Is Alcoholism and Drug Addiction Really a Disease?

The short answer is yes. It is a Genetic Disease that you don’t trigger until you take your 1st drink or pill. There are 2 sides though to Addiction, Physical and Mental. The Physical (craving) will leave within a few days in most cases once the user has stopped using. The Mental (obsession) will take much longer. The question is how long? And that is what treatment is for.

The modern disease theory of alcoholism states that problem drinking is sometimes caused by a disease of the brain, characterized by altered brain structure and function.[1] The existence of alcoholism as a disease is accepted by some within the medical and scientific communities,[2] although critics exist. The American Medical Association (AMA) had declared that alcoholism was an illness in 1956. In 1991, The AMA further endorsed the dual classification of alcoholism by the International Classification of Diseases under both psychiatric and medical sections.

In 1980, the American Medical Association (AMA) Council on Scientific Affairs (now the Council on Science and Public Health) noted that “alcoholism is in and of itself a disabling and handicapping condition”. Between 1980 and 1991, medical organizations, including the AMA, worked together to establish policies regarding their positions on the disease theory. These policies were developed in 1987 in part because third-party reimbursement for treatment was difficult or impossible unless alcoholism was categorized as a disease. The policies of the AMA, formed through consensus of the federation of state and specialty medical societies within their House of Delegates, state, in part:

“The AMA endorses the proposition that drug dependencies, including alcoholism, are diseases and that their treatment is a legitimate part of medical practice.”

Alcoholism and Drug Addiction is a chronic, life-long disease, such as diabetes. However, if managed properly, damage to the brain can be stopped and to some extent reversed,[3] In addition to problem drinking, the disease is characterized by symptoms including an impaired control over alcohol, compulsive thoughts about alcohol, and distorted thinking. [4] Alcoholism can also lead indirectly, through excess consumption, to physical dependence on alcohol, and diseases such as cirrhosis of the liver.

The risk of developing alcoholism and drug addiction depends on many factors, such as environment. Those with a family history of alcoholism are more likely to develop it themselves; however, many individuals have developed alcoholism without a family history of the disease. Since the consumption of alcohol is necessary to develop alcoholism, the availability of and attitudes towards alcohol in an individual’s environment affect their likelihood of developing the disease. Current evidence indicates that in both men and women, alcoholism is 50–60% genetically determined, leaving 40-50% for environmental influences. [5]

The current mainstream scientific and medical view is that alcoholism is a disease, although some debate on this topic still occurs. [6][7]

In 2004, the World Health Organization (WHO) published a detailed report on alcohol and other psychoactive substances entitled “Neuroscience of psychoactive substance use and dependence.”[8]It stated that this was the “first attempt by WHO to provide a comprehensive overview of the biological factors related to substance use and dependence by summarizing the vast amount of knowledge gained in the last 20-30 years. The report highlights the current state of knowledge of the mechanisms of action of different types of psychoactive substances, and explains how the use of these substances can lead to the development of dependence syndrome.” The report states that “dependence has not previously been recognized as a disorder of the brain, in the same way that psychiatric and mental illnesses were not previously viewed as being a result of a disorder of the brain. However, with recent advances in neuroscience, it is clear that dependence is as much a disorder of the brain as any other neurological or psychiatric illness.”

References:

1. Leshner, Alan I., Addiction is a Brain Disease, and It Matters, Focus 1:190-193 (2003)

2. Alcohol – Frequently Asked Questions, US Centers for Disease Control and Prevention (CDC)

3. Bartsch, Andreas J.;Homola, Gyorgy; Biller, Armin; Smith, Stephen M.; Weijers, Heinz-Gerd; Wiesbeck, Gerhard A.; Jenkinson, Mark; De Stefano, Nicola; Solymosi, Laszlo; and Bendszus, Martin, Manifestations of early brain recovery associated with abstinence from alcoholism, Brain 130(1) (2007) pp36-47.

4. Morse, RM; Flavin, DK (August 26, 1992). “The definition of alcoholism, The Joint Committee of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine to Study the Definition and Criteria for the Diagnosis of Alcoholism”. The Journal of the American Medical Association 268 (8): 1012–4. doi:10.1001/jama.1992.03490080086030. PMID 1501306. http://jama.ama-assn.org/cgi/content/abstract/268/8/1012.

5. Dick, DM; Bierut, LJ (2006). “The Genetics of Alcohol Dependency”. Current Psychiatric Reports 8 (2): 151–7. doi:10.1007/s11920-006-0015-1. PMID 16539893.

6. http://www.bhrm.org/papers/Counselor3.pdf

7. Ruth Engs (ed.): Chpt.6 Controversies book-disease concept of alcoholism should be rejected

8. Vaillant GE (August 2003). “A 60-year follow-up of alcoholic men”. Addiction 98 (8): 1043–51. doi:10.1046/j.1360-0443.2003.00422.x. PMID 12873238. http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0965-2140&date=2003&volume=98&issue=8&spage=1043.

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