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The disease model of addiction – it’s a concept that gained authority in the 20th Century with the backing of public health bodies including the American Medical Association (AMA) and the World Health Organisation (WHO). However, the definition of addiction as a disease is still fiercely debated in medical and scientific communities, as well as dividing opinion in wider society – including in 2019, when WHO ratified gaming disorder as a disease. [1]
In this article, we look at the history and purpose of classifying addiction as a disease, as well as the case for moving beyond the diagnosis.
Where Did the Disease Concept of Addiction Come From?
Though addiction has been examined for centuries across many cultures and societies, today’s disease model of addiction in western society emerged in the United States.
In 1956, the American Medical Association defined alcoholism an illness. [2] In the same year, Narcotics Anonymous published their first literature, in which they described drug addiction as a ‘disease, just like alcoholism, diabetes, tuberculosis, heart trouble or cancer.’ [3] By 1987, the AMA had officially classified addiction as a disease, along with backing from other health organisations. [4]
Jason Shiers, Psychotherapist at UK Addiction Treatment, says: ‘Certainly, the 20th century definitions helped to establish addiction as a healthcare issue, increasing treatment options and scientific research, as well as specialised education for professionals to train in the field. For these reasons, the disease concept has undoubtedly saved countless lives – not least because the definitions allowed patients with medical insurance to access certain forms of treatment.’
Subsequently, scientific researchers have uncovered genetic, environmental and physiological risk factors for addiction. For example, studies have shown that genetic variants of enzymes involved in alcohol metabolism can increase the risk of alcohol use disorder. [5] Children of alcoholics are more likely to develop an alcohol problem, as compared to children who do not have an alcohol dependent parent. [6] Substances including alcohol, opioids and benzodiazepines can lead to physical addiction in regular users, whereby the individual suffers moderate to severe withdrawal symptoms if they discontinue use abruptly without medical help.
Is There Another Way of Looking at Addiction?
What if addiction isn’t defined as a disease in its own right – instead, it’s a symptom or manifestation of underlying chronic mental stress? In this respect, the goal of addiction treatment isn’t simply achieving abstinence or reducing the harms associated with addiction, it’s actually peace of mind.
By learning how to nurture peaceful mental states, and in doing so, restoring a sense of personal wellbeing, this allows people to rediscover themselves as innately healthy human beings. In terms of individual recovery plans, the focus can then shift to health promotion, rather than disease prevention or long-term management.
According to Jason Shiers, it can be useful for treatment professionals and individuals with addiction to be open on this question. ‘What matters most isn’t the definitions of addiction, nor a particular treatment modality, it’s helping each person to move beyond active addiction in ways that are meaningful and sustainable for them. At UKAT, we provide addiction rehabilitation through the 12 Steps and our unique Strengths model, integrating holistic treatment modalities into all our programmes. This provides our clients with a choice of frameworks to understand and overcome their addictions.’
Learn more on the UK Addiction Treatment website about the disease concept of addiction, as well as how to recover from the harmful thoughts and behaviours associated with addiction.
Sources:
[1] https://www.who.int/news-room/detail/25-05-2019-world-health-assembly-update
[2] https://www.ncsbn.org/Understanding_the_Disease_of_Addiction.pdf
[3] http://www.nauca.us/wp-content/uploads/2015/05/1956-First-NA-Literature-Published-in-California.pdf
[4] https://www.ncsbn.org/Understanding_the_Disease_of_Addiction.pdf
[5] https://www.sciencedirect.com/topics/neuroscience/adh1b
[6] https://www.nacoa.org.uk/concerned-others-and-professionals/research.html
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