40 drinks a day or night. I developed a fatty liver and decided to stop…my physical withdrawal was almost nothing…gone after a couple of days….after a year my liver has completely healed….alcohol is not an issue for me…i can stop after 2 drinks. I could back when i was boozin too..i just didn’t want to…telling someone you are moderating in the recovery community is extremely taboo..I never tell anybody…I did once and they accused me of such horrible things…and even blamed me for putting peoples lives at risk….this is my life..they can stay home and drink tea….if i want to go play some cards..drink some beer..or go dancing and have a few..that is my business…I could care less what any disease model 12-stepper thinks…..btw i never once had a “craving” for alcohol….is that like a craving to get laid or more like a bacon cheeseburger craving?
the recovery community will change…the BS is getting called out now
Donjuan,
Me too. I used to abuse alcohol when I was also using cocaine, but, since quitting the coke, I’ve been able to moderate. I know three other people who share my experience, as in, went to rehab at one point, were told that they were a powerless addict whose only chance for a functional life rested in aa rooms. For some, this is the case…for others, it isn’t…it’s quite simple.
I used every drug I could get my hands on for a good 4 years. I used heavy amounts of cocaine and heroine (speed ball) on a daily basis. I used a syringe, “using any other way is wasteful”, I use to say. I got in some big trouble for selling large amounts of drugs. I was sent to a rehab after about a year of being locked up. I used in jail.
Once in rehab, they would smack that idea into your brain, “this is a disease!” I knew the whole time it wasn’t, that I just had to make a choice. Getting off of drugs is the hard part, staying off is the easy part. Don’t get me wrong for the first 18 months I would think about it a few times a day. How nice it would be, but I knew that it really wouldn’t be that nice, that in fact I hated drugs. That was just my brain telling me that I wanted drugs. I have been clean for almost seven years now, I never think about it anymore. In fact, I am able to drink socially without going home and drinking more and more. I have even smoked pot without going back to being a routine smoker. It isn’t a disease. Its a addiction, addictions are hard to break, that’s all.
Your article is excellent, and I am glad I found it. I have had a very long list of friends go down the horrific road of addiction, my brother is in rehab right now for addiction to several drugs, and I have had my own struggles with drugs. This issue is extremely important to me, and it is great to find the rare person who agrees with me on this. Practically every article I find on drug addiction takes the “Boo hoo, poor victims” approach. Drug addicts are not victims to any greater extent than they are perpetrators. They are victims only of themselves.
I was addicted to Dilaudid for about nine months in the middle of last decade. For those who don’t know, Dilaudid is a form of synthetic heroin, and it is arguably more addictive than heroin. I knew that I was playing with fire, but what kept me going for so long was my repeatedly false declaration of, “One more time.” I kept telling myself every time I did it was that it was the last time. I finally got to the point that I decided to make it clear to myself that the “One more time” declaration was really just a matter of my giving myself an excuse for my absurd behavior. I wanted to shoot up, and I wanted to have an excuse for doing it. Once I faced the fact that the only way to quit was to not accept “One more time” as an excuse, I told myself that “One more time” had already happened and that “one” does not equal “one more.” I decided to bite the bullet and quit doing the garbage no matter how much it hurt to quit. No matter what cravings or outrageously exaggerated presentations of potential pleasure my mind presented itself, I stuck to not doing the stuff. It hurt pretty bad, on and off, for about two months, and then I was at peace with not shooting up any more. I did not need rehab or even so much as a talk with a counselor. I decided to quit and refused to give into temptations, excuses, and exaggerated mental images. I knew what I had to do, and I did it. I know first hand that it can be done.
I won that battle because I decided to win it, but it was part of a war. I also had problems with alcohol and marijuana. Those were not as serious, but they were issues. Marijuana is the least serious of all of them, but that doesn’t mean it is not a problem for anybody. It was a problem for me. I let those issues go on for too long, but I decided to quit alcohol and pot 10 weeks ago. As with Dilaudid, I did not go to rehab or talk to a counselor about quitting. I made the decision to quit and have stuck to it for 10 weeks.
Is drug addiction a disease? Not in the way cancer and multiple sclerosis are. I think the disease issue is really just a semantic issue. The key fact that gets lost when people argue that addiction is a disease is the fact that a conscious decision to take a drug is a conscious decision. Strong temptation is real, and so is the often outrageously exaggerated expectation of pleasure that comes with temptation, but that does not change the fact that doing a drug is a decision, unless somebody forces you to do one or gives you one when you don’t know it’s being given to you. If you decide to take a drug, you made a decision to take the drug. There is no way around that.
Dilaudid…Pfft. Try some Fentanyl and then get back to me.
Love ya Steve!
Matt
Of course everyone has to make the choice to stop abusing drugs….as did you. But its not like deciding…. I don’t like dancing anymore so I’m going to take up skydiving. All these symptoms you expressed and thought patterns you mentioned are the very reason addiction is likened to a disease like any other disease. People who view addiction as a disease aren’t “BOO HOOing” themselves….they are simply accepting what has happened to them (regardless of the choice they made to start using) as a developed “state” that needs help in most cases. The fact that someone can get clean on their own without intervention or help like you claim you did….doesn’t make you a stronger person or more intelligent and it doesn’t make YOUR way of recovery or perspective the “ONLY” way of handling the problem. People recover from addiction just as well with the “disease model” perspective. Most people need support and help in various aspects of their life in order to complete a 180 and live life drug free. It’s a process!! Powering through the physical withdrawal and cravings and habitual thought patterns is not as easy for most as you claim it was for you. Therefore…logically you cannot claim that EVERYONE should be able to just stop cold turkey. Doesn’t happen that way for most dude!!! Thats why the claims on this site and from people like you come across as arrogant and insensitive and shallow. THERE IS WAY MORE TO ADDICTION THAN “JUST SAYING NO”!!!!
So let me just ask you a few questions if I may….
1. “I was addicted to Dilaudid for about nine months”…………Why didn’t you quit after a week? A month? 7.8 months? Cause you were ADDICTED!!!!!!!!!! You developed the disease!!!!!!
2. “I knew that I was playing with fire, but what kept me going for so long was my repeatedly false declaration of, “One more time.”….. Why was your brain saying this Spencer??? Over and over again like a broken record??? Why weren’t you able to CHOOSE the first time Bro???? Because……..Thats the Disease!!!
3. “I wanted to shoot up, and I wanted to have an excuse for doing it”. Gee Spencer…..why was your mind thinking this way instead of some other way???? Because the disease of addiction influences our thinking and certain parts of our brain get hijacked so that we cant use our frontal lobe properly in order to make the proper choices. This is why addicts complain about “being stuck” and not ABLE TO SAY NO!!!
4. “It hurt pretty bad, on and off, for about two months, and then I was at peace with not shooting up any more”…… Why did it HURT for 2 months Spencer??? Why was there residual pain??? Because you had the disease and just like all diseases it takes time and treatment to fully cure!! WELL….FOR MOST ANYWAY!!! If addiction was simply a matter of choice….like choosing to stop chewing a certain brand of gum that you have been chewing for years and switching to a new one…… There wouldn’t be any pain!! WHY???….BECAUSE WE DON’T GET PHYSICALLY ADDICTED TO GUM!!!!
Lastly,
“I knew what I had to do, and I did it. I know first hand that it can be done”……… That’s fine Spencer, God bless you!!! More power to you for sticking it out through the pain and sticking to your guns. But that still doesn’t mean that you weren’t suffering from an affliction (or disease”) just like ALL ADDICTS!! And regardless of how we CHOOSE to perceive addiction or classify it or label it…..its still something that causes a tremendous amount of suffering for the individual and the families….and it behooves us all to quarrel about HOW it should be treated or HOW and addict SHOULD LOOK AT IT. Disease or choice….it really doesn’t matter….Addicts need support, love and understanding. NOT condescending people telling them ……… HOW THEY “SHOULD” LOOK AT THINGS.
And this is precisely what this article attempts to do!!!
Most people need help….they need treatment….and they need support Spencer. They don’t need people telling them…..They are “BOO HOO baby’s and should just MAN UP”. That’s arrogance at it’s highest level!!!!
Wow! Ryan, finally, someone had the balls to say what I’ve said before, but not in such a kick ass way as you did! The point I have been trying to make here on and off for the last 3 years is that not everybody is the same, and the path to recovery is not the same for everyone. You explained to disease model better than I could have even begun to! The main issue that I’ve had here is that just that because someone goes “cold turkey”, claims that they are above and beyond anyone who can’t. To place themselves on a pedestal and pronounce themselves better than people who struggle, is just what you said: Arrogance at it’s finest! To discount the experience and beliefs of someone is nothing less than inhumane. The fact is that there is more supported, research based evidence that addiction IS a disease…..far outweighs the evidence against it. I don’t discount anyone with ideas different than mine……one of the many things I’ve learned by being sober…..is that everyone’s opinion is just as valid as mine, even if I don’t agree with it. Too bad some of the people who post negative and downgrading comments here, don’t get it. I have thought many times of unsubscribing from this site….but it’s people like you Ryan, that keep me coming back….albeit less frequently than before. Thanks so much for being one of the few voices of reason!
Thanks for the kind words Clay!!! I almost didn’t look the post as I usually get vigorously attacked!! So that was a pleasant surprise!! Yeah, the reason I fight on this site and others is for that reason…. I CANT STAND SELFISH ARROGANT “KNOW-IT-ALLS” who think that they have it ALL figured out….and this whole idea of everything having to do with drug abuse…. boiling down to merely “making better choices” is the most illogical and insane concept I have ever heard of. Especially when the scientific evidence is OVERWHELMING that there are biological, chemical, psychological, emotional as well as genetic factors and components involved. Claiming that it is ALL simply a matter of choices………………… is just PLAIN IGNORANT AND FRANKLY……STUPID!!! And unfortunately……Stupid usually means stubborn, unreasonable and unwilling to admit they are wrong. That’s why all they can do is come back with insults. Their minds are too closed and hearts are too hardened!! But I post on here mainly just so that others who feel that they do have a disease and need help will seek it….and also so that they can feel like they are not alone in their thinking. Sure we all may have made the mistake to choose to try drugs and unfortunately it griped us and destroyed much of our lives….but we are still human, and deserve forgiveness and the right to retain our dignity. The assholes who post this arrogant “choice” bullshit…..if you think about it….. are simply cowards who still cant admit they had a problem and to elevate themselves…they have to pimp themselves for their heroic accomplishment for making the choice to quit and remain sober. But if you read ALL their testimonies……………….IT WASN’T AN OVERNIGHT DONE DEAL, FLASH IN THE PAN IMMEDIATE RECOVERY. THEY ALL STRUGGLED IN ONE FORM OR ANOTHER. IT’S PRIDE BRO…..NO ONE WANTS TO ADMIT THEY HAD A DISEASE THAT CONTROLLED THEIR LIVES. PRIDE….PRIDE….AND MORE PRIDE!!! They all had the same symptoms as I did and you did and everyone else did. And the last time I checked….any doctor diagnosing a disease will ask you…”what are your symptoms”? God Bless, take care…..and keep praying for all those out there who are still suffering with this horrible DISEASE!!
I hear what you guys are saying..but i’m sorry I believe you are very wrong. alcoholism is a made up word…only alcohol dependence is a scientific word…physical withdrawal…after physical withdrawal..you are left with yourself without the substance..one cannot be born addicted to a substance unless their mother used in pregnanancy…addiction after physical withdrawal is quack psychiatry…it is all made up..If it is hard for you to stay off the drug then..it was just as hard for you in the first place to stay away from it…that is not a disease and Nobody that went through medical school will say that it is if they are being honest..in fact a 88% surveyed said it wasn’t a disease…the rest wouldn’t answer or probably lied to keep their job. telling somebody a lie will never help their recovery from substance abuse or any mental illness…saying it is a disease is in every way a cop out…a cop out for the individual..a cop out in the legal system..and a cop out for the insurance companies that pay for treatment..anybody is free to believe whatever they want ..but everybody doesn’t have the right to be correct.
I’m one of those people who is strong in my beliefs, but sometimes finds it hard to choose a side. I’ve been reading posts here for about 3 years, and there are more people here who show no respect whatsoever, than do, for someone else’s opinion. If I had to choose a side in this matter, I lean toward the disease model. I don’t claim to know it all, and can’t quote verbatim tons of scientific research on either side. I’m more of a simplistic kind of guy. That being said, here are a couple of things I found, simplistically:
Definition of Disease, from The Oxford Dictionary: a disorder of structure or function in a human, animal or plant, especially one that produces signs or symptoms or that affects a specific location and is not simply a direct result from physical injury.
Definition of Disease, from Merriam Webster, and I like this one, because it is simple, and to the point: a problem that a person, group, organization or society has and cannot stop.
I read from someone’s post saying that a broken leg from skiing is not a disease, and Oxford clearly discounts a physical injury as a disease. However, a broken tibia or femur is listed in the International Classification of Diseases, 9th Edition. It may not be a disease per se, but it does initiate a disease process.
Here is a quote from Issues in Science and Technology Online. I copied and pasted….just to let you know.
“Many people also erroneously still believe that drug addiction is simply a failure of will or of strength of character. Research contradicts that position. However, the recognition that addiction is a brain disease does not mean that the addict is simply a hapless victim. Addiction begins with the voluntary behavior of using drugs, and addicts must participate in and take some significant responsibility for their recovery. Thus, having this brain disease does not absolve the addict of responsibility for his or her behavior, but it does explain why an addict cannot simply stop using drugs by sheer force of will alone. It also dictates a much more sophisticated approach to dealing with the array of problems surrounding drug abuse and addiction in our society”.
Voluntary behavior can, and does lead to involuntary behavior. Voluntarily picking up a cigarette, leads to involuntary behavior, which can, and more times than not, lead to disease. Picking up a drink of alcohol, can start out as voluntary, which, again, soon leads to involuntary behavior, and, if taken in excess, does cause disease. Not all addictions cause a physical disease process, but the symptoms produced can lead to physical harm.
Again, I have not done a lot of research on this matter. However, I used and drank from age 15-50. I don’t know by what means I am still around. All I know is that as much as I tried, no matter what lengths I went to, as long as I was actively using, there was no way in hell that I had the sheer willpower to stop. It doesn’t matter the methodology I used to stop. That is irrelevant. I needed treatment, and that consisted of psychotherapy, pharmacotherapy, and 12 Step Programs.
Any credible provider of information or a suggestion of a course of action, should be able to offer, and consider, that there may be another prescription of methodology or belief. There is plenty of evidence on both sides of the fence to discredit the other. It’s all in the delivery. Without even trying to think too hard, I am fairly certain there is more published evidence that addiction IS a disease, in contrast that it is NOT.
With all that being said, anyone who resorts to name calling, belittling, discounting, and dismissing the opinion of someone else, is in the wrong. I know that feelings and emotions run high on this issue, and I have really had to sit and think before I start slamming the keyboard. A great deal of the bantering that goes on here, is completely immature. Anyways, that’s my story, and I’m sticking to it.
Just a couple of humorous comments to add. While arrogance, bull-headedness, being an outright asshole, condescension, and inconsideration are not diseases, they are, by Merriam Webster’s definition, a disease:
” a problem that a person, group, organization or society has, and cannot stop”.
I know of very few people with these afflictions that have, or can, stop of their own free will. Maybe what they have is an addiction too! Or, an as of yet, not medically recognized disease! Ha!
Love the comments Clay…..and I don’t think you give yourself enough credit!! You are very articulate and intelligent and have a generous grasp of the subject and much knowledge. I on the other hand simply try to argue from logic. I think the quote you pulled from Scientific Tech online sums up the debate quite well. And theoretically…..almost ANYTHING that afflicts us as humans could be considered a disease. Even ego, or greed, or hate!!! We are ALL fallible!!! We are not perfect creatures………….and we certainly do not have the ability to CHOOSE the correct course of thought and action ALL the time. We are limited somewhat by our brains ability for one. This is why I feel that this concept of Choice being the cure all to addiction…is absurd. Of course at some point we ALL do make the choice to quit using if we haven’t died from an overdose or something…..but MOST of the time…..that choice must be immediately followed up with treatment. We need to get the chemical imbalance in our brains corrected….our thought patterns under control….our lifestyle changed….our beliefs and spiritual life usually needs work and on and on it goes. This is why recovery for most takes a long time and is a continual process. And these “choice” people want to claim that ALL of this can be accomplished by a simple….”I Quit”. No way!!! Again….I simply feel it is a Power-trip…these people are on and an ego-boost. But that’s just my opinion. But like you said…..most of this is highly subjective and in the realm of opinion. But the science IS there…for sure.
