Societal Perception Of Addiction

In 1956 the American Medical Association labeled alcoholism as an illness, and in 1966 upgraded the identification to a disease. In professional circles today alcoholism is viewed as one form of addiction. Most therapists and treatment centers view addiction through the disease model. Yet the societal view of addiction often remains one of stigmatization, and is largely misunderstood.
First it is important to define addiction. Addiction is not defined simply by daily use, using needles, becoming homeless, or losing employment. These may be true of someone with an addiction, but are not requirements. Basically, addiction for this article is defined as an unhealthy relationship with a substance, resulting in consequences. These consequences can be financial, social, biological, or within the family system. This can be true even if the individual only uses a substance a couple of times a week.
I have worked in the field of addiction for over 15 years, am a Certified Addiction Professional, and have a Master’s degree in Psychology I am often confronted with a scenario where the family of someone suffering with an addiction seeks treatment for the addicted identified patient. Often, the family members maintain a stance of substance dependence being a choice. They often blame it on the peers of the identified patient, on moral weakness, or on a lack of personal fortitude. What amazes me even more is when the identified patient’s themselves, following extensive education regarding the disease concept, have difficulty accepting the disease model and experience the shame associated with the societal stigma of addiction.
It is not my intention to completely excuse the addict or alcoholic from consequences for their behavior. I do not minimize the impact of some of the exte
al factors such as peers, poverty or social status, or geography on the individual. Nor do I wish to minimize personality traits that lie within the individual making them more, or less, susceptible to an addiction. But I do wish to lend a hand in working towards changing the perception this culture has of addiction.
There are so many studies indicating a genetic predisposition to addiction. From experiments which compare the liver’s processing of alcohol in young men whose father’s are either alcoholic or not, to MRI’s that illuminate the difference in brain chemistry reaction in substance abusers versus non users, the evidence for the disease concept continues to grow. Genetic science, a relatively new addition to the scientific world, has made substantial progress in identifying strings of gene abnormalities in those with addiction. Yet society as a whole continues to look upon those who become addicted with disdain.
Science continues to find support for the theory that many who become addicted had a genetic predisposition. This predisposition is similar to those that have a predisposition to heart disease, diabetes, or high blood pressure. And just as it is commonplace in this country to eat poorly, especially in youth and the early adulthood years, it is normal (normal is not necessarily healthy) in this culture for teenagers to experiment with alcohol and other drugs. It is estimated that 80% of teenagers try alcohol and 50% try marijuana before completing high school. It is reasonable to say that those that have a genetic predisposition then run a high risk of becoming addicted with little warning. Because of their genetic predisposition, their brain may react differently to the substance, and the addiction becomes activated. Although it can be anywhere from months to years before the addiction begins to reap serious consequences, the journey has begun. And once the addiction becomes ingrained, choice becomes clouded and less dictated by logic.
I think the comparison to diabetes, heart disease, and high blood pressure is a good one. Behavioral choices often impact these illnesses. The same is true for addiction. As poor diet, stress, and smoking impact heart disease, choices in peers, ability to cope with stress, and susceptibility to peer pressure impact substance abuse and dependence. But unlike the other diseases mentioned, addiction also impacts the thinking of the inflicted individual. Natural human defense mechanisms such as denial, rationalization, projection and minimizing become over utilized and affect the addicted individuals perception of reality. And for all these reasons, addiction is identified as a disease. Individual substance dependence issues are listed in the Diagnostic and Statistical Manual IV TR (a handbook for mental health professionals that lists different categories of mental disorder and the criteria for diagnosing them, as defined by Wilpedia).
It is my hope that the overwhelming evidence of addiction as a disease as opposed to one of personal or moral weakness becomes part of the cultural consciousness and begins to chip away at the stigma that exists currently. Yes, addiction can be ugly. Yes, people who are addicted sometimes do unsavory things. But, this is often a result of the disease rather then there volition. And when in recovery from addiction, many of these former active substance abusers become productive, empathic, generous members of society. This seems to be more evidence that the addiction causes the behavior, rather than the person causing the addiction. n