Addiction as a Disease - Essay Example

Addiction as a Disease Addiction is difficult to understand had it has always been a controversial topic. The reason for the controversy, in this author’s opinion, is that people are so upset by the fact that a family member is addicted to something that they think there must be a way for the individual to stop. Thinking about the addiction as a disease, puts it into a context where the individual cannot stop on their own. Because of the way that alcohol and chemical abuse has been portrayed by the media as well as by movies, most people think that a “habit” is just that – a habit, something that can be broken with a little will power or determination. Whether the addiction is to a substance or to an event, those who are having the experience of addiction usually need help to stop. Usually there is an intervention that includes rehabilitation and continued work after they stop using the substance or after they stop the event. These behaviors are consistent with the idea that addiction is a disease. This paper will discuss my feelings about this issue and it will include research that I have conducted on the topic. The Medical Model of Addiction I thought it appropriate to begin with the medical model of addiction because this is usually the model that most people understand in chemical or substance addiction. Most people know that the body breaks down after continued abuse with a chemical or substance and that people lose liver and kidney functioning and they can be at risk for heart disease or other problems. Doweiko (2009) discusses the medical model at length. According to Doweiko’s explanation, an individual’s behavior is biologically based and if an individual’s behavior is inappropriate, they have a “biological dysfunction” that causes the “pathology” (p. 17). There is other literature that also suggests that alcoholism is genetic, or at least that those individuals who have a parent who is alcoholic are at risk of being alcoholics themselves. There are many books on children of alcoholics and the literature is not exactly certain whether this is always true. As an example, a twin study that was conducted by Slutske et al. (2008) looked at whether exposure to an alcoholic parent was a cause for children to become alcoholic adults. Although they studied over 1,000 pairs of twin parents and their offspring, they did not find that exposure was the reason for alcoholism. After reading this study, I could see that the biological factors were probably more accurate than environmental exposure, but that certainly, an individual who had alcohol in their environment may be more at risk for using it at an early age. I also think that an individual who has a family member who is an alcoholic has a predisposition for alcoholism. The medical model points out that there is a process involved when an individual moves towards addiction and I believe that this process starts when the individual has a parent who uses. One model that I found particularly interesting was Jellinek’s Four States of Alcoholism. These four stages show how an individual becomes addicted. Stage one is called the pre-alcoholic stage where alcohol is used as a means to relieve social tension. This seems to be the case for many people who use alcohol or other substances because they are able to feel a high and a change in mood. This can happen with children who taste some type of alcohol for the first time as a dare from their peers. The second stage is the prodromal phase where the individual begins to have blackouts and they are preoccupied with alcohol to the point of feeling guilty about what they are doing. As the individual continues to drink, they move into the third phase where they lose control over their use of alcohol and they become even more preoccupied with alcohol. In the final or chronic phase, the person begins to lose all control, drinks obsessively, and has alcoholic tremors (Doweiko, 2009, p. 18). Although these four phases are applied to alcohol addiction, they can actually be applied to any type of addiction. As an example, an individual who has a gambling addiction will start out playing their favorite type of gambling in the first phase and finding that they love it so much they keep playing whether they win or lose. At this phase, they just like being around other people and they like the game whether it is horse racing, sports book play or something else. They move into the second phase when they continue to gamble and are preoccupied with winning. They must go as often as possible to feed this and they feel guilty about it at the same time. They may have blackouts during this phase when their anxiety is too high. By the third phase, they too are more preoccupied with gambling and having to get to the track or to their game in order to win. By the fourth stage, they are truly addicted to it because they are buying books that talk about how to win, they are going to the track or gambling casino as often as they can and they often experience tremors when they cannot go and play. This example is just one of many that I have seen with friends who say they are not addicted to something and they can stop anytime they want (but they do not stop without help). Studies have shown that there is a genetic base for addiction. Early researchers studied children of alcoholics and found that there were two types of alcoholism: Type I and Type II. More research was done on these to understand the distinctions between the two. They found that environmental factors including poor parenting, stress, marital problems, and abuse played a part in addiction (Doweiko, 2009). Another twin study by Agrawa and Lynskey found that there are genetic factors, but that these factors may need to be separated into three categories: those individuals who are experimenting with the substance because they have been exposed to it, those who are more influenced to use at later stages, and those who have a liability towards the dependence. In reading this study, I felt that they were trying to break this down too far. To me, it does not matter how genetics specifically play a part in addiction, but that they it dos play a part. Miller (2011) agrees with the medical model but he suggests that addiction is a brain disease. He states that addictive substances “simulate the release” of dopamine into the “nucleus accumbens” of the brain (p. 72). This basically means that the individual is not able to make wise choices in their lives when this happens. White and McClellan(2011) further add to this discussion by showing how addiction is a chronic disease. Because of this, they state that addiction should be treated as a chronic disorder instead of an acute one. The authors compare addiction to other chronic diseases in the same way that Doweiko does, and says that they share “multiple biological, psychological, and social factors” (p. 76). White and McClelland also say that there are three factors that all chronic disease has: 1. Treatment can reduce or remove symptoms but they cannot address the root cause of the disease; they cannot take away the problem. 