Ryan – Your comments are insulting to the intelligence of everyone involved here. You are fighting boogiemen and straw men. You are misrepresenting the views of others, sometimes distorting them, other times creating them whole cloth.
For example, you referred to Spencer, who said:
And you said:
That’s a distortion of what Spencer said, and it assigns intent to his statements that simply wasn’t there. He did not say that this is what “addicts” necessarily think – he said that the articles he usually reads about addiction take a “Boo hoo, poor victims” approach’ to the topic.
But you don’t stop your distortion there, you DOUBLE DOWN on it, saying:
And you had the nuts to put quotes around that statement, leading other readers to believe they were Spencer’s words. Where I come from, that’s called slander. You SHOULD be ashamed of yourself. He never used the word “baby”, he never told anyone to “man up” and he only used the term “boo hop” once, in the quote I provided above, that referred to authors who write articles about addiction. Again, you should be ashamed of yourself.
I advise that you look back through the comments on this page, and please reread the article itself, and you should be able to see that you have assigned a bunch of views to others that they never expressed.
For instance, you keep repeatedly insisting that the message here is that “addiction” is simply solved in an instant. Your lie that Spencer told people to “man up” is on example – here are some of your other statements that portray the choice message in this way:
I’m not telling anyone to flip a switch. I’m not saying “just say no.” And I am not saying change isn’t a process – and that last point in particular is really irking me. Deciding whether to have steak or chicken for dinner is one kind of choice – and then deciding to raise a family is another kind of choice that represents a more complex process – BUT BOTH ARE CHOICES. You have repeatedly asserted in your comments, the message that if one claims that something is a choice, then it must be like that simple choice between steak or chicken. You are repeatedly ignoring the vast array of choices that people make throughout their lives. You are distorting my message when you do so. My point is that “addiction” is volitional. The act of using substances is volitional. The act of thinking thoughts that make substance use attractive to you, is also volitional. At no point is there any mechanism forcing people to use drugs and alcohol. There is only their own freely chosen thoughts and beliefs motivating them. They can choose to change all of this. It can be quite a process to do so. But that’s still not enough to call something a disease – if it was, then we’re in the territory of the ludicrous postings of Clay, who pasted metaphorical definitions of disease here. You wanna call it a metaphorical disease? Have at it. But KNOW THAT IT’S ONLY METAPHORICAL.
You step into another realm when you claim that something is an organic disease. When you make that claim, as with all positive claims, it is on you to provide evidence to sufficiently prove it. In the case of saying that addiction is a brain disease, you need to show what it is about the brain tissue that has malfunctioned and is causing the symptoms. As Dr Carl Hart, a neuroscientist who’s been studying the effects of drugs on the brains of both animals and people for 25 years now, published many papers in prestigious journals, is widely recognized as an expert, and currently does his research at the prestigious Columbia University, said in a recent interview:
Addiction is not a brain disease, it is a choice.
Notice what I said, and DIDN’T SAY in that statement PLEASE. I have not said that – addicts are weak; they need to man up and use willpower; people who quit without help are better than those who quit with help; quitting is instantaneous; everyone should quit using drugs and alcohol now; just say no; ETC ETC ETC. There are plenty of things I didn’t say. And in fact, on many of those issues, I’ve addressed them all over this site, and specifically shown that I do not believe those things and that they are not part of my message. SO PLEASE DON’T ATTRIBUTE THESE IDEAS TO ME. I AM SAYING THAT EVERYONE HAS VOLITIONAL CONTROL OVER WHETHER THEY USE SUBSTANCES, HOW MUCH THEY USE, AND WHETHER OR NOT THEY CRAVE/STRONGLY DESIRE SUBSTANCE OR NOT. It’s a lot to cover the many sub points of how people get themselves into a place of choosing to change effectively, but I can’t write that everywhere on every post on my site. This post is about the brain disease model of addiction. It is not about all the nuances of choice. Just because I haven’t written about all of those nuances here doesn’t mean I believe all the things you are attributing to me. SO PLEASE STOP AND DESIST WITH SLANDERING ME OR OTHER COMMENTERS ON MY WEBSITE NOW.
Steven Slate, Author, The Clean Slate Addiction Site.
Steven….. My comments were aimed at the whole!!! I argue from logic and use comments from the choice crowd in general. My Boo Hooing comment was a “general” statement piggybacking on Spencers comments…..addressing his perception of articles supporting the Disease model. I was defending those articles. But to your claim…………. “EVERYONE HAS VOLITIONAL CONTROL OVER WHETHER THEY USE SUBSTANCES, HOW MUCH THEY USE, AND WHETHER OR NOT THEY CRAVE/STRONGLY DESIRE SUBSTANCE OR NOT”……………That is the most ridiculous claim backed up with ZERO SCIENTIFIC EVIDENCE!!! THE SCIENTIFIC EVIDENCE IS IN FACT….THE EXACT OPPOSITE!!!!! Not to mention the testimony of MOST addicts will tell you the same. That is where you are wrong!!! Addicts in the height of using DO NOT have control!!! PERIOD!!! It is a scientific and experiential fact!!! DUDE you are WRONG and always will remain WRONG!! No matter how hard you try to intellectualize and rationalize your position!!! Dude….your fight here is one you will NEVER WIN…PERIOD!! It is based on nothing more than PERSONAL PERSPECTIVE AND EGO DRIVEN OPINION. I still have yet to see any goal to this campaign you are on. It will go nowhere!!! Its as if you are trying to shut down the treatment industry and convince ALL addicts to just give it up….without help. This is why it IS A DISEASE!! People need HELP….you dumb ass!!!! If it wasn’t a Disease…………..than why do severe alcoholics need MEDICAL TREATMENT in order to get clean or the body can shut down and they can die.??????????? Dude….you can pick apart every little nook and cranny of my posts….and spend hours defending yourself and squirming around the main purpose of your agenda by…..”Im not saying this” and “I’m not saying that”…..Blah Blah Blah!! Bullshit…..you are saying ALL addicts are in FULL control of their minds 100% of the time…..and can CHOOSE to give up their addiction at any time. Bullshit BUD!!! You have no clue!!! Again, they need help, love and support…..and treatment!!! Perhaps, You should have thought through your endeavor to “change the world” of addiction and treatment and decades of research when you divided to embark on this campaign. But that’s the problem when EGO and PRIDE get the best of us!!! Again good luck convincing the WORLD to accept “YOUR” PERSPECTIVE!!! Cause that’s not what science nor the majority of addicts believe!!! Good luck with that BUB!!!
Steve, here’s a very basic primer for you regarding addiction and more importantly, PAWS (if you don’t know what that acronym stands for, you have more research to do): http://www.huffingtonpost.com/2014/02/12/post-acute-withdrawal-syndrome-addicts-alcoholics_n_4775009.html
I just smiled when I read this report because it just shows me how people who have never walked in an alcoholic or addicts shoes would speak. All I have to say is that I pray you never end up becoming one of us. Just remember that when you laugh and spit up in triumph the saliva falls in your mouth. You never know what can lead you to alcoholism or drug addiction. I am grateful for my years clean and sober and that I understand my disease of alcoholism and drug addiction so that people do not confuse me to the point of relapse. I know that where there is a Higher Power a lower power also lurks and you are the lower power trying to confuse great people who are trying to get their lives in order. Shame on you!
anybody has the right to their opinion..but nobody has the right not to be offended…in other words shutting down a conversation because it offends you or hurts your feelings is very dysfuntional and close minded… I never talked down to anyone ..I just stated facts..and logic… I am not someone who just has done research but never abused substances. i drank enough to give myself liver damage….about a 30 pack of beer a day…for 3 years..i have experienced treatment centers..psych wards..therapists..group therapy..AA….i have worked in homeless shelters..watched people get loaded on the street..talked to people like this about booze and drugs…..
i will not be told i’m don’t get it or i’m insensative…..neither are true…I certainly won’t be told UI wasn’t an alcoholic…because nobody is..it’s a nonsense word with no meaning
Right on DonJaun!
While many of the comments made here are “offensive” to a particular individual or group, it is not the offensive comment or person who is responsible for allowing another to be offended. No person can make another feel any certain way. It is up to the “offended” person or group to allow themselves to feel that way. If one is strong and confident in their beliefs, then there is some sort of doubt or weakness that allows that group or person to be offended. This may sound insensitive, but no one is responsible for how another feels, We are all responsible for our own feelings, and how we process them.
To comment on the statement from Donjaun that alcoholism is a made up word, that is hogwash. First off, alcoholism was first recognized as a disease, or “condition”, for the sake of argument, in 1956, and still is today. I am not trying to incite more conversation in regards to whether it is a disease or not, we all are implicitly aware of how we all disagree on that matter. Getting back to alcoholism being a made up word. If that is the case, words like bronchitis, lymphoma, cellulitis, cardiomyopathy, and many more, are all made up words. They all contain “”root” words, containing either a prefix, or a suffix. When those components are put together, they are used to describe a “state of”, or “condition”. Only an ignorant person would make a statement like that. I am not calling you stupid. Ignorance and stupidity are two different words, each with a different meaning. Some of the most intelligent people can also be ignorant. If what you stated that 88% of surveyed medical specialists state their view is that alcoholism is not a disease, then I am certain that it would not be listed in the International Classification of Diseases as such. It would have been challenged, and most likely, removed as a disease.
I said this in an earlier post: research on both sides can find fault with the other. But, an overwhelming amount of research, proved over and over again, states that alcoholism, or drug addiction, is a disease. Personal stories from opponents and proponents are valid to the person making the statement. This becomes a problem when others put down the experience of those making those statements, on both sides of the opinion. Each sides opinion matters, and possesses a certain amount of validity. Most of the conversation here is intelligent and well thought out. Some of it, however, comes from anger, ignorance, misinformation, and mostly, our emotional connection to the issue. In the words of Rodney King, can’t we all just get along?
if you can tell me what the criteria to classify an alcoholic is in simple scientific terms…i will not disagree with you..because then it would be a valid scientific classification and not something 100% variable
my point wasn’t that is not a word…of course it is a word…I’m simply stating what it is referred to meaning….a set scientific criteria to classify an alcoholic does not exists…organizations like the AMA are political..not scientific….really..they will classify anything a disease if it save s money and can be used for insurance reasons…the same thing with obesity…that is also classified a disease…being a fat lard a– is a disease…
please don’t complain about being offended then use things in your response like personal attacks..and name calling.(which I never did) I really don’t need to be called ignorant ..thank you
First off, I did not say you were ignorant Donjaun. What I did say was that any person who makes comments about a subject without first having a valid platform to back it up, was ignorant. It’s ok, I am ignorant of a lot of things. So are most people. I wasn’t complaining about being offended, and I never attacked you, or anyone, and I never called anyone a name. If I made a statement that you took personal, then maybe there is some validity to what I said.
I may have made an unsupported comment about the AMA, and I apologize for that. The AMA is a highly controversial and volatile organization. However, The World Health Organization is the authoritative body that decides what, and if a disease, should be classified as one. The AMA is consulted, and together, a unified decision is made. There is a “scientific” definition of alcoholism, as determined by both the WHO and the AMA:
Alcoholism is characterized by:
1. A prolonged period of heavy, frequent alcohol use
2.The inability to control drinking, once it has begun
3. Physical dependence manifested by withdrawal symptoms when the individual stops drinking
4. Tolerance, or the need to use more and more alcohol to achieve the same effects
5. A variety of social and/or legal problems, arising from alcohol use
The WHO and AMA don’t have any biases for deciding what and what is not a disease, and therefore do not have any motive for doing so. A disease, or “malady”, is not added to the International Classification of Diseases for monetary purposes. Obesity, as by your example, is classified as a disease for “saving money” and “insurance purposes”. Interestingly enough, obesity is one of the few classified diseases that a majority of insurance companies don’t pay for, at all. Also of some significance, most insurance companies will pay for drug or alcohol treatment programs. Obesity and alcoholism can both be considered a “social disease”, of sorts. They both have emotional and psychological components, as well as physical effects. One more thing worth mentioning. Obesity is responsible for 1 out of 5 deaths for people aged 40-85, while alcohol is attributed to 1 in 10 deaths in people aged 20-64. It’s interesting that obesity kills more people than alcoholism, yet insurance won’t pay for treatment.
I do apologize Donjaun if you felt I was directing ignorance at you. That was not my intent. This is a case of “generalized ignorance”, and most people are ignorant of one thing or another. We all have beliefs that are no less valid than the other. Perhaps my beliefs are biased. As a matter of fact, I don’t think anyone’s belief in something can’t exist, without a certain amount of bias. What I present here is based on my personal experience, my education and research, and similar experiences from people I come into contact with. I don’t claim to have all the answers. I do claim, however, that what I post here is not meant to be malicious, and is based on personal experience, and facts.
This is one those subjects there is not much middle ground. By that I mean, you either believe it, or not. And, it is a breeding ground for promoting arguments, rather than discussion. This rebuttal is not to try and prove you wrong, but to address your comments or disagreements. That is all.
well..you clearly called me ignorant..and on top of that you are telling me I don’t have a “platform” to make valid statements on the subject..whatever that means….maybe you can stop with this bs…and I wasn’t offended…so your pet theory on someone being offended means your surperior opinion must be right …well that is total nonsense
the World Health Organization is directly influenced by the AMA and the NIDA…..of course the are influence by politics…this is consensus science…it is influenced by insurance companies…pharmacueticals..and politicians with their hands in all that money…now look even if a group of so called addiciton specialists..got together and made this vague..list..that really can only be used for self diagnosis….it has nothing to do with science.. You are telling me you cannot see that? saying someone can’t stop or control drinking is a theory..that has never been even close to proven..it’s just an idea that people like…if you makes you feel better to call alcoholism a disease..that will be a lifelong struggle..go ahead..that’s your business…you can call it an ancient hindu kundalini awakening that only true alcoholics can experience… for all I care. the point is none of this has anything to do with real science..of course anybody is allowed to believe whatever the hell they want
just one last thing..that wonderful list that is used to classify “alcoholics” has nothing to do with “facts” or is even in the same ballpark
“There is a “scientific” definition of alcoholism, as determined by both the WHO and the AMA”: Alcoholism is characterized by:1. A prolonged period of heavy, frequent alcohol use;
2.The inability to control drinking, once it has begun; 3. Physical dependence manifested by withdrawal symptoms when the individual stops drinking; 4. Tolerance, or the need to use more and more alcohol to achieve the same effects; 5. A variety of social and/or legal problems, arising from alcohol use.”
Clay, I only wanted to address this part of your post, although it may be unnecessary since you did put “scientific” in quotes. The definition you cited is not a scientific definition; it is a medical definition. Without going into a lot of detail, medical models tend to group symptoms, and scientific models tend to group causations. There is currently no scientific model of addiction that deserves the qualifier “scientific.” Anyone who belives that addicts have a genetic marker that distinguishes them from non-addicts should look at what meager evidence that we do have. Our current top etiological candidates, including amino acids and neuropeptides (University of Utah, 2014):
1. The A1 allele of the dopamine receptor gene DRD2 is more common in people addicted to alcohol or cocaine.
2. Mice with increased expression of the Mpdz gene experience less severe withdrawal symptoms from sedative-hypnotic drugs such as barbiturates.
3. Mice without the cannabinoid receptor gene Cnr1 are less responsive to morphine.
4. Mice lacking the serotonin receptor gene Htr1b are more attracted to cocaine and alcohol.
5. Mice bred to lack the β2 subunit of nicotinic cholinergic receptors have a reduced reward response to cocaine.
6. Mice with low levels of neuropeptide Y drink more alcohol, whereas those with higher levels tend to abstain.
7. Fruit flies mutated to be unable to synthesize tyramine remain sedate even after repeated doses of cocaine.
8. Mice mutated with a defective Per2 gene drink three times more alcohol than normal.
9. Non-smokers are more likely than smokers to carry a protective allele of the CYP2A6 gene, which causes them to feel nausea and dizziness from smoking.
