Addiction - A Disease

I was having a conversation the other day with our auto mechanic, a wonderful and kind man, about addiction, as I was picking up our car from his shop. I was explaining to him why I, and many others in the recovery community, think of addiction as a disease and how this requires a shift in our thinking about the meaning of that term. I have had the same conversation with some family members who, even on the occasions of my mother's and brother's deaths from addiction related behavior, were struggling with this idea.

The problem usually revolves around the issue of choice and the assumption that people choose to behave in a self-destructive way as an escape mechanism or to mitigate pain of some kind. Most commonly, I think, we try to psychologize the cause and link the behavior to a particular event or series of events believing that, if the abuser understood why they were using they would be able to stop or at least, be able to control their use like other people. A simple version of this scenario would go something like this: John used because there was alot of change and instability in his life as a child and therefore he did not get all of the attention that he needed. His using was the way he escaped from that pain. In this view his using was not pathological - disease based - but a response to trauma of some kind. Usually what accompanies this assessment is the implication that he should be able to understand this and do something about it so that he stops hurting himself and others. There are almost always strong moral overtones that accompany this perspective.

Several things helped me to begin to consider that addiction is a disease - in the sense that it has its own pathology - and that the treatment of it must address the whole person. One - we now know, in part from the human genome project but also from neuroscience and beahavioral studies, that the causality of addiction is far more complex than was once believed. Two - the fact that unmitigated drug and alcohol abuse is almost always fatal to the individual. Three - the treatment of it as a moral or behavioral problem or according to a traditional medical model has had a miserably poor success rate compared to the "treatment" of it in AA or other 12 step, spiritually-based, programs.

My understanding of addiction as a disease was really furthered by reading "Addiction and Grace," by Gerald May, a psychiatrist who has worked with addicts for decades, and by becoming actively involved in Families Anonymous, a 12-step group for parents of users. As a Christian, I have also found it helpful to look at addiction through the lens of Eastern Christian theology because it views destructive or negative behavior (which we commonly call personal sin) as the symptom of the disease that ensues from not being in communion with God and eventually results in spiritual death.

Here is the meditation for today called "Addiction - A Disease," from "Today a Better Way," a little book published by Families Anonymous. I think it is helpful:

"When some people come to Families Anonymous for the first time, they have trouble accepting the fact that addiction to mind-altering substances is a disease. All they can think of is the horrible way the addicted person has been treating family and friends.

It is difficult for family members to recognize disease when all they have seen is hostility, contempt, lies, and even stealing.

But all of this is part of addiction - the disease that causes its victims to choose drugs over people. Until we accept addiction as a disease, we remain stuck at the level of hostility and contempt. We feel the need for revenge. We want to punish the addict for what he or she has done to us.

As I begin to work through my resentments in FA, I come to see how they damage my peace of mind, my spirituality, and the well-being of family relationships. I will be far better off when I react to my addicted family member without punishment or negativity. Then I will be free to grow myself.

TODAY I WILL accept addiction as a disease and lay my feelings of hostility aside."