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The Disease Concept

Why can’t they just stop using drugs and alcohol? For many generations, the stigma associated with addiction is that they don’t want to stop. Substance Use Disorder (SUD) is defined as a disease by the American Medical Association and the American Society of Addiction Medicine (ASAM). Yet, many people still think that it’s possible for someone suffering with these disorders to stop on their own. While this may be true for some patients, we are talking about the cases who, at one time in history, would have been considered hopeless. The alcoholics and addicts who have been to several jails, treatment facilities, and institutions but still cannot find the ability to change. The truth is, they are probably just as confused as you are as to why they cannot stop. Many of them have no idea what they are suffering from. What they do know is they cannot control their drinking. Why is acceptance of the disease concept so difficult? This misunderstanding is what makes addiction one of the deadliest diseases.

Addiction is caused by a combination of behavioral, psychological, and biological components, much like diabetes or heart disease. Over time, addiction alters the functioning of the brain and body and can cause both physical and mental health disorders. ASAM released this short definition of addiction in 2011: “Addiction is a primary, chronic disease of brain reward, motivation, memory, and related circuitry.” Those of us who have struggled with SUD have an abnormal reaction to substances. Our brain chemistry reacts differently when substances enter our body than those who do not have this disease. Upon ingesting the first drink or drug, an abnormal or allergic reaction causes a physiological craving in the individual that cannot be controlled. Many of us can think of nothing else once this craving is triggered, leading to mental obsession. Further, we have a mind that will lead us back to a drink, even after long periods of abstinence. Thus, addiction affects both mental and physical health. In the rooms of Narcotics and Alcoholics Anonymous, they say, “One is too many, and 1000 is never enough.” Truer words have never been spoken.

Understanding the Disease Concept

Many addicts and alcoholics struggle with understanding the disease concept, even after experiencing the mental obsession firsthand as described above. Addiction is the only disease that place’s fault on the person suffering from it. The actions of addicts and alcoholics can cause their friends and family to suffer right along with them. Eventually, even those closest to them can give up hope that their loved one might recover. It takes a lot of work, but addicts and alcoholics can ultimately discover that they are not bad people. Instead, they can come to understand that they are mentally, physically, and spiritually sick, and the disease of addiction has robbed them of any choice they had to say no. When those with SUD accept the reality of the disease concept, they can begin to forgive themselves for the things they have done during their addiction. I went through the same process 20 years ago. The pain had become significant enough for me to agree to a treatment facility, but it is the Twelve Steps and a deep self-appraisal that have kept me sober this long. I no longer have trouble accepting addiction for precisely what it is: a deadly disease. Through accepting that addiction is a disease, I was able to begin my journey towards long-term recovery.

Michael Duffy
Executive Director
Limen Recovery + Wellness Inc

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