10. Alcoholism is rare in people with two copies of the ALDH*2 gene variation.
11. Mice lacking the Creb gene are less likely to develop morphine dependence.
So, if anyone is worried about cross-addiction in mice, feel comforted. Other than that, this state-of-art genetics is not even suggestive of a meaningful, causative genetic link to addiction in humans.
You’re welcome for trying to be kind. I stand corrected on a couple of items. I do understand how politics, insurance companies, the AMA and NIDA and the like can be connected. I was essentially addressing your comment on obesity, and it having to do with money. If obesity was listed as a diagnosis, a medical disease, and the purpose of it was to bilk money from insurance companies, it is odd that insurance does not pay for anything related to obesity. Rarely, they do if a life or death situation is substantiated. I do know that for a fact, I bill insurance companies for a major medical provider. So, I wasn’t necessarily addressing alcoholism, rather, using your example.
I never called anyone ignorant. I made a general statement. My “pet theory”, as you call it, doesn’t make me superior. It is an observation of my past experience, and with countless alcoholics and addicts. Maybe it doesn’t apply, per se, to someone without an addiction problem. And perhaps my statement about not having a platform, was misworded and the statement I was trying to convey was lost. Again, my apology.
As far as that wonderful list, each and every point stated has everything to do with addiction, whether it is from a scientific, non-scientific, medical or personal standpoint. My use of quotation marks, was yet, another error on my part. With that being said, it is relatively hard to discern the difference between “scientific” and “medical”. I do know that science proves medical theories. Medical science, which can at times be theoretical, is based on science, which is exact. There are countless studies and published research that supports that addiction is a disease, and, yes, the same goes for addiction not being a disease. Hence, the endless bantering back and forth here. So, when I say there is scientific proof that addiction is a disease, I am not making that up. Same goes for it not being a disease. Each side claims to have “scientific proof”. My statements sometimes are made from an emotional level, seconded by information I have read, coupled with my own personal experience. On both sides of the fence, claims made could very well, and are likely, theories. Arguments against each “theory” will go on until the end of time.
My personal experience in recovery have not made me decisive on this issue. If I (or any other person) sides with the idea that addiction is a disease, then opponents say that I needed an excuse for what I did. Proponents will argue for it using the same, but differently interpreted, outcomes of that scientific research. I stated here before, a few years ago when I found this website. that I was not 100% sold on the idea of addiction being a disease. But, after years of being sober, being around active addicts and people with arrested addiction, along with information I have found, I lean slightly toward the idea that it is.
Yes, I am emotional. But, I am not illogical. Yes, I am informed. But, I am not a scientist. Yes, I am passionate. But, I am not an extremist. Yes, I am Human. And yes, I am far from perfect. So any misstatements I may have made here, I humbly apologize. And, especially if discounted your statements, beliefs or theories. But when it comes down to it, every time one of us argues, or states our opinions, or quotes facts that are contrary to another’s statements, it is a form of discountenance. I think I’ve said enough.
Science will never prove or disprove that addiction is a disease because it is not a scientific question. In the medical model, “Addiction” is a label of grouped symptoms agreed upon by whoever happens to be attaching that label. In a scientific model, “addiction” would have to be a falsifiable hypothesis that requires demonstrable causation. I don’t see how I can make the distinction between grouped symptoms and demonstrable causation any clearer. Within Science there is absolutely no debate about whether or not a group of symptoms should have a particular label, because it is a scientifically meaningless question. Within Medicine, isolated data (meaning not attached to a scientific theory) that was collected by hard-working scientists are applied by non-scientists, non-scientifically, to non-scientific models, with non-scientific results. And as a practicing Scientist I can tell you that Science is far from exact, and most of my colleagues have a healthy skepticism towards any scientific studies, because we know how much disortion occurs when information is transferred from laboratory to publication.
Thank you. Point well taken.
they just made obesity a disease…and even if some insurance companies aren’t picking up the tab for obese people..they will eventually..that was the whole point of making it a disease
if we take way the scientific criteria to classify something a disease…well what happens is the word itself becomes useless…because then anything can be called a disease. In that case scientists and doctors should never use the word again..because it is completely meaningless
That’s thinking logically Don Julio!
Don Juan…… Dude…..addiction is considered a Disease because of NOTHING BUT SCIENCE!!!! Its all about scientific criteria!!! Ahhh lets see….. chemical imbalance in the brain (science)…… changed structure and function of neuronal pathways (science)….. altered and heightened reward pathways reinforcing behaviors (science)…..biological and environmental factors (science)….genetic markers (science)….and on and on it goes!! You are right though….. anything can be labeled a disease……for example….. you choice proponents are a disease to logic and reason!!!
ryan with all do respect…they never came close to proving or even being able to suggest that there is a chemical balance in the brain that causes addiction. There is no disease in the brain. Brain scan rsearch shows nothing about addiction. writing this post is currently altering an ever changing brain scan…if it was being taken….anything a person does or doesn’t do alters their brain scan image..connections between brain scans and addiction or completely bogus
scientists can’t even honestly suggest there is a change is nueral structure or pathways that causes addiction..there is no evidence of that…There is currently no valid evidence to any form of addiction is genetic in any way…the articles or studies that hint to that are lies and propaganda…to the best of our knowledge nobody is born an addict unless their mother was using during pregnancy…..Using a scientific criteria any credible scientist will never claim addiction or alcoholism is a real disease.. I know with all the propaganda on this subject it’s easy to be duped…Therapists and drug counselars also lie or propagate mis truths.. I know that sounds horrible but it’s 100% true
on the other hand..why would you want to have a disease? especially if there is not even a hint of evidence that you do?
Don Juan….look man…….. NOONE (I hope) is saying that we all don’t at some point make the choice to get clean. That is obvious….we either decide we have had enough…seek help and start the healing process. But from that choice…. comes a rehabilitation process. For me it was a crash and burn that landed me in jail. And even after I was released (6mo) I still struggled with cravings and I relapsed and had to do more time. I then was afforded some healing and clarity that allowed me to begin recovering. I received treatment and so forth. But the healing process is STILL ONGOING to this day!!! It was not like I woke up one day and said “i’m done” and that’s it….and I rode off into the sunset!! This is what you people are trying to claim that should be the case!!! IT’S NOT….AND NEVER WILL BE for the vast majority of addicts!! That is the whole issue here!!! If choosing to quit using drugs or alcohol was as simple as any other everyday choices we make….there would be no need for treatment centers now would there??? if you can’t accept that basic logical truth…than your thinking is flawed. Like I wrote in another post….If I choose to switch chewing gums because I’m tired of the old one….I am making a choice right? However….I wouldn’t have to seek treatment for withdrawals….would I??? Of course not!!! Many times I tried to “choose” to stop….but I was unable to fight off the cravings! I rode that roller coaster for many years until circumstances forced me to stop. And now with treatment and tools and more knowledge as well as my brain and body being in better shape…I am ABLE to “choose” with more effectiveness. But this is why addicts need treatment and why they seek help dude!! Again…if it wasn’t a disease or affliction or condition that required this type of intervention and process than perhaps we wouldn’t be having this debate…now would we. But that’s not reality….and that is why your claim that “EVERYONE” should be able to just simply stop cold turkey doesn’t even hold a drop of water. It’s NOT REALITY!!! It’s fantasy!! Addicts need a lot more in the way of treatment to fully recover….than just making the choice. Yes that is the first step…..and when they take that first “choice” step to seek healing…..they still have a disease that needs to be cured. And that takes time and much much more!! Plain and simple!! THERE IS WAY MORE INVOLVED……THAT’S WHY THE DISEASE MODEL FITS!!
“there is no real treatment past medication for physical withdrawal”….”the rest are just placebos”!!
See dude….that’s where I get upset!! You make the most unrealistic and frankly “imbecilic” claims imaginable!! You make a blanket statement like that…that is purely based on ridiculous logic and just like last time…..again you are trying to claim that “ALL” TREATMENT IS SOME SORT OF FRAUD!! Are you freaking serious!!! So you are saying that AA is worthless….NA is useless….counseling is a waste of time….antidepressants and psychiatric meds are an illusion!! See this is a prime example of the type of claims people make when their argument has no basis in logic or reason. It is just simply retarded in my opinion to attempt to discredit the countless millions and millions of caring and dedicated people working in the treatment field doing everything they can to help others recover from their addictions…..just to try and prove your ridiculous self-centered agenda!! Let me ask you this…..if everyone in the treatment field are liars and frauds and are just in it for the money…… WHAT IS YOUR GOAL IN THIS FIGHT BRO? Tell me that? You have none!!! There is NOTHING beneficial to the world of addiction and its treatment, its research and the lives and families involved….by trying to prove that addicts need to simply “think differently”….. That we ALL need to have the perspective of Don Juan…or Stephen…or Kevin B (butthole). Dude….perceptions, opinions and viewpoints are just that!! The scientists and researchers and therapists and counselors and loving caring people are the ones making a difference. Not people like you who are wasting their time trying to argue on what people should be allowed to label a disease. That’s all your doing….You for some reason….don’t like the idea that addicts have some sort of condition that they can’t control…or a brain disease that needs treatment. ALL BECAUSE YOU “THINK” IT HAS NOTHING TO DO WITH ANY OF THAT….AND IS ……………”JUST THOUGHTS”…..”JUST WILL”….”JUST CHOICES”!!!! That is merely intellectual pride and arrogance!! Nothing more….and again it does the suffering addict NO good except to cause them to feel inferior and weak!!!
No “REAL” treatment huh?
So let me guess dude….. all of this is FAKE….
Medically supervised Detox and withdrawal therapy and treatment…
Cognitive–behavioral therapy…
Multidimensional family therapy, which was developed for adolescents with drug abuse problems—as well as their families…
Motivational interviewing and Motivational incentives (contingency management)….
Individual and Group Therapy and Counseling….
Moral Reconation Therapy….
Supplements to Treatment Program: Cognitive, Holistic, Faith-Based, 12-Step, Native American based groups….
Nutritional and Fitness Planning and Activities: Nutrition, Vitamins, Exercise training….
Acupuncture and Massage Therapies, Osteopathic Manipulative Treatment….
Education (GED, College, Financial Literacy, and Life Skills), Lectures, and career Workshops…
Spiritual and religious studies….
Aftercare Programs, sobriety maintenance groups and relapse prevention programs….
And that just scratches the surface of the wonderful help available to the recovering addict!!
BUT NONE OF THAT IS REAL according to DonJuan!!!! ITS ALL A FRAUD!!! WOW….Gotta be the dumbest thing I’ve heard yet on here!!! Except for Kevin B….who is simply a raving lunatic!!!
Dude….I am deeply offended that you would ridiculously try to discredit the many millions of caring and loving people who dedicate their lives HONESTLY to help others!! YOUR OPINIONS MY FRIEND ARE THE FRAUD!! Give it up dude…..FOR REAL!!
That is correct….these treatments can be used for anything. But if everything boiled down to choices bro…then NO TREATMENT WOULD BE NEEDED…..FOR ANYTHING!!! We would all have “the right choice” at our disposal all the time!! But we are not born with that capacity now are we!!
And again….you make a blanket claim that all of these treatments are Placebos….and then you go a quantum leap further by claiming this is backed up and “PROVEN” by research. Dude….come on man!!!!! The placebo effect is merely a research tool to see what is most effective in treatment or rather to gain insight. It PROVES nothing 100% as it varies for different people and circumstances. Example….not ALL depressed people get well with sugar pills like you apparently are trying to claim!!!!Furthermore…this claim is absurd when you consider the countless millions of lives that have been improved by these treatments. THAT’S COMMON SENSE!! Wow….can’t believe I just argued that point with you!!! Ugh!!!
I am happy that I am on the road to recovery and feel very very lucky and grateful….but who’s to say that I wouldn’t still be using or dead without the intervention and treatment I received!!
Finally….. its like this man…. Yes anyone can make the choice to stop using and they all do unless they die first. But the problem….is very simple! Every other normal everyday choice is not influenced or affected by biological factors. IT IS A FACT THAT DRUGS AND ALCOHOL ARE “MIND ALTERING”….and if you deny this your are not human!!! All it takes is this one (of countless) FACT that an addict experiences CRAVINGS…… much of the time long after they have quit. Cravings are a proven neurological and biological symptom that the addict HAS ZERO CONTROL OVER….NONE!!! Therefore….the ability to choose normally as in normal everyday situations is hindered and affected. If you remove ALL of the biological and psychological factors influencing the brain and body….then you may have a sound argument. But again….that is not the case and the factors involved are numerous!! Again, your argument falls on its face again!!
That is correct….these treatments can be used for anything. But if everything boiled down to choices bro…then NO TREATMENT WOULD BE NEEDED…..FOR ANYTHING!!! We would all have “the right choice” at our disposal all the time!! But we are not born with that capacity now are we!!
And again….you make a blanket claim that all of these treatments are Placebos….and then you go a quantum leap further by claiming this is backed up and “PROVEN” by research. Dude….come on man!!!!! The placebo effect is merely a research tool to see what is most effective in treatment or rather to gain insight. It PROVES nothing 100% as it varies for different people and circumstances. Example….not ALL depressed people get well with sugar pills like you apparently are trying to claim!!!!Furthermore…this claim is absurd when you consider the countless millions of lives that have been improved by these treatments. THAT’S COMMON SENSE!! Wow….can’t believe I just argued that point with you!!! Ugh!!!
I am happy that I am on the road to recovery and feel very very lucky and grateful….but who’s to say that I wouldn’t still be using or dead without the intervention and treatment I received!!
Finally….. its like this man…. Yes anyone can make the choice to stop using and they all do unless they die first. But the problem….is very simple! Every other normal everyday choice is not influenced or affected by abnormal biological factors. IT IS A FACT THAT DRUGS AND ALCOHOL ARE “MIND ALTERING”….and if you deny this your are not human!!! All it takes is this one (of countless) FACT that an addict experiences CRAVINGS…… much of the time long after they have quit. Cravings are a proven neurological and biological symptom that the addict HAS ZERO CONTROL OVER….NONE!!! Therefore….the ability to choose normally as in normal everyday situations is hindered and affected. If you remove ALL of the biological and psychological factors influencing the brain and body….then you may have a sound argument. But again….that is not the case and the factors involved are numerous!! Again, your argument falls on its face again!! It’s a disease!!
That’s ironic……..where is your “evidence” that brain scans are bogus? Dude….and we never claim that a chemical imbalance causes addiction. Its the other way around!! Depressed people don’t necessarily use drugs. But there is plenty of evidence that addiction does cause a chemical imbalance. Just ask addicts how they feel after they come down….or when they are going through withdrawals!!!!!! And furthermore…..the depressed state and sickness that addicts suffer contributes to a need to continue using. Ask any heroin addict!!! And dude…..brain scans is only a tool to look at brain function as to gain insight and clues. THE PROOF IS IN THE ADDICTS EXPERIENCE!!! Science doesn’t have to prove its a disease…….the plight of the addict is all you need to PROVE its a disease!!! You ever seen a crack addict fiend for their dope 24-7… 365 days a year???? Guess not!!! And your trying to tell me that at ANY time during that time…..they should be able to “just stop”!! That’s whats laughable!!! You people are just like Atheists who claim….there is NO EVIDENCE for God…..and need 100% conclusive without a doubt scientific proof. THAT’S impossible!! All you need for a classification for a disease is something that affects the normal functioning of the body. A heroin addict is 100% proof that the drugs do exactly that………they alter and effect the normal functioning of the body. You choice proponents have the most ridiculous agenda trying to PROVE that it ALL boils down to making better choices. Well, I can tell you first hand bub….that when I was at the height of my using….there weren’t even any “choice thoughts” entering my mind!!! I was a robotic compulsive animal….who had only ONE THOUGHT…… how am I going to get high today. And just because there isn’t any current evidence that addiction contains a genetic marker (which is false, and frankly irrelevant anyway ) doesn’t mean that genetics doesn’t play some kind of role. All scientist are doing is looking for clues. Why?…… Because it is OBVIOUS by looking at addicts……that there is something going on inside of them that is causing them to compulsively use day after day after day after day!! THEY HAVE A DISEASE…..and scientists are simply trying to find out why. Scientists don’t usually research and study things dude unless they have a pretty good basis to do so!! Lastly…..you claiming that all this science is bogus and everyone is a liar and its all propaganda is simply juvenile!! You sound like a freaking conspiracy theory junkie!! That’s merely your opinion based on nothing!! Its simply an immature excuse to attempt to back up your “choice” claim. EVERYONE IS A LIAR!!! Yeah….sure they are!!! Nice try buddy….