2. They all require significant changes in a person’s lifestyle and behavior in order to receive the best from treatment. 3. There is an ongoing need for both medical treatment and lifestyle change; the individual can also have a relapse. When looking at addiction as a chronic disease, the authors also note that they cannot classify every addiction as chronic instantly, but it can become chronic over time. As we think about addiction as a disease, it is important to think about how it relates to other diseases and to understand that family members or those in the community may take issue with some addictions being seen as chronic diseases. The Disease Model Controversy There has always existed a difference in philosophy about accepting that addiction is a disease. Those experts who argue that alcoholism is a disease suggest that this addiction has similar characteristics to other chronic diseases like hypertension, asthma, diabetes or chronic heart disease (Doweiko, 2009); they also point out that these other diseases also have a genetic component. Those who are opposed to accepting alcoholism as a disease suggest that it is a form of reckless behavior like speeding and it should be treated as a criminal offense (Doweiko, 2009). Some experts state that alcoholism does not meet the standard definition of disease. In other words, it is not a terrible virus, bacteria or fungus and it does not cause an “unusual” genetic disorder. Although I understand their point, it can be argued that the substance (whether it is alcohol or a chemical) acts as the virus or bacterial because it eventually creates problems for the body as the individual continues to use the substance. Psychological Model of Addiction There are many arguments that state that some people are more susceptible to addiction because they have an addictive personality. In my opinion, to say that some people have an addictive personality and others do not is very accurate. Perhaps this has to do with the genetic factor as well. Nakken (1996) suggests that addiction is a process in which the individual attempts to use addiction as a way to control uncontrollable cycles. Nakken also states that addiction is a disease that is progressive and “no matter what the addiction is, every addict engages in a relationship with an object or event in order to produce a desired mood change” (p. 2). I believe this to be true. A friend of mine related her experience with her father who was a chronic gambler. He spent as many days at the race track as he could and spent a lot of money. Sometimes he won, sometimes he lost, but he was able to work regularly and tried to keep his family going. He never had help for his addiction and he probably would not have admitted to the fact that it was an addiction, according to my friend, but in her explanation of what happened, one could see that he was definitely having a mood change when he went to the track. My friend does not gamble because she has felt “the bug” many times, whether it was with a friendly game of blackjack with her friends or spending a few dollars in a slot machine. Although she was not directly exposed to horse racing, she has felt the urge when she was around gambling. I believe that Nakken is correct in his definition because the people I have known with an addiction do progress from one stage to another. This has not mattered whether the person was using a substance or participating in an event. When I think back about their description of what happened to get them started, I can definitely see the stages they have gone through. Khantzian and Albanese (2008) state that addiction is a form of self-medication. Many of those who are addicted have had sever psychological trauma and they use the substance or even to numb feelings or to alter them. They use the substance because it “relieves psychological pain and suffering” that is “unbearable” for them (p. 42). I think this is very true because many people will use a drug that is easy for them to find and get often. Many children today are able to afford the drug ecstasy and it takes away their inhibitions and allows them to feel loved. This is a very sad think to think about but with the world as it is today, it is difficult for many people to feel loved. In conclusion, to see addiction as a disease, we must look further than alcoholism and see that addiction is the same across the board. The addictive personality can be a reason that, coupled with a genetic predisposition will cause an individual to need help to recover from the drug. Implications for treating it as a disease will mean that more people will receive assistance for there addiction and there may be more research into the causes and reasons why people find themselves addicted. References Agrawa, A., and Lynskey, M.T. (2008). Are there genetic influences on addiction: evidence from family, adoption and twin studies. Addiction, 103, (7). 1069-81. Retrieved from CINAHL with Full Text. Doweiko, H.E. (2009). Concepts of chemical dependency. 7th Edition. CA: Brooks/Cole Cenage Learning. Espejo, R. (ed). (2011). Chemical dependency: Opposing viewpoints. NY: Greenhaven Press. Khantzian, E.J. and Alanese, M.J. (2008). Understanding addiction as self-medication: Finding hope beyond the pain. NY: Rowman & Littlefield Publishers. Miller, M.C. (2011). “Addiction is a brain disease” in Espejo, R.(Ed ). Chemical dependency: Opposing viewpoints. 71-74. NY: Greenhaven Press. Nakken, C. (1996). The addictive personality: Understanding the addictive process and compulsive behavior. 2nd Edition. MN: Greenhaven Press. Slutske, W.S., D’Onofrio, B.M., Turkheimer, E., Emery, R.E., Harden, K.P., Heath, A.C., and Martin, N.G. (2008). Searching for an environmental effect of parental alcoholism on offspring alcohol use disorder: A genetically informed study of children of alcoholics. Journal of Abnormal Psychology, 117 (3), 534-551. doi: 10.1037/a0012907 White, W.L. and McClellan. (2011). “Addiction is a chronic disorder” in Espejo, R.(Ed ). Chemical dependency: Opposing viewpoints. 75-88. NY: Greenhaven Press Read More