I love your claim….”I know that sounds horrible but it’s 100% true”. WOW…. its no wonder why I get so pissed off on here!!!
the precepts of the disease model clearly imply that addiction is ingrown..meaning you are born with it and it is lifelong. now.you have told me throughout your posts that you don’t believe in this made up myth..ok..but you see that is the whole premise that the disease model stands on..of course none of this had become even close to proven..You tell me that while in your addiction you had No choice but to use? I wonder then how did you stop using or moderate form that point? I’m assuming you are not using in an abusive manner anymore..How did you stop then..and how was that not your choice..well it is your choice..as it always is..consuming drugs and alcohol is a complex involuntary action..that means we have total choice over it. Therapists and drug counselars are most likely alligned with AA or NA. even if they they know there is no scientific basis in the disease model..which they probably do…they may feel this is the only support you can get. going to NA..and with that they can’t go against the made up science and religion..It’s not that it’s a conspiracy theory..it’s just that the interest in this field is for making money and not so much using the valid research that they do conduct..because their policies always go against the facts
I meant “voluntary” not “involuntary”
Ryan,
I’m done trying to form rational arguments to counter your comments, because you’ve proven, over and over again, that you’re a confused child with a grudge that you don’t even understand. Your logic is incorrigibly flawed, you’re delivery is unnecessarily aggressive, and you’ve made it abundantly clear that reasoning with you is a lost cause. It scares me that people like you are allowed to vote, and, if I were you, I may as well go back to using because there has clearly been no progress in brain functioning since you went sober. I’m fine with being accused of lack of empathy…I don’t feel bad for you.
with certain physical withdrawals of drugs like alcohol and benzos it is advised to have medication intervention to ease physical withdrawal symptoms….after the physical withdrawal symptoms have subsided which is very brief with ALL drugs..what do you claim needed for a “recovery” program?…AA..NA? drug counselars? psychiatric medication? There always seems to be this big mystery about treatment like they are doing miracles in drug rehab centers…did I miss anything in what i listed in your experience with rehab? besides physical withdrawal therapy… maybe with the exception of psyhciatric medication which is supposedly used to treat underlying mental health issues…the rest are just placebos…insurance companies are shelling out big bucks for placebos…there is no real treatment past medication for physical withdrawal
besides your medical supervised detox..which is medicating physical withdrawal symptoms..none of which you listed has anything to do with substance abuse..those are popular and trendy therapy practices at the moment…whether it be Cognative Behavior Therapy….Dialectical Behavior Therapy..counseling with families….counseling with groups. these are methods used for ANY reason ANY person seeks counseling for ANYTHING…they are not special to drug addicts…and for the most part the are just common sense approaches to life that are made to look complicated..AA and NA..are special to addicts as a support group..and yes they are placebos as proven by research and the fact that there is nothing remotely scientific about them..I’m glad you are better really..but why not give yourself credit..after all you did this by yourself…you really don’t have to give credit to things like this
It does the addict “no good” to lie to him or to tell him fairy tales under the guise of that will help him get better. It never does
The reason NA and AA are a placebo there is no scientific basis..logic or research that proves they help anybody with their addiction in any way. A placebo doesn’t have to work..as you imply..to be a placebo..that is incorrect. It simply has to be a null.
Why the F*** does something have to be somehow “scientifically proven” in order for you morons to find it beneficial. You can’t scientifically PROVE something as subjective as AA or NA…………. It’s what works for the individual……..and MILLIONS upon MILLIONS of people have been helped by AA.
Don Juan…..Im just going to come right out and say it……………… YOU’RE AN IDIOT!!!
> The solution then, is to change one’s mindset – but the brain disease model of addiction essentially says this is an irrelevant matter.
I … what?
No, it does not.
You clearly do care about this issue, rightly so, addition is a more pervasive issue in society than people realise. However I arrived here via your comment on Russell Brand’s evidence given to the parliamentary committee regarding addiction; your opinion that his comments treated the issue as a binary choice is poorly reflected in the above comment, which seems to be making a binary point. For someone who dislikes the apparent presentation of issues as binary matters you appear to be indulging in the same mistake.
My going on here about this won’t help; I would like to direct your attention to Daniel Kahneman’s “Thinking, Fast and Slow”. The relevance to your work will become quickly apparent and I am sure it will further insight and ability to help people overcome their addiction problems.
funny how the drug addicts are all p.o.’ed that they don’t have a disease…you’d think it would be good news.
I remember when I was 10 and my poor brother was put into treatment for a little bit of weed and they sold him on the disease theory right then and there.
Now he’s had a whole life of being “PROGRAMMED”
I thought it was bs then and have known it is bs for a long time now.
imho i think it’s mean to tell drug addicts they have a disease and are POWERLESS ……
Why would I and others who hold to the disease model be P’o.ed…. “because we don’t have a disease”??? Nothing to be mad at there….. because IT IS WRONG!!! What I personally and I assume others are upset at is people in the choice camp who ignore the mountain of evidence, the personal experience of countless addicts and the overall reality of the matter……and make the claim that it is simply a choice with NO hard evidence to back up that claim. That claim is simply an opinion….nothing more!!!The only thing you have to base your assertion on is either your own personal “outsider looking in” opinion or the fact that some people are able to just quit without treatment and therefore you claim that “everyone” should be able to do the same. That is simply not reality!!! That Is what we get upset about….its people trying to change the reality of the suffering addicts experience to push their own agenda while at the same time pressuring addicts to believe “they are weak-willed” “character flawed” and need to just make better choices. They then pile on and attack the countless millions of caring people who work in the treatment industry and try to downplay it also in order to attempt to bolster their absurd claims. THERE ARE COUNTLESS REASONS WHY THE DISEASE MODEL OF ADDICTION HAS BEEN ACCEPTED……….. for many many decades now. The vast majority of people who become addicted to substances and use for long periods of time….have “developed” a disease and need some sort of treatment and support in order to get clean. THAT IS THE REALITY!!! That is why the disease model applies…..
Now in the case of your brother when you were 10….. I agree that perhaps telling him he has a disease for smoking a little weed is not realistic either. The disease develops over time. But if he is continuing to use now and is finding it harder and harder to stop….. then it is possible he has developed the disease….then perhaps he does need treatment again…..or like you state, he should just choose to stop and either way he can recover. But even in the case of someone quitting cold turkey….. the disease IS STILL THERE!!! But telling someone they have a disease does not necessarily affect someone in a negative way as you state….. “he is now PROGRAMED”. A viewpoint shouldn’t affect an addicts recovery or lack of recovery to any huge degree. You cannot tell me that because someone told him he has a disease a long time ago in some treatment program….that this is the sole reason why he is still using today….(if that’s the case). Some of the disease is psychological to be sure…..but making the claim that its “the disease model perspective” that is keeping people from recovering is frankly absurd. I and millions of others have been treated with the disease model presented or used in some way shape or form and had no problem accepting it, using it and recovering with it. Imho….. addiction “becomes” a disease over time…. at some point we make the choice to quit…. and because for many, the disease symptoms have set in…. we may need treatment and help to recover. There should be NO shame in that and there should be no feelings that “someone is cruel” for explaining that you or I have a disease. BECAUSE FOR COUNTLESS MILLIONS AND MILLIONS OF ADDICTS WHO “STRUGGLE” TO STOP ON THEIR OWN…………….. THIS IS WHAT IT FEELS LIKE…………… A DISEASE!!!
Ryan,
The substance of this article is the brain disease model of addiction – the literal claim that addiction is an organic disease in the brain that causes substance craving/use. I have made my arguments against this model directly, and over the past year I’ve added new quotes from neuroscientists and other researchers who concur. I haven’t seen you argue against any of my points, so frankly I do n’t know what you’re doing here. What I have seen you do is engage in basically, screaming back and forth, saying that the choice view is an insult, assign your assumptions to myself and others who disagree (i.e. that we think “addicts” are bad, or weak, or whatever), make appeals to authority, talk about your feelings (essentially, that you feel like a disease so it must be one), and any number of other arguments that come nowhere close to examining the facts and logic associated to claims that an altered brain causes substance craving/use.
So again, what are you doing here? You’re adding nothing to this debate, and frankly, it’s embarrassing to have this comment area filled with rantings from the likes of you and Clay.
Please try to put together a substantive counterpoint to the topic of this article, or just stop posting here. Again, the topic, and my claim is that the changes to the brain we’re shown by brain disease proponents do not cause substance craving/use/ I’ve approached this from a few angles. You should read back thru the article, and if one of those angles doesn’t seem correct to you, then go dig up the related info, discuss it in a logical point by point way, and post away. Remember though, an appeal to authority doesn’t constitute an entire argument. What I mean by that is that saying something to the effect of “John Doe PhD says it’s a brain disease” is useless. I can come up with John Doe PhDs too, and they’re listed in the article, and I do more than just refer to their authority and their conclusion – I try to include quotes that go a little deeper into their thinking on the topic.
Again, if you’re not willing to do something like what I just suggested, then you don’t want to really debate in any logical fashion, and you simply won’t be welcome here, nor will Clay. This page isn’t for endless pointless bickering. I’m the author, the owner, I spend my own money to publish this site, and I will block you from commenting further if you continue the same crap.
-Steven
By the way…I don’t see you charging people like Don Juan to make substantive arguments!! He posts crap like this……..
“The reason NA and AA are a placebo there is no scientific basis..logic or research that proves they help anybody with their addiction in any way”.
(what a f**** joke)
“besides physical withdrawal therapy… maybe with the exception of psyhciatric medication which is supposedly used to treat underlying mental health issues…the rest are just placebos…insurance companies are shelling out big bucks for placebos”
(yeah….insurance company’s are knowingly flushing money down the toilet on treatment that doesn’t help people….. sure they are!!!)
“There is currently no valid evidence to any form of addiction is genetic in any way…the articles or studies that hint to that are lies and propaganda”
(that’s always a valid argument………….. everyone is a liar!!)
“AA and NA..are special to addicts as a support group..and yes they are placebos as proven by research”
(Where is this research???????? Id like to see that pile of shit …..if it even exists! which I can guarantee it doesn’t!!)
– “No research that proves that AA works”!! Oh just that there are millions that would testify to its success…. and plenty of documented statistics of its benefits.
– “all treatment” employs the placebo effect!! Yeah so everyone that is helped by treatment is under an illusion!! Fucking Laughable….
– every genetic research done is simply “LIES” and “PROPAGANDA”…………. sure they are!!
AND YOU LET PEOPLE LIKE THIS SPEW THIS CRAP STEPHEN!!!! Oh I guess its ok as long as it seems to support your view….even though its a bunch of idiotic nonsense!!!
Oh and what about your boy Kevin B…..who does nothing but spew insults and is a stark raving madd asshole!!! Don’t see you rebuking him for his methods of argumentation….
This whole site is full of Jokers on your side too Stephen!!! Why don’t you make them bring “substantive counterpoints”? Oh….because there aren’t any!! You can’t scientifically substantiate a theory based on simply perspective and moral worldview. The REALITY of addiction for the individual, families, its scope of influence on society and the world as a whole, and the billions and billions of dollars spent in research and treatment are proof positive that there is a HELL OF A LOT MORE INVOLVED………….THAN JUST “poor choices”.
Congratulations Ryan, you have the distinction of being the first user I’ve ever added to the “commenter blacklist” of this site!
Why? Why do I tolerate negative, irrational, unproductive comments from people on both sides of this debate? I don’t know. I give most everyone a chance to speak their peace on the topic here, as long as they don’t appear to be using a fake email address or to be a spambot of some kind. But you entered 36 comments of nasty irrationality and essentially saying “you’re wrong just because I feel like it’s a disease” or some appeal to authority. You repeatedly assigned assumptions to others that they didn’t express. You had more than your chance to express yourself, and when I asked you to reel it in to a soundly on topic debate, you refused, made 2 more comments of the exact same nature, and suggested I don’t have the right to decide what people get to say on my website. But as I explained, I do have the right. I own this website. I pay for it. Not you. Not a government. Me, a private person. It is my property. I can’t come into your house and say whatever I want. You can’t come here and say whatever you want.
You keep making points that are directly contradicted by this article, and I don’t have the time to keep responding to them. For example, in your previous comment you said that I deny the evidence that the brain changes in addiction.
This tells me you’ve probably never read this article on which you’ve lodged 38 comments now. Never. Thus you don’t belong here. Anyone who’d read it would know that I’m not denying that the brain changes. I accept that as fact. One of the main lines of argumentation here has to do with making sense of such neural adaptations – with understanding their significance – do they indicate the presence of a disease, or do they have some other meaning? You may disagree with my analysis of this topic, and I would welcome that. I would welcome a counterargument to mine. That is what I’m asking you for. Instead, you completely mischaracterize me – saying that I deny the brain changes altogether, which I clearly haven’t done. The evidence that I don’t deny brain changes is THE ENTIRE ARTICLE I WROTE AT THE TOP OF THIS PAGE STARING YOU IN THE FACE. You don’t belong here, it’s a waste of my time, and a waste of any other readers’ time.
Thus, you are banned from commenting here. Why don’t I do this to everyone? Why are you the first to make the blacklist? Why don’t I ask every irrational commenter to make real points or get banned? Because most of them don’t go on for 36 comments making the same non-points again and again. Most of them don’t go on for 36 comments demanding information that is easily found all over this website or in fact on this very page in the very article they’re commenting on. But you did all of that and worse.
Speak your mind elsewhere.
-Steven Slate
I thought I was your first ever blacklistee. 🙁
I’ve been periodically reading, posting, commenting…..sometimes positive, sometimes negative, other times very informed, and a few times, more emotional and less factual. I know all about the means by which an “ailment” is listed as a disease, a syndrome, or whatever, and the implications it has on insurance payments, or the lack of them. I have seen it posted here time and time again that people with addiction, usually the ones who don’t have the “willpower” to do it on their own, say that they subscribe to the disease “theory” now have an excuse for their behavior. The ones who have the “willpower” are quick to call 12 Steppers weak, losers, lacking willpower and character…..maybe not in those exact words, but probably more vulgar.
Who the hell cares what someone else believes? Who the hell cares if you think you have more willpower than someone else? Why does this issue even exist? Who, I mean, really, who gives a crap whether addiction is a disease or not. Technically, it IS a disease. In 1956, it has been listed as a disease, and continues to be recognized as one, paid for by insurance companies as one, and has more evidence, whether it be scientific, or medical, to prove that it is.
I don’t think this is really a moral issue. As long as we all breathe oxygen, this battle, the worthless and pointless one going on here, will go on. As long as people are self-righteous, think of themselves better than the one “who has no willpower”, this “debate” will continue. I think this is an issue of superiority, self-righteousness, self-serving and overly confident “ism”. Yes, some of the nay-sayers, the 12 Steppers, supporters of the disease module, are of the same rank. What I have seen here is an overall blatant disregard for people’s genuine life experience, and a complete lack of compassion and empathy. Period. I do understand how people who think they are superior never admit defeat, never show compassion, or even entertain that another person’s experience, is just as valid as theirs is.
Continue on everyone. I’ll probably get some negative comments too. Why not? Any ideas, thoughts, or theories different from what this site advocates, get put down, discarded, and discounted and tossed aside as invalid. That’s ok. I am one who knows my worth. I don’t need to be personified one way or another. Happy Holidays Everyone!
Go ahead Steven, block me. While my “rantings” may not be scientific in nature, they do include a human element. As far as the endless bickering, that is all that goes on here. I get it. You, and what this site represents, is that addiction is not a disease. I personally am not 100% convinced that it is. I have made that statement more than once. My whole issue with this site is, the endless disqualification and discountenance of opposing opinions, and people’s personal experience, aka the human element. I don’t necessarily always agree with the way opposing opinions are presented, and the content of such opinions. What did you expect when you started this site? That everyone would agree with you?
You are to be commended for using your own funds to publish, operate and moderate this site. It has enlightened me immensely over the years. It has also sparked a little anger, yes, emotion based, not because of the evidence presented, but, as has been my platform all along, negative connotations to those of a different way of thinking. I suppose that even I have made comments that could be considered negative. Steven, you have even shown understanding and compassion towards a couple of my postings, and I thank you for that.
This topic is a hot one. One that will be debated until the end of time. This is not a black and white subject, as is evident by all the disagreement here. As I said before, I have tried to include a less scientific element here. And maybe, just maybe, this is not the place for that. Bickering and debating are not close in the literal meaning of the words,, theoretically, but in practice, they are. I don’t post here very often, I go in spurts. I am a bit biased, as is everyone here. So, if you feel the need to block me from this site, then by all means, do it. I just think that a site such at this would be pretty boring if everyone thought the same way. If I am not blocked, I will try and make more substantive counterpoints to the topic, as you suggest.
I remember I made a comment once here, can’t remember my exact wording, that science was a precise and exact, well, science. I was countered by someone saying that no, it isn’t. As is the human element and experience not exact, but it does have validity to this subject.
Look Bud….you are the one making the claim…”addiction is all choices”…….therefore it is up to you and the rest of your “choice” clones to back up YOUR claims with evidence. You are the one who created this site and you are the one with the agenda. I don’t have to personally counter your claims with scientific data and spell out the decades worth of research and data and evidence that addiction is a disease. THAT’S ALREADY BEEN DONE!! If you choose to ignore all the evidence….that’s your fault!! If I choose to argue MY WAY using logic…..for instance….siting my experience using and how I experienced cravings and it caused me to NOT be able to simply make the choice to stop on my own…. THAT IN AND OF ITSELF IS EVIDENCE BACKING UP THE SCIENTIFIC RESEARCH!!! And if I choose to get to get snarly with some of the other people on here for their ridiculous statements….I have the prerogative as well.
And as for this claim that addiction is an “ORGANIC DISEASE”……………I don’t think I or any of the disease model backers here have made that claim at all. IT IS however a psychological and biological disease. It does change brain chemistry…..it does create NEW neuronal pathways and it does create “patterns” of thinking. THESE ARE FACTS!!! And if you want to sit there and deny it….THEN WHAT THE HELL “ARE YOU DOING HERE” STEPHEN???? You cannot ignore scientific evidence and then claim…. eureka….”I HAVE THE ANSWER” “CHOICE”!! Furthermore….if you can’t respect the reality and experience of most addicts and be understanding to their plight in a realistic and compassionate way and at least consider the disease experience we have………… Then go jump off a cliff!!!
There is a choice component in all of this to be sure…………… but it is simply to “choose” to get help….to seek treatment….to recover….to mend your life and to live a life drug free. But it’s not “just choose to quit” and ride off into the sunset!!! A process of recovery from the disease must take place and that takes time and treatment!!! To deny that the addict are suffering, to deny that there is more going on inside the mind and brain of an addict, and to deny that they need help and support…………AND CLAIM THAT THEY SHOULD JUST BE ABLE TO “JUST QUIT”…………is irresponsible, it is arrogant, it is selfish and it has NO BASIS IN REALITY WHATSOEVER!!!
And like you said….. “I have made my arguments against this model directly, and over the past year I’ve added new quotes from neuroscientists and other researchers who concur”.
I could do the same freaking thing Dude!! I could probably go out there and find thousands of Phd’s backing the disease model!!!
I could site articles, research data, names places blah blah blah……….. BUT Neuroscientists aren’t the addicts!!! They are only trying to discover WHY addicts behave the way they do. They only use brain scans and other tools to discover what is wrong. And gee Stephen…………..I wonder why they are doing that???? Huh???? Gee maybe its because of what people have been observing for decades now and what addicts have been experiencing for ever. A complete lack of control over their addictions!! That’s why it is labeled a disease, that’s why it feels like a disease to the addict and that is why they are researching it as A DISEASE!!!
The PROOF is in the pudding BUB!!!! It’s in the plight of the addict!! It’s in the suffering of the person who tries over and over again to stop but the cravings are to strong. It’s in the downward spiral….its in the physical deterioration of mind and body…..Its in the constant struggle to find hope….the battle to recover….the loss of family and jobs….the effect on crime and society….the loss of self-worth….the loss of direction and purpose in life that addicts experience ……that is where the DISEASE lies!!!!
It’s like I told you before……if you want to squabble over what constitutes a Disease…..you have that right (meaningless as it is)!! But addiction is a Disease of mind-body-and soul none the less!!
So it’s not “organic” like cancer……………………………………………………. Who gives a F**** dude!!! Really!!! Does it really have to be??…………………….NO!! IT DOESN’T!!!!!
P.S…..here is an article written by an MD describing what happens in the brain that causes “cravings”!! Which you apparently deny even exist!!! Therefore, I doubt you will gain any insight from it as you have your mind made up that addicts don’t experience ANYTHING that should prevent them from simply “CHOOSING” to stop. But Hell….you wanted a “substantive counterpoint to the topic of this article”……
substantive counterpoint to the topic of this article……………. http://www.hbo.com/addiction/understanding_addiction/12_pleasure_pathway.html
P.S.S…… I have the right to say or NOT say whatever I feel!! Who are you to make up RULES for posting? Oh….. guess that would be your intellectual ego talking again!!!!
You started this disaster Bro!!! LOL
Really, you have to ask the owner of a website “Who are you to make up RULES for posting?”
Really? You are that obtuse? It’s his site, his rules. Get over it, say a serenity prayer and Let…it…go.
ps: any sign of the word alcoholic or alcoholism in the DSM V codes for diagnosis? I’ll give you a hint, the answer is: No
Disease-advocates: why must it be a disease in order to have compassion for someone suffering with an addiction? I’ve made my share of very poor choices–but they were the best option I saw in those moments. In hindsight, these were often myopic views (including legal matters) and I’ve worked hard to change my beliefs about myself, others, and the world.
I still have self-compassion for these items as well as my addiction. Bottom-line, though, they were and are choices.
Calling addiction a choice doesn’t make it any easier to deal with–it’s just more helpful and empowering.
i realize some people are angry here. The anger they have can’t be because of this site though. it is easy to see that. i never posted anything to get anybody angry…my points are backed up by facts. Even the ones ryan posted..i don’t know how he could be so offended by them.. There is research to show AA or NA are placebos in statistical data and by the fact that there is no scientific research to back up a claim that they help addicts..you can google to get such information. yes there are long studies on the success rates of AA and NA…I realize maybe you can’t call a religion a placebo…because there is nothing scientific about it to begin with..but at any rate I don’t have the need to bs people on this program..I have no beef with AA….i don’t care to say the truth…if you are angry it is not because of this website…you need to come to terms with that
Viktor..I never understood that either..the claim they don’t want to have a victim mentality….but then why want to believe you have a disease with no evidence of that?
as far as genetic research to prove addiction is a disease…of course they are valid studies..but none of them have found anything to imply a genetic connection to addiction that would support a disease theory.. there are articles from such studies that seem to suggest that there is such a genetic component..they will have misleading headlines like, “Alcoholism is in the genes” or “drinking seems to be genetic”…this is propaganda..pure and simple. I don’t say this to argue with anyone. This is the truth. The truth which you can find yourself… it is really nothing to get angry about
In replying to concerned’s quote,”addiction is a more pervasive issue in society that people realise”
well that I can’t agree with. In the states if you go to a psychiatrist or therapist for a mental health issue and you include that sometimes you get drunk…you will run a chance of him/her telling you that you are an alcoholic. Now I know this from my own experience and from working and being a part of “dual diagnosis” programs. To me addiction is a scapegoat or real problems that will never get addressed …when we introduce religion as the main option for a recovery..this is the type of ideology we spiral to…anybody who drinks too much… however often..for any reason..should never be called an addict or an alcoholic..that is damaging and psuedo science in my opinion……ok I know that is a mainstream label for most of western society…but it is based on nothing and it crates more problems then it is worth…addiction is over diagnosed and there is indeed a paranoia about it..and misinformation to horrible proportions…..you can google Dr Carl Hart who mainly researches addiction in urban communities in the US..the drug war and all the scams that go along with it…he is not someone that is looking for fame or money..he is someone like who created this website..he is fed up with this nonsense and all the lies.. especially in the black community. I like russel brand but with all do respect.he is an actor..that bases his assertions on addiction from feelings and not thoughts..I would stick with the professionals if I were you
Well, here I am, In an attempt to make more substantive comments. I will not misquote statistics, or speak about something I can’t speak intelligently on or comment about. I will mainly speak from my personal experience, and from others whom I surround myself with. I’m first going to reiterate my thoughts on the disease model, which is I am not 100% convinced that it is true and correct. Let me just start by saying something I think is relevant. I think, perhaps addiction could be classified as a syndrome. A syndrome is a group of symptoms that consistently occur together or a condition characterized by a set of associated symptoms. Addiction, is in layman’s terms, is simply a syndrome. A collection of diseases like obsessive compulsive behavior, depression, suicidal thoughts or ideations, mental instability, dermatological ailments, high blood pressure…..the list is endless. All of these symptoms of addiction, are diseases. Which, when all put together, can be interpreted as a syndrome. AIDS, for example, is a syndrome. So is Asperger Syndrome, and Turrets Syndrome. Yet, the collection of those symptoms, which are then called a syndrome, are diseases.
I disagree that addiction is a scapegoat. Addiction, without calling it a disease, is simply a symptom of underlying issues. They could be emotional, psychological, or maybe even environmental. How I try and wrap my head around this process, is that once the symptom of addiction takes hold on someone, it does bring about chemical and physical changes in the body and brain. I am of the belief, that these chemical changes induce a disease process, that in itself, creates more and more symptoms. I am no scientist, that’s for sure. It has been suggested here that if addiction was a disease, it would have to be genetic in nature. Now, there are many diseases that are caused by non-genetic sources or processes. For instance, asbestos exposure causes lung disease, such as pleural disease, lung cancer and mesothelioma. Long term alcohol intake causes cirrhosis of the liver. Addiction, once again, a symptom of underlying causes, does have an effect on the brain, whether it be “visual in nature” on, say a CAT Scan. Some will argue that if a person stops using or drinking, those changes in the brain go back to “normal”. Sure they do. But, frequent exposure to drugs and alcohol, in my experience and opinion, have a long term effect, with more symptoms, such as compulsive using or drinking, erratic behavior, and, other physical symptoms, such as bacterial and viral infections, organ malfunction or failure, the list goes on and on. The hardest thing for an addict or alcoholic to kick is the “mental” dependence , but not in all cases, or with different addictive substances. I do agree that many mental health professionals suggest that if a person says they get drunk or high frequently, they’ll suggest that they are an addict or alcoholic. Some suggest 12 step programs, some suggest getting medical intervention, while some continue to try and treat the underlying problems that contributed to their compulsive need for alcohol or drugs. As you well know, not everyone who gets drunk or high often is an addict, I personally think the therapists or psychiatrists who say go to AA or NA, without really going into any substantial examination, are simply dismissing the issue by the referral.
I get it, that for some addicts, adopting the idea of addiction being a disease gives them an excuse for their behavior and actions. But, I go to a lot of AA/NA/CMA meetings, and I know hundreds and hundreds of recovering alcoholics and addicts, none of which say that they are happy to know that they have a disease, and now justify their actions or behavior because of that. I’m sure, there are the exceptions. Donjuan, I may have taken out of context of your mention of religion and recovery in the same sentence. !2 step programs don’t claim to have anything to do with religion. Yes, they use the word God. However, what is suggested, and promoted, is that everyone can define for themselves what, or who, their God, or Higher Power is. It is simply spiritual suggestion, that may or may not help everyone.
You are also correct, Donjuan, in saying that there is no scientific evidence that AA and the like have any impact on getting, and keeping anyone sober. But, there is no scientific evidence to prove otherwise. There are no real statistics, and if there is, they are based purely on the affirmation of people for whom AA did not work. Those statistics, if any, have absolutely no scientific validity at all. I made a statement here once that science, is exact. I was politely corrected by someone that in fact, it isn’t. There has been plenty of scientific research which states, that addiction is not a disease. And, there is plenty of the same research, done by different scientists and researchers, that say it is. Each side quotes a study by this guy or that guy, citing specific points that discredit the other. Each side presents evidence, that in whole or part, is correct. Since science is not as exact, as was pointed out to me, as I thought it was, it can be suggested that the scientific evidence presented, cannot be specific to any particular individual.
Addicts who use the disease model as an answer to their addiction, in my experience, are generally the ones who don’t profit from 12 step programs. This is general statement, and is not true of all 12 step participants. Often times, these are the ones who are victims, and will always remain victims. The reason for this may be organic, it may not. I don’t think it’s really fair to say that addicts, in general, use the disease model as an excuse. This is not my experience, and, again in general, not the experience of the hundreds of addicts I know, or know of. I haven’t really presented a lot of scientific evidence, quoted famed authors, scientists and researchers. But, what I have presented is based on what I’ve seen, experienced, and witnessed. Again, what I have posted here is certainly not scientific in nature, and since scientific method “as defined by various scientists, has a ‘fairly’ rigorous structure that should be followed”. I found this definition on explorable.com. I could go to another website, and the definition could be totally different. The word “fairly” leaves room for error. I am certain that the outcome of scientific research, can have different results, performed in the same exact way, when done by different researchers. I am also certain that the results of that research is interpreted differently, depending on biased opinions one has before the research begins. Not every single researcher is free from bias, just as not is any living human, completely free of bias. What I am doing here, is simply suggesting an alternative point of view. There is a margin of error in everything. Well, most everything. Scientific evidence, is just one of the many of them. And that error, is on both sides of the fence.
I personally don’t go to 12 step meetings because I have to, or need to. I don’t go to get sympathy, or to blame a disease. I go because I want to. I go because of the social and emotional support. I go because I enjoy the company, experience, and comfort I get from people. We are NOT victims of a disease. We are simply people that choose the 12 step programs, to augment to other solutions. This is my experience, truth, and belief.
There is nothing to suggest addiction is a disease in a scientific basis. disease is a scientific classification. you can claim science is not exact and there can be personal or political bias….well with this i agree fully…it is a travesty what special interest and politics do to the integrity of science…and by all current evidence that issue is only getting worse…people make scientific decisions on political party lines and also instill anger into issues that have nothing dividing about them until you instill politics and throw a couple publicity clowns into the mix ..like actors and tv scientists.
Now making up ideas and connections that have no basis in scientific reality is different from bias or science not being “perfect.” There has to be a reason people came up with the idea that addiction is a disease. Unfortunately this reason has nothing to do with science..it just uses made up science as propaganda. Making up something and trying to prove it with no prior evidence is not science. That is politics. They are not trying to prove it is a disease because like I said any reputable scientist or doctor will not in honesty ever suggest addiction is a disease…The fact that people think addiction is a disease is not the biggest problem. the biggest problem is the whole adicition game is rigged…and this phony science is just one factor of it. How dare people suggest these scientists are making up phony conclusions? that is the mindset of the addiction community. real..it is one big scam..for the most part..and that is not an exaggeration .
To all of you readers and commenters…Merry Christmas! As “merry” as we can make it that is! From reading these many, many comments which are not so merry, the only real, coherent, conducive, and educational information and comments I’ve read came from the author, Steven Slate and John Tale.
I came to this website to find information about making a “clean slate” break from addiction. I recently was burglarized by my neighbor’s daughter who was witnessed by two maintenance men as to being in my bedroom, looking at my jewelry, without approval from me to be there. I found jewelry missing, filed a police report, she has been arrested, and so on and so forth. I found out later, that this is the one and same girl who a year earlier was attempting to break into her mother’s apartment (right next door to my apartment) and the one I called the police about at that time.
Today, I was asked by the prosecuting attorney a very important question: “What do you want to see happen with this case?” Originally, I decided to “do the Christian thing” and let her go for “lockdown” treatment for heroin addiction and jail time, which would be a 1 mo. to 6 mo. minimum and a maximum of 1 year. Or keep her in for the jail time, which I believe was a minimum of 2 years and, since this is considered a “grand theft”, a maximum of five years.
However, after learning from the building manager and others who know about the “lockdown” court treatment process, she would be out on probation after one month and free to come back here….I called the prosecutor right back and changed my mind. Knowing and seeing what this girl is capable of is amazing…..she is very convincing, abusive, devious, deceitful, manipulative, and physically strong enough to break the frame of the door she was pounding on last year in 3 places! I told the prosecutor “we” need protection ! Her own mother, myself, and the old guy down the hall who is also in his mid to late 80’s, like her mother is and others who are not physically strong enough to “take her on” need to have her kept away for our own safety !
After reading all this information from Steven Slate, John Tale, ALL the many comments here listed, and considering the experiences with my own brother doing the very same thing to my mother years ago (may she rest in peace), and my own experience with alcohol, I am MORE convinced now, that this may be the “clean slate” break she needs from her pattern or “habit” of lifestyle she has willingly or unwillingly gotten into. Yes, it’s hard to break a habit, we ALL know that. Question is: are we “willing” to try? It is a “CHOICE”. We MUST make that “choice” by ourselves alone to TRY. One little habit change, 2 little habit change, 3 little habit change and so on builds up to MAKE THE LEAP for the BIG HABIT CHANGE !
Personally, I was given the name “prayer warrior” by others whom I know. I will continue with this calling to battle, pray, and work on behalf for her (and all addicts) recovery from addictions. I invite all christians and the “experienced” recovering addicts out there in cyberspace to add any prayer they wish while reading this. I promise it WILL help her and other addicts too !
In closing, I personally believe “God helps those who help themselves” or who are at least trying ! Merry Christmas !!
Happy Holidays Everyone! I trust you are doing well. I know I am. I’m here again, not ranting as I’ve been accused of. I’m trying very hard to comment, not by making statistical quotes, naming famous researchers and neuroscientists, or even claiming that I know it all. I’m just a guy who actively used drugs and alcohol for 35 years, to excess. My experience and intellect count for something. The same that all of yours does as well.
I just saw a couple of new comments posted, and am once again, as a result, am compelled to comment myself. The first comment I want to address is the one made by Marvin. I agree that addicts are con artists, are very convincing, manipulative, and are liars and cheats. Your comment Marvin, that “the ‘only’ reason why addiction is recognized as a disease, is because they are con artists, and so on and so on. Hardly true. An addict didn’t sit in front of a board of doctors or researchers and convince them of anything. There was as much research and investigation put into stating that it is a disease, as there is stating that it is not a disease. Plain and simple.
Another comment that “made up science is used as propaganda”. It’s not made up science. It’s the same science, whether it be perfect or exact, that is used to the contrary. I never said that anyone made up anything, to prove or disprove the question at hand. I’m glad that you agree that politics has some impact on this subject. Politics is bankrolled by huge corporations, private individuals, hell, maybe even the government as well. What I did say that can influence an outcome is bias. That in itself, is not scientific. I’m not saying that the evidence that leads to a conclusion is false. I’m saying that the results are left to interpretation of a person who may, or may not be, biased. I find it very difficult to believe that every scientist or researcher is 100% free of bias. This may be a poor analogy, but here it goes. Take a jury. Evidence is presented. Evidence is processed, and interpreted. That same evidence can come out at the other end, in more than one way. That is not always the case, but it can explain why we have the hung jury issue. So, no. I am not assuming that these scientists are making up phony conclusions. I’m sure the advocates of the disease theory have some biased opinions that have an impact on the outcome of their research. As I said, it could also have a lot to do with who has a stake in the outcome, ie: the people or organization providing capitol for the research. Everything is open to interpretation.
Your comment that any reputable doctor would not suggest or subscribe to the disease theory, is incorrect. If you type, as I did, “is addiction a disease of the brain” into Google, Bing, Ask.com or any other search engine, you will come up with a plethora of information, both in support of, and against, the disease theory. Just a few of those doctors you claim to be not reputable, work for institutions like Harvard, Stanford, The National Institute on Addiction, John Hopkins University, and so on……and yes, I’m sure that those same organizations have scientists, doctors and researchers that believe that addiction is not a disease. The point I am trying to make here, is that there are plenty of reputable doctors who think addiction is a disease, and visa versa.
I can find by searching on those search engines information, claims, research, sworn statements…..any and all the information any of us could ever need to argue our points. Both opponents, and proponents. I, as a layman, would have a very difficult time making up my mind with all the contradictory information. Many times, a person, a layman, starts research, or just seeks enlightenment, reads, processes, interprets, and makes a conclusion not so much on what they have read or became privy of…..but in many cases, makes a conclusion on what their idea was to begin with, even after there is an equal amount of information AND statistics provided. I know, laymen are not scientists or researchers, But, just because they are scientists and the like, they are still subject to being biased. Once again, not all conclusions are derived with bias as a factor, however, I am sure it occurs more than anyone will admit.
So, once again, I want to make it implicitly clear that I am not convinced that addiction is 100% a disease. What I question here is not if addiction is truly a disease. What I question here is the motive to try and prove it isn’t. I may be slightly biased, but not to the point that I am so happy to proclaim that I have a disease…..and now all my actions are justified. That’s simply not the case. I believe everyone who comments and posts here, has a valid statement to make. I guess I am kind of rooting for the underdog here. I do see a lot of statistical information, quotes from researchers and neuroscientist supporting the topic of this site. I do have to agree that the people who post here against the topic, are many times motivated by emotion and experience, not from a study or from a book. Their comments and posts, as well as mine, come from life experiences. Which in my book, can be more profound and motivating than what I read.
I haven’t made a comment on here for a while but have been reading most of the recent comments. For the 17 years that I was an addict I thought I had a disease because I felt like I couldn’t help having the craving, need, desire or whatever you may call it. I always knew I had a choice to pick up a drink or drug, but I was convinced that not being able to help having the craving was a life long disease that I would have to deal with. Well, that all changed in Feb of 2012 when I got my life right with God and have remained clean/sober ever since.
When I was about 8 months or so into sobriety I noticed that the cravings/desire were not as strong as they once were. After about 1 year to 1.5 years I noticed that I didn’t have any at all. From my experience it seems like addiction is not a disease like I once thought it was. I believe that just abstaining from using/drinking will help reverse the cravings/desires, but making other life changes are necessary as well.
I appreciate an article that can start a long-lasting dialogue on a topic that desperately needs talking about. I don’t, however, agree with the author 100%. I am in awe of people who were able to “just stop” and I consider myself one of the strongest people I know. There is also a very large spectrum of info that I wish the author had touched more on: i.e. trauma, mental illness and/or genetics. At this point in my life my addiction is a choice but there was a time in my life when it was anything “but”. A lifetime of trauma and mental illness made me the perfect candidate for self medication. I knew what I was doing and why. But waking up every day wanting to die was no way to live and so I sought solace in the warm fuzzy bosom of opiates and for a time, they worked. I’ve always been an athlete and go-getter: I was able to work longer, run faster, be more “sociable”, not have panic attacks. The embrace of opiates very swiftly turned into a strangle-hold and I became a full blown addict with all of the attitudes and behaviors that go along with being an addict. Then came the spin cycles – the detoxes and the relapses, the promises and the betrayals. Was I a douchebag? Absolutely. Was I lazy? Hell no – anyone who takes up addiction as a full time job is anything but lazy. Was I a source of pity and embarassment? Of course. How did I stop? I was arrested and pretty much reached a place where I realized that I was going to die if I kept going the way I was going. But criminal charges were not enough to keep me away so I checked into a year of Intensive Mental Health Treatment. Not the kind where you whine and complain and kick about how shitty your life is, but the kind where you learn real coping skills and what the underlying causes were when you decided “it would be a nice day to shoot some heroin”. I truly believe that my brain was set up to use from a very young age (I started drinking and taking downers when I was six). There are many kinds of diseases and not just the physical kind. My addiction blossomed from a diseased soul and bad programming. If we treat addiction with such black/white thinking we will create sober people with the same type of polarized arguments. I respect the author and his continued sobriety: Good job, Sir! But I just can’t get on board with the tone of this article; I personally find it to be shame based and smug.
This is like a horrible college thesis.
If there isn’t an agenda to prove addiction as a real disease using phony science then how come there have been countless government funded studies to prove addiction to be genetic that would come to the conclusion that they found the evidence..only to be completely debunked later on. This is every study ever conducted to prove addiction had a genetic component. How come NIDA gets government grants to this day for many years to study brain scans which to this date have proven to have no connection or prove anything about addicts? if you can show me brain scan research that is conclusive i would love to see it. Lastly how come government surveys that are conducted annually are hidden from the media and general public?
This is the most ignorant close minded article I have come across. I never remember thinking as a little girl, ” I am going to be a strung out addict and alcoholic when I get older.” Yes it is a action that was driven by obsession only to eliminate the never ending mental anguish every waking moment of our life. The priority’s for basic human needs for most people are 1.food, 2.clothes, 3. shelter. For the addict drugs out alcohol is always number one before basic human needs to live. This is a disease of the mind and an allergy of the body, the alcoholic/addict is also spiritually broken and constitutionally uncapable of living a life that demand rigorous honesty. The part of a normal persons brain responsible for choice thinks about the consequences of actions and how it may affect their future. The addicts brain responsible for choice is not only completely wired differently, where the choice comes from is actually located in a completely separate part of the brain entirely, it is generated from the minds effort to stay alive without doing so in pain, so consequences or who they may hurt in the process to stay alive is never even thought of because this is simply survival. So in asense it is a choice if you are speaking about the physical action alone. Odd if you told an alcoholic here is this shot you can have our but if you do you will be shoot in the head…. The normal person wouldn’t think twice about not touching it, the addict/alcoholic may hesitate for a few minutes but what their mind is actually telling them is this…., ” maybe I can drink it before they pull the trigger, or maybe the gun isn’t even loaded, or most likely I hope I can feel relief of this before my brains are blown out and now I won’t have to live in agony every day and this mental torture will finally be over.” Now that is by anyone standards of living pain and tourture that they don’t deserve not do they want. I suggest you do a LOT more research before making an ignorant statement such as it’s our choice, if it is then or is our choice to want to die. Addiction is a disease that wants you dead PERIOD. Please tell me in what medical book does that suggest a “Healthy brain” capable of making healthy choices to better themselves and others. My aunt just completed her Masters in Human Relations focused on addiction and the medical books have found conclusive evidence and extensive research supporting the fact that the part of the Brian responsible for choice is entirely located in a separate center it is also severely damaged from drug use clouding the mind and changing its chemistry. Recovery is possible with constant and daily progress in a program usually twelve steps but so far that is the only known method that has worked, those odds are about as scary as cancer in its 4th stage. Please be kind everyone is fighting a battle you know ABSOLUTELY NOTHING ABOUT!
This is a topic I am very passionate about because it haunts me every breathing moment of my life , to me that is not a healthy or happy existence. I never remember thinking as a little girl, ” I am going to be a strung out addict and alcoholic when I get older.” Yes it is a action that was driven by obsession only to eliminate the never ending mental anguish every waking moment of our life. The priority’s for basic human needs for most people are 1.food, 2.clothes, 3. shelter. For the addict drugs out alcohol is always number one before basic human needs to live. This is a disease of the mind and an allergy of the body, the alcoholic/addict is also spiritually broken and constitutionally uncapable of living a life that demand rigorous honesty. The part of a normal persons brain responsible for choice thinks about the consequences of actions and how it may affect their future. The addicts brain responsible for choice is not only completely wired differently, where the choice comes from is actually located in a completely separate part of the brain entirely, it is generated from the minds effort to stay alive without doing so in pain, so consequences or who they may hurt in the process to stay alive is never even thought of because this is simply survival. So in asense it is a choice if you are speaking about the physical action alone. Now if you told an alcoholic here is this shot you can have our but if you do you will be shoot in the head…. The normal person wouldn’t think twice about not touching it, the addict/alcoholic may hesitate for a few minutes but what their mind is actually telling them is this…., ” maybe I can drink it before they pull the trigger, or maybe the gun isn’t even loaded, or most likely I hope I can feel relief of this before my brains are blown out and now I won’t have to live in agony every day and this mental torture will finally be over.” Now that is by anyone standards of living pain and tourture that they don’t deserve not do they want. I don’t agree that it’s our choice but this is what I have spent over 30 years fight, wondering why me, feening, hurting, and just knowing from a young age that I had a different way of thinking than my friends and siblings, if it is then it is our choice to want to die because. Addiction is a disease that wants you dead PERIOD. Please tell me in what medical book does that suggest a “Healthy brain” capable of making healthy choices to better themselves and others would rather be dead because the mental and physical pain is more than anyone would want to handle. My aunt just completed her Masters in Human Relations focused on addiction and the medical books have found conclusive evidence and extensive research supporting the fact that the part of the Brian responsible for choice is entirely located in a separate center it is also severely damaged from drug use clouding the mind and changing its chemistry. Recovery is possible with constant and daily progress in a program usually twelve steps but so far that is the only known method that has worked, those odds are about as scary as cancer in its 4th stage. Please be kind everyone is fighting a battle you/we know ABSOLUTELY NOTHING ABOUT!
i ll just have to disagree completely with everything on the last post. There is no evidence for any of the assertions made and mostly that was just cut and pasted from AA literature which has no scientific validity. i think you are making it too complicated really. i don’t think your beliefs help you. If there was no such thing on earth as mind altering substances like alcohol and drugs would you suddenly have that healthy mind you claim to not have?
unless you are in a delusional state drinking or using drugs is always a choice. of course anybody can stop using drugs or drinking. Alcohol does not have control over your mind as you suggested. Drinking or using is a rational choice. In other words people drink or use because they want to. The first drink and the 18th drink as well. if you examine your thoughts when you are about to drink you can discover this. i am going to drink this because i like to drink or i want to get drunk..end of mystery..with the exception of physical dependence..there is no other influence controlling the puppet strings…there is no such thing as a different brain that alcoholics have or a seperate “choice ” region of the brain..that is nonsense
I’m changing my view and opinion about the disease model. After extensive research, I don’t believe that addiction is a disease, as described by its definition. I understand completely that there has to be a physiological and biological dysfunction for a disease to be a disease. If the definition of addiction started out with “addiction is a syndrome (a collection of symptoms), or disorder”, I believe it would be closer to what addiction really is. However, I am respectfully disagreeing with a couple points that this article, and most of the research states. I will get to that in a moment. I do want to mention that almost all of the research that opposes the disease model, ridicules and demeans other opinions, often times poking fun and making statements that are derogatory, condescending, and downright disrespectful. While on the other hand, research supporting the disease model rarely make references to their opponents. That is also true of some of the comments made on this site. I can really only recall one commenter who was both disrespectful and ill-informed: Ryan. I am going to make my assertions and comments in a respectful, informed, and not so scientific manner. I am also going to use “I” statements when talking about addictive behavior, based on experience, both in active using and behavior since I’ve gotten sober.
I first want to say that your assertion that drug addiction is a theory is ludicrous. Let’s just say the disease model is a theory, as is asserted here. According to The American Medical Association, it is not a theory. Addiction is real, the only theoretical thing about it is the beliefs of many different people. Addiction, as I see it, and as I stated previously, is not a disease by definition, but, whether addiction is truly a disease or not, does not mean that it has any less significance as a medical problem.
My first point of real dissention is the poorly used analogy of the taxi drivers and piano player. I completely understand how repetitive behaviors create “lasting pathways”, and the physiological and physical changes that occur in the brain. The main difference in the behavior of the taxi drivers and piano players is that there are no foreign chemicals introduced into the body. And, the “positive” or “good” behaviors that are repeated over and over, don’t produce any ill effects, physically, mentally, or emotionally. The enlargement of the hippocampus, the same enlargement that allows for a taxi driver to navigate without much effort, the same enlargement that occurs in piano players, athletes, scholars and so on, is produced by positive enforcing repetitive behavior. The hippocampus in an addict, or myself, also increases in size, because of repetitive behavior. What discredits your analogy is this: In addicts like myself, or non-addicts, the hippocampus is important in memory of previous euphoric or dysphoric experiences, and with the amygdala being important in having motivation concentrate on selecting behaviors associated with these past experiences.
I’m going to go right into my next disagreeable point. In reference to the hippocampus and amygdala automatically wanting to recall pleasurable moments or experiences that happens because the brain remembers the pleasure obtained by those activities, there is one huge difference between that of a person having sex, eating, the thrill of winning an athletic event, and my previous self, and that is: During sex or other “normal” pleasurable activities, about 150 units of dopamine is released into the brain. That is what gives us a feeling of elation or euphoria. When an addict (for this instance, I will use a meth addict, or myself, for reference) takes that first hit, over 1500 units of dopamine are released. That’s 10 times the normal amount. Yes, the euphoria lasts longer, and the “come down” is devastating. So, after a person eats or has sex, the dopamine levels return to normal relatively quickly, the substantia nigra and ventral tegmental areas of the brain have no problem keeping up with production. The rate at which dopamine is released when I used was abnormally high, thus, the time it took to replenish dopamine is much longer. Here is where I truly believe that compulsion to use over and over again, comes into play.
Before I go any further, I want to make the distinction between gambling, sex, eating and the like. I am mainly talking about drug addiction, more specifically, methamphetamine. I am going to quote something here, from the American Society of Addictive Medicine, which, by the way, has nothing to do, or is affiliated in any way, with NIDA.
“The frontal cortex of the brain and underlying white matter connections between the frontal cortex and circuits of reward, motivation and memory are fundamental in the manifestations of altered impulse control, altered judgment, and the dysfunctional pursuit of reward”.
They go on to say:
“The frontal lobes are important in inhibiting impulsivity and in assisting individuals to appropriately defer gratification”.
With that being said, the amount of dopamine being released, up to 10 times the normal amount, is what, over and over again, leads to compulsive behavior. Not only does the dopamine producing brain components have a hard time keeping up with production, long-term use also “kills”, or depletes the receptors of dopamine. So yes, there are definitely changes going on in the brain. Some of those changes are possibly not even visible on a scan, I can’t say for sure. There is much debate over the difference between the brain and the mind, and I’m not proposing debate on that matter. Here is a quote from Dr. Daniel Siegel, a professor of psychiatry at UCLA School of Medicine:
“It is a powerful lens through which we can understand our inner lives with more clarity, integrate the brain, and enhance our relationships with others. ‘Mindsight’ is a kind of focused attention that allows us to see the internal workings of our own minds. It helps us get ourselves off of the autopilot of integrated behaviors and habitual responses. It lets us ‘name and tame’ the emotions we are experiencing, rather than being overwhelmed by them”.
I personally believe that the mind and the brain are integrated in some fashion, and I make no claims that they are two different components However, that is debatable. The brain is the computer, and the mind, the software. What I am trying to get at here, is that the mind takes over rational behavior, or so it is perceived, as it was by myself. The brain is already in a state of disarray, and if the hardware has issues, so will the software. I know, you might say that my “analogy” of the brain and mind to hardware and software is ridiculous. But, there who’s to say that it’s not a valid, or even a logical sounding assertion?
So, I had a brain with a frontal cortex sending faulty messages to my reward centers, an excessive amount, and then, rapid depletion of dopamine and a paved pathway of behavior battling with my mind telling me that I can’t live without meth. Every time I started “coming down”, all I wanted to do was to get back to that feeling of feeling better. All I knew to facilitate that, was to compulsively seek out, and use meth again. My brain, not being able to produce a normal level of dopamine, which caused a dysfunctional pursuit of reward, and my mind telling me that meth was my only answer to feel better again, is the very compulsion that kept me in my meth addiction for over ten years. I was constantly chasing that first high. No matter how much I did, or how I did it, I could not reproduce that first time I did meth. This is the very crux of addiction, whether it is a disease, or not.
I finally did make a choice to get better. Yes, the consequences, losing jobs, money, relationships, health, family, self-respect and self-worth, the list went on and on. The only choice I had was a pre-mature death, or to take steps to stop using. I did it, yes. Not everyone can, and there is no evidence anyone can present, that can make a general statement that everybody can stop by choice alone. Many addicts and alcoholics will never make it out of their active addiction, not because they thought they had a choice, but, because in their mind, they had no choice. The assertion that anyone can make a conscious choice to stop, is absurd. Who can say what really goes on in the mind of an addict? Nobody can. And nobody should make that assumption. That would be like saying all people from the Middle East are terrorists, and therefore, should be treated as such. That’s insane.
I found help in the 12 Step rooms of recovery. You can think what you want, and frankly, I don’t care. My first 15 months were spent in a residential program, and I was shown that I have choices. If I followed suggestions, did the work, I was told things would get better. I struggled a lot. By this time, I was over the threshold of believing that I did not have a choice, but there is no way in hell that I could have done it on my own. Every individual’s path to recovery is not the same. I don’t have to agree when someone says they have a disease. As a matter of fact, the assertion that addiction is a disease, rarely comes up. Ashely posted her thoughts and beliefs about her program, and she mentioned a “spiritual malady”. And then, she was chastised for it. Unacceptable. For me, I truly believed that I was spiritually bankrupt, which in turn led me to make a conscious choice to use, and because meth is so addictive, soon led me to believe that I had no choice.
I haven’t always been exactly polite, and often times, spoke from an emotionally motivated place. I am emotional while writing this, but my logic and intelligence are in control. I believe everyone who comments here, is making what is to them, a valid statement. Not everyone agrees with everything that is posted. As I said in a previous comment, this debate will go on forever. Each side will believe they are right. And, each side makes substantial arguments to the opposition. For every fact that is presented by one side, there is another that that can accurately dispute the other.
What I have found interesting while doing a little research, is that for every article or paper that is in favor of the disease model, there are 4 in opposition. And, as I stated before, the authors or researchers adamantly discredit and denounce their counterparts. That cannot be said, in almost every case, of proponents of the disease model. What I’m wondering is, why all the uproar? Why is so important that this debate even exist? Does it really have any impact on anyone? I know it has been said that since it is proclaimed by some that addiction is a disease, and that the addict now uses that as an excuse for their behavior, thereby justifying their behavior. That may have some validity, but it’s a weak statement. In the rooms of 12 Step programs, we believe not so much on focusing on what we did, or why we did it, but how we can make it better for not only ourselves, but everyone our addiction affected others. I don’t know of one single addict who says that their actions were justified in any way or form because of addiction. Perhaps the people that use that excuse are the ones who never make it to the rooms of recovery. There are no statistics that substantiate my assertion. But I do have over 5 years of experience in recovery, and that very experience has shown me that a majority of us have found a solution, and that solution is Spiritual fitness. That is certainly more than I can say of many people, even some who make unjust accusations and assumptions, and who post insensitive and undeserved commentaries here. A lack of common courtesy, in my opinion, is a result of someone completely spiritually unfit. So, a lot of what I have said here might be interpreted by some as speculation, or nonsense. That’s fine. I don’t have a scientific mind. But, I am logical and intelligent. So are most of the people making comments here, as well as the authors and researchers who write articles and papers. Intelligence does not guarantee compassion, kindness, open mindedness and logical thinking. Before commenting in a retaliatory fashion, think of the person as an individual, a fellow human being. And treat them with the same respect that you expect to be shown to you. One last comment. Delusional is, in most cases, a state in which every addict lives in. I’m done.
I didn’t chastise anybody. There are many problems with with your assertions about brain functions especially the dopamine..but I won’t get into that because I don’t want to chastise or crucify anybody, God forbid they realize thier life can get better and it;’s not even that hard. i do have a problem with you claiming all addicts live in a delusional state..that is phony science and quite frankly if you never had a real delusional state that is disrespectful to hijack that term..even more so then the disease term..because really comparing getting high everyday to somebody who has no control over their thoughts is a new level of reckless phony addiction horsecrap that I won’t stand for… not even for a second
Don’t even start by claiming you know what I am about spiritually. really that is complete bunk. You don’t know anything about that. Telling somebody they are not spiritual or spiritually fit is always a load of bs anyway you slice it. i could have a whole other conversation about levels of consciouness..spiritual princaples..things i have experienced personally. if you are going to make a claim that i am a mean person or the opposite of spiritual…because why? something you learned in recovery about defiant people? that is nonsense…just spare me the spiritual bs please
studies to prove addiction as a disease are a scam.. that isn’t honest science. That is why people refute it. The government does honest research that isn’t made public. However every phony disease model government funded study will be made public in various media outlets…people have the right to be angry scammed or duped. That is rightgeous anger. That is good anger..if there is an honest study..people won’t try to debunk it as much…are you starting to understand? Corrupting science or medicine is a huge deal.
studies to prove addiction as a disease are a scam.. that isn’t honest science. That is why people refute it. The government does honest research that isn’t made public. However every phony disease model government funded study will be made public in various media outlets…people have the right to be angry about being scammed or duped. That is rightgeous anger. That is good anger..if there is an honest study..people won’t try to debunk it as much…are you starting to understand? Corrupting science or medicine is a huge deal.
Forgive me, chastise was an inappropriate word to use. However, a majority of your comments on other people’s posts are slightly disrespectful. In so many words, you condemn their way of thinking, and blatantly discredit them. But, I’m sure that’s because you feel strongly about what you are talking about.
My statements about dopamine are true and correct. I did a little research on this matter, and have every article I read said basically the same thing. Not one of those articles or papers I read had any connection or relation to any article or paper in support of the disease model. Perhaps you should look up the word delusion: a false belief that is based on an incorrect interpretation of reality. I was referring specifically to meth addicts, I also said most addicts, not all. If you think that using meth everyday doesn’t make someone delusional, you’re sadly mistaken.
I did say that many of the commenters here may lack spirituality. I made that statement because of the less than kind rebuttals, and lack of compassion. That is not true of everybody here. I didn’t claim to know anything about your spirituality. I never said your name, or made a reference to you. If for any reason, you thought I was talking about you, then perhaps, you have guilty conscience. Something I have come to embrace in recovery is tolerance, and open mindedness. I first came upon this site with the belief that addiction was a disease. Because I was open minded, and tolerant of other opposing opinions and research, I was able to accept something different than what I once thought. Defiance and disagreement are not the same thing.
So who says the research in support of the disease model is phony science? Is it phony because you or others don’t believe it? Are you a scientist? Who has the absolute truth about the matter? Is there anyone objective enough that can make a definitive statement? Research, what we read, or watch on TV or in documentaries, is written words. Yes I get it, we all believe what we want to believe. How can anyone, be absolute about what they read or hear? How do we know for sure, it is absolute? Absolute means there is undeniable and irrefutable truth. The fact that this debate is going on is evidence that this is not an absolute, definitive truth. We can believe what we read or hear,, and declare that the final word. But to do so, is being closed minded and not realistic.
So what would be the purpose of this so-called scam? Who is scamming who, and what would the “scammers” be trying to scam? What is it that want to scam someone out of? If someone is trying to “dupe” someone, it could be said that each side is trying to do the same thing. You see, I don’t think anyone is trying to scam or dupe anyone. People or organizations are just stating what they believe to be true. It’s not really “phony” science that you don’t like. It’s the result. I don’t like everything I read or hear, even sometimes if it’s, well, absolute.
Anybody who reads this comment, will not see anyplace, or in any way, that I have said that you, anyone or anything is wrong. I’ve respectfully stated what I have to say, and have left myself open to polite and respectful rectification. There will never be a final word on this subject. And if one believes that, then they are close minded, in my opinion. Donjuan, if you believe I was referencing you by that last statement, then so be it.
Forgive me, chastise was an inappropriate word to use. However, a majority of your comments on other people’s posts are slightly disrespectful. In so many words, you condemn their way of thinking, and blatantly discredit them. But, I’m sure that’s because you feel strongly about what you are talking about.
My statements about dopamine are true and correct. I did a little research on this matter, and every article I read said basically the same thing. Not one of those articles or papers I read had any connection or relation to any article or paper in support of the disease model. Perhaps you should look up the word delusion: a false belief that is based on an incorrect interpretation of reality. I was referring specifically to meth addicts, I also said most addicts, not all. If you think that using meth everyday doesn’t make someone delusional, you’re sadly mistaken.
I did say that many of the commenters here may lack spirituality. I made that statement because of the less than kind rebuttals, and lack of compassion. That is not true of everybody here. I didn’t claim to know anything about your spirituality. I never said your name, or made a reference to you. If for any reason, you thought I was talking about you, then perhaps, you have guilty conscience. Something I have come to embrace in recovery is tolerance, and open mindedness. I first came upon this site with the belief that addiction was a disease. Because I was open minded, and tolerant of other opposing opinions and research, I was able to accept something different than what I once thought. Defiance and disagreement are not the same thing.
So who says the research in support of the disease model is phony science? Is it phony because you or others don’t believe it? Are you a scientist? Who has the absolute truth about the matter? Is there anyone objective enough that can make a definitive statement? Research, what we read, or watch on TV or in documentaries, is written words. Yes I get it, we all believe what we want to believe. How can anyone be absolute about what they read or hear? How do we know for sure, it is absolute? Absolute means there is undeniable and irrefutable truth or proof to disclaim something. The fact that this debate is going on is evidence that this is not an absolute, definitive truth. For instance, we know smoking could lead to death. That is absolute. It is not debatable. We can believe what we read or hear,, and declare that the final word. But to do so, is being closed minded and not realistic.
So what would be the purpose of this so-called scam? Who is scamming who, and what would the “scammers” be trying to scam? What is it that want to scam someone out of? If someone is trying to “dupe” someone, it could be said that each side is trying to do the same thing. You see, I don’t think anyone is trying to scam or dupe anyone. People or organizations are just stating what they believe to be true. It’s not really phony science that you don’t like. It’s the result. I don’t like everything I read or hear, even sometimes if it’s, well, absolute.
If you, or anybody who reads this comment, will not see anyplace, or in any way, that I have said that you, anyone or anything is wrong. I’ve respectfully stated what I have to say, and have left myself open to polite and respectful rectification. There will never be a final word on this subject. And if one believes that, then they are close minded, in my opinion. Donjuan, if you believe I was referencing you by that last statement, then so be it.
sorry if i hurt anybodies feelings. really. The thing is this is not a support site. this is a site for free thought of ideas on addiction. trying to shut down the debate or give people guilt trips or claiming feelings have been hurt is not what this sit e is about. i’m not going to read your response clay. there is no need to. i come here to exchange ideas. this is not an Aa meeting or group therapy. There are plenty of support sites out there that will coddle your every whim and complaint..and always protect peoples feeling first and foremost. this is not the placw for that. i am not reading your posts anymore.
Well Donjuan, I don’t think you own an apology to me. On the other hand, perhaps I owe you an apology. Some of my statements did sound a bit accusatory, and, without me actually saying it, some yes, were directed at you. I meant no harm. And you’re right about a couple of things. This is not the forum to discuss spirituality, or, propose that the way I have found recovery is by any means the only way. I am not trying to shut down the debate at all. I did not present any information that could bring an absolute, definitive end to this debate. What I did do, was present substantive information, as was suggested by Steven Slate. This is not an AA meeting, or a place to garner support for my situation, or the plight of others. I don’t need to be coddled, and I wasn’t complaining. I don’t need or want support for me personally, and my whims have nothing to do with what we are debating here.
As I said, Steven stated that more substantive comments are what is really the purpose of this site. I have expressed my support in the idea that addiction is not a disease. And while it is not a disease, as defined word by word, there are a couple of points I personally, found fault with. There was also some evidence I presented that was not personal. The two main components that I disagreed with was the paved memory pathways in regards to repeated and/or habitual behavior, in regards to compulsive using and seeking of drugs. The other, which you and I disagree on, the dopamine factor, That evidence is no way whimsical or made up. It is fact.
Ashley said something about addiction and the spiritual malady. My extensive participation and personal experience in 12 Step programs leads me to the conclusion that in fact, the people in 12 Step recovery can determine that this lack of spirituality is in fact, their opinion of their addiction and/or abuse to substances. This is very real, although, it isn’t to everyone. I realize that we should keep to scientific evidence,, or reliable research, but, I think the 12 Step component is relevant when it comes to arresting active addiction. Not everybody gets it, and not everybody will be helped.
You don’t have to read my posts. But, any post I make from here on out will be based more on research and information I find, and less about my personal experience. Although, there is elements of that experience that is relevant, which, I will keep minimal.
people can write whatever they want here but if you want to make an assertion it is better to back that up with a study. Claiming spirituality helps addiction is not invalid but every study conducted into the twelve step network or for people who claim to be born again has fell flat on proving this hypothesis. Going into a religion to help a behavioral problem creates a tribal mentality. Circle arguments for people that don’t agree with the program like “you are spiritually unfit” or “obviously you have work to do spiritually”
are not any different then the “dry drunk” circle argument or the ” it works if you work it” argument. They are straight from the cultist handbook. They are meaningless and are used to perpetuate a myth and to sustain membership. it’s not uncommon to hear the ‘ you have work to do spiritually” comment. I have been to Aa many times and I have read the literature. You will hear people in recovery make this comment over and over.. it really is a double edged bs sword because it has the accuser claiming that he knows everything about somebody elses spirituality from (what essentially boils down to outdated turn of the century temperance dogma)….. and at the same time claiming his spirituality is superior to the person he is pointing a finger at.. a huge amount of ego for a program that claims it want s to squash ego…..at any rate making claims is not the problem..getting angry or self rightgeous and lashing out by throwing guilt trips for this reason is.
Hmm, Donjaun, I thought you weren’t going to read my posts anymore. It’s ok, I get it. I’m compelled as well to comment on something I’m passionate about. I’m going to make one last statement about 12 Step groups, and be done with it. You can call it a cult, religion or misguided…..the fact is that thousands upon thousands of addicts or alcoholics have found a way to get, and stay sober. I do agree with your statement that many 12 Steppers have a “holier than thou” attitude, and it’s unfortunate that that message rings louder than what the traditions and concepts of 12 Step Programs promote.
I can say that for me, I seem to have gotten off topic. While it’s somewhat relevant how an addict or alcoholic gets and stays sober, this reason for this site is to debate, and/or consider information in relation to addiction being a disease. I have already stated my conclusion on this matter, but, I question a couple of components of the theory stated here. From this point on, I am going to address and limit my posts about the learned behavior patterns of both good and “bad” behavior, and how compulsive using can be attributed to a mal-functioning reward center process. I work for UCSF Medical Center, in the administration area. I have some medical education, and while that does not make me a scientist or expert on this, or any other medical condition, it does provide me with an opportunity to illicit information from scientists and researchers alike, such as Steven L. Batki, MD, and Stephen Dominy MD. I will be able to comment on a more informed and research based platform.
I’m pretty sure I have not been self-righteous and angry. Perhaps my earlier posts may have had that tone, but it is certainly not the case as of late. The same goes for your accusing me of lashing out. It’s all good. I’ll make sure that doesn’t happen again. Donjuan, you suggested that I don’t make assertions without studies to back up my claims. I’ve looked over your posts, and I cannot find one single study or project that you cited to substantiate your claims. Not one. I’ve done the same in the past as well. For me, that will no longer be the case. I suggest that you, Donjaun, do the same. That way we can stick to the topic at hand.
I still didn’t read your one long response..i just wanted to make it clear that I wasn’t trying to blindly refute anybodies claims. When you get into spirituality there can be many problems. it is very hard to study this because what is spirituality really?..and to who is it this or that or something else. How can you prove that spirituality ever helps this problem for somebody who claims to be recovered?..you cannot scientifically..however you can run long statistical studies of AA or NA. you can look those up for yourself. I can disprove your claims on dopamine and your other assertions…I can give you links to any of my other claims..i believe I gave a link to Carl Harts studies..or are we not allowed to post links? I don’t know but i will write back after work tomorrow..
I’m not educated or understand much about the brain but good article,addiction is not a ‘desease’.I spent thirty five years in and out of addictive behaviours from crack,heroin,prescription meds you name it i would take it,dont even have control over a pack of biscuits.After my detox’s, it was allways my choice too go back.I know my brain functions were changed but they have since returened,well what little i had.Too many people fail because they believe the mantra of the steps and i was one of them
Hi,
I’m a student writting an essay on the different perspectives of addiction and I was hoping to get a publish date for this article/blog so I can cite it properly.
Thank you
The original publish date is Sep 25 2010. The latest revisions to the article were done Oct 1 2014.
Steven:
Sincere congratulations on 4+ years of giving people a much-needed place to exhange ideas on this all-too-often incendiary topic.
Although I have not been a regular contributor, your cleverly-named site came up on my radar some time ago and has helped me re-think and fine-tune quite a few of my positions. I am curious if any major changes have occurred in your position on this subject since the publication of your original article.
Thank you for your continued efforts.
Do you realize you can die from alcohol withdrawal as an alcoholic. Not a disease?
Diabetes is your body doing exactly what it was supposed to, you just abused it. Not a disease?
Further, diabetics can basically remove their diabetes by not consuming sugar. Simple choice. Not a disease?
Can choose to start eating better and exercising to prevent and reverse cardiovascular issues. Obesity, hypertension, stroke, heart “disease”… all not real diseases?
I guess its just convenient to choose whichever definition of disease enforces your opinion.
Do I, the author of this site, and this article realize that alcohol withdrawal can be deadly? Let me se… OH YEAH I wrote a passage on detoxification that appears on the home page, this page, and almost every one of hundreds of pages on this site. Here’s an excerpt of it:
Then I give links to the SAMHSA Treatment locator which can be used to find detox clinics, and a link to a private clinic that I recommend. So yeah, I realize you can die from alcohol withdrawal.
Thanks for asking.
Now let me ask you a question:
DID YOU READ THE ARTICLE BEFORE COMMENTING?
I mentioned the diabetes comparison in the article. Again, here is an excerpt:
GET IT? Diabetes doesn’t go away because you change your diet. The symptoms may be lessened. But individuals cannot directly choose to change the cellular malfunction… which is the disease.
Believe it or not, you aren’t the first person to use this diabetes comparison. It’s been written about ten billion times before. It doesn’t hold water. If I lose a leg, I can get a crutch, but it doesn’t change the fact that I really lost a leg.
Where is the true lost leg in addiction? Where is the cellular malfunction that causes a problem? It isn’t there. If you had read the article, then you might try to make an argument that establishes the cellular/physiological malfunction – but you clearly haven’t read it. So until you do read it, and think about, please do not comment further, because you’re wasting everyone’s time.
The primary argument seems to be that the brain is doing what it is “supposed” to. Well damn, in diabetics the body is doing exactly what it was designed to do, too. It simply wasn’t designed for the sufferer’s LIFESTYLE. Same with heart disease, alcoholism, and yes, drug abuse.
Contrary to what you seem to believe, diabetes can be reversed with lifestyle – it is not merely covering symptoms. I also do not see why something that is caused by the sufferers decisions in the past inherently makes it a disease simply because the choice isn’t in the present, and that the presence of an immediate choice removes its possibility as a disease. This is incompatible with many issues most would call diseases (or not diseases). For example, I just explained how diabetes can be solved with in immediate decision. Just because the cure doesn’t have a 100% success rate and takes a period of time does not change that it is a decision that can be made.
Before getting condescending again, take a long hard look at your argument and then try to give a definitive answer why you are the authority on whether a particular bodily function change is considered a “malfunction” or is merely “normal,” as this is the crux of your argument. The classification regarding the time of decisions is equally questionable with little evidence besides “because I said so.”
I have to admit, I am not a medical expert, so I can only appeal to authority here. They may or may not be correct about diabetes, but here goes. I googled “can diabetes be cured”:
Several of the search results discuss how diabetes can sometimes be stopped from progressing, but they’re clear in that the condition can’t be cured. You can’t change the malfunctions in either insulin resistance or reduced insulin production that is at the core of diabetes – you can live with that and permanently change your lifestyle to compensate for this malfunction, but you can’t undo the malfunction – and certainly YOU CANNOT UNDO IT BY A DIRECT ACT OF WILL – YOU CANNOT SAY I WILL PROCESS INSULIN AND SUGAR PROPERLY NOW, and then proceed to just do that. You can however say I WILL STOP DRINKING NOW and directly do that.
Again, I’m not an expert on diabetes. These sources could be as full of nonsense as the NIDA and NIAAA are about addiction/alcoholism. I really do not know, nor do I intend to turn this into a diabetes discussion board. I am satisfied with the comparison though.
As for your past/present discussion, I am highly confused by it, and I’m not sure what you are getting at. I will reiterate the point I think you are responding to: Right now, you can directly choose to use or not use drugs. Right now, if you have developed diabetes, you cannot choose to simply process sugar and insulin like a non diabetic it is not directly amenable to your will.
Massive neural adaptations are the norm with any repetitive behavior. I gave a few examples of this. I have also provided quotes from a neuroscientist and some addiction researchers reiterating my same points (I added those quotes to this article 6/10/14). This isn’t just me deciding out of nowhere that such changes are normal, they are normal. Furthermore, they do not cause continued heavy substance use as Gene Heyman demonstrated, where I quoted him in the article.
If you want to believe it’s a disease, be my guest. You will be believing a falsehood though.
I’ll admit my answer depends on the definition of “cured,” so in some sense is just as ambiguous. Point still stands that just because the brain does what it is made to do doesn’t mean we cannot classify it as a disease. To be clear, I do consider most “addictions” to be a matter of choice. However, there is a point where the body will physically respond to drug withdrawal to a point where *I* would classify it as a disease.
While I do appreciate your outlook on the disease choice model, I find your angle a little combative.
I would argue that those stuck in cycles of addiction are stuck in cycles of bad behaviour. They need to break the cycle of repetitive behaviours. I also do think the brain nueroplasticity model is part of that. Take a heroine addict who relapses and kills himself because he’s chasing after the last high he experienced and his body can’t handle it.
There was an article by newsweek on how the brain rewires itself with addiction. It’s strengthens reward pathways. Yes, your brain does rewire itself over time; however, for those stuck in a poor pattern of behaviour, the options to break free seem very limited.
Again, I do appreciate your website. I love the citations. Finally someone with some material to back a pov. However, your model for quitting is a very poor unempathetic model. It’s not just as easy as “saying no”. Some people need a change in environment. 12 step programs if anything else, offer that. They give a person the opportunity to become part of a routine that helps them focus on their issue vs trying to do so oneself (albeit in a dangerous method in my opinion, one that doesn’t treat the “why” but the “that” of their symptons. That if they use, they will use again. Vs why do they use).
I just started reading cognitive behavioural therapy. A philosophy based in Stoicism (ironically, so is AA). Stoicism talks about conditioned and unconditioned responses. They also talk about beliefs, and our opinions about those beliefs. A disease model is dangerous, because it’s a belief that once one relapses, they are powerless to stop it, so they might as well enjoy the ride (possibly the cause of the heroine overdoses after large stints of abstinence)
http://www.skepticink.com/gps/2013/11/22/12-step-programs-versus-evidence-based-addiction-treatments/
Basically, we have actions, beliefs about those actions, and consequences about those beliefs. ABC.
My point is, your “it’s not a disease, it’s a choice; so just quit already!” is kind of insulting. It’s not so easy. People are stuck in neurplastic patterns of behaviour. 12 step programs if anything else offer two things. A change in environment, and a mentorship program. Aside from that, I don’t think they teach much useful things; but for those who have an honest desire that there own management of their lives seems futile (the patterns of behavior), they reach out for guidance.
If your website was a little more cordual in the way it rips apart 12 steps, I think it would find a wider audience.
I do believe that drug addiction is a disease. It starts out as a choice but develops into a messed up brain that is diseased. I had the disease of skin cancer in my forties. The doctor said it was from my earlier years of sun tanning. Many diseases develop from bad choices that humans make. Fortunately I was able to get treatment before the disease spread. Many addicts don’t get help till after an overdose. It seems that you have a problem with addiction being called a disease. It’s just a word so get over it.
Thank you Steve for such an informational site. I am saddened that folks get so upset and then hateful when their thinking is challenged. Lots of assumptions are made of people, whether they suffered with poor choices or not. Being a cancer survivor and now living with an incurable cancer, in remission for 6 months, it breaks my heart that people compare my disease to some one who is choosing to put a needle in their arm, or drink to oblivion, then call it a disease. This isn’t even logical. Not that making the choice is easy, but its the ONLY way out.
My last point is, I am a phd, dual diagnosis therapist and when I have folks come to me with addiction issues and they refer to themselves as sick, less than, not a normy, etc. makes me sad. We all have issues, and in this case there is no us and them. But when a person is walking around thinking they are sick, they have a disease, its a perfect set up to keep using. I am not going to get into any science about it, but just labeling yourself constantly, “Hi I am so and so, I am an alcoholic, addict, gambler, etc. Guess how you are going to behave. I work at harm reduction first, and then work out the reasons people decided to use in the first place. Why are they self medicating. Sometimes I think this is just all part of the Human condition, I dont think anyone gets off the planet without some crap in their life. And yes the only way to change is to choose to stop then find tools and support. I personally dont refer to aa/na programs as I believe they create a whole other issue. But there are plenty of other healthy places to get love and support. You hear well only an addict can treat or help an addict. This thought is insane. My oncologist didn’t have cancer, and was able to help me get into remission. Thanks again for your work on this site. I hope alot of people feel empowered and learn they dont have to suffer forever.
thank you Becky. it would be interesting to know how you juggled your belief on the issue (which is more like reality) with the guidelines or curriculum of where you work. I have experience with dual diagnosis centers. There didn’t seem to be any wiggle room in how you approach this issue with anybody. There seemed to be this guideline for everyone. Diagnose their addiction, diagnose a mental health issue, prescribe 2 or 3 medications then enroll them in a day program supplemented with AA or NA. . There was an option to attend AA but it was frowned upon not to attend and if you didn’t buy the disease or the 12 step mantra you were alienated pretty quick. ironically the ones who didn’t like the program but sort of “woke up” have had to most success as compared to the long term patients.
Thanks Don Juan for your nice reply. I know what you mean about working in facilities. Its is very hard because most believe in the disease model, aa etc. So, I have a private practice. Thanks goodness. I have literally been yelled at by a few co workers, who actually told me I was full of S…….sad so many people get so defensive, to me it just means their recovery is very fragile, my opinion should not change their behaviors. I know theirs doesnt influence mine. Have a great day.
This author has no idea what he is talking about even though he states that he was “addicted to drugs”. He does state some interesting opinions but I would rather trust doctors and a medical community that has spent years researching addiction. To compare addiction to cancer is ridiculous but to deny that addiction is a disease is even more so. If withdrawal can force your body to experience “flu like symptoms” than it is a disease. Your body becomes physically dependent on the drug which with abrupt stop forces you to experience nausea, increased temperature, diarrhea, cold sweats, hot flashes, body pains and aches, and many more symptoms. Anything that causes you to feel those symptoms is a disease. yes you have a choice to take the drug or not but you also have a choice to swim in cold water or not regardless you will feel symptoms.
Another part of the article i do not agree with is the 3-day withdrawal theory which is completely absurd. Heroin withdrawal symptoms take weeks to wear off and those are just the physical, the psychological and emotional damage as well as the cravings can take months if not years to repair. Sounds like a disease to me. Again, yes it is a choice but regardless the term “disease” is the correct word to describe what addicts go through.
I used to get hammered every single day of my life. Drinking 30 beers in a day was easy for me and there really weren’t many days I didn’t have some level of the shakes. And those things were caused by my CHOICE! I chose to drink and I suffered. I also chose to stop drinking and felt better.
What kills me the most about this whole “disease” nonsense is that it tells people they have no power in their own lives. If any health professional who buys into this disease of alcoholism knew that to this day I have ONE and only ONE beer every day they would tell me that I “can’t” drink. I don’t have a disease. I used to be a drunk and now I drink one beer a day. And if I want to skip a day that’s no problem…because I have choices in the matter.
People do not choose to give themselves MS or cancer. People CHOOSE to drink too much and that’s as simple as it gets. Is drinking addictive? No question…that feeling of being drunk and finally relaxed in your life makes it very easy to over drink and drink constantly. But as for some force making you drink…it’s just not the case.