[Popskid]

Am I the only person who hates and disagrees with the idea of addiction as being a disease? I know that I chose to use and to keep using. I know that today I can choose not to use or drink. I don't blame myself, that just makes me feel ashamed and guilty, I just don't blame anything else. I made many bad choices, but I don't have to make bad choices in the future if I don't want to. Does this make sense to anybody else? By the way- I drink a couple of times a month, but after years of heavy use I have been completely clean from all drugs for 14 months. Anyone willing or able to point out scientific articles or research that validate the disease theory would be welcome. I like to be well informed!

[J.O.M.]

It is odd isn't it that disease usually has to do with the physicality of a person...ie; having to with the body, yet anything that has to do with the mind, excepting addiction is referred to as a mental illness.

Two out of three potential indications for the disease diagnosis are that it progresses and that it's treatable, yet mental illness also meets those indicators and is still differentiated from disease...hmmm

As to a science based documented reasoning for the pronouncement of disease isn't, at least within my knowledge, and I read extensively, available.

Since addiction most closely resembles a mental condition, I would suppose that a great many people are very comfortable with the idea that it's a disease, meaning that while they did make choices, the condition they acquired wasn't truly related in a conscious way to those choices.

I like the concept that you don't accept self blame nor 'cop out' in blaming anything else. Accountability, stepping up to the plate, accepting that you made your own choices and accept the responsibility of the results of those choices, and choose to make different choices and accepting the responsibility of the results of those as well.

You have come to the realization of a concept many have yet to discover.

[Perna]

http://www.medical-online.com/addict.htm

[Ygrec23]

I think it's possible that everything said on the subject of addiction by both J.O.M. and Popskid is correct. To read their posts, one gets (perhaps I'm misunderstanding) the idea that there is some kind of bright line boundary between the "disease theory" and the personal responsibility approach. I don't agree. I think the probabiliity is that BOTH the disease theory AND the personal responsibility approach are correct. Here's why.

As has come to be accepted over the past fifty years (read Jerome Kagan, psychology professor at Harvard), approximately fifty percent of each individual's "behaviors" (i.e., temperament) are inherited through his/her genetic make-up. The other fifty percent is supplied by that person's "environment," including his/her parents' interactions with him/her as a small child, the influence of siblings and the environment external to the family.

Whether or not addictive behavior belongs in one column or the other has been the subject of intense study. The result seems to be that the mix of inheritance/environment factors is different for different people. A certain percentage of people may have "addiction" in their genes, while others learn addiction from their environment, and some have both. Further, do not forget that a substantial amount of addictive behavior stems from either lower pain tolerance (an inherited behavior) or higher internal natural pain levels (two different things). The amount of self-medication going on among addicts is substantial, but it isn't the whole story. Many do get high simply to get high.

I don't know that anyone, on a clinical level, has ever tried to ferret out the particular mix of inherited/environmental factors in a particular patient. It's just too complex, requires all kinds of testing, and is just not economical for standard medical practice.

As far as I know, that is the reality of the situation: a large population of affected individuals who have drug/alcohol/tobacco (or other) addictions; a scientific background of quite some depth but not for use in daily clinical practice; and a choice of two different "frames" (the medical and the personal responsibility ideas) helpful in framing the problem for a successful attack. I believe that the medical model was devised in no sense whatever as a "scientific" approach, but simply as an aid for individuals who have a high respect for science. It's a bed-time story. Remember, a very large part of medicine is not at all scientific, but must rely on psychology in determining what approach is best for a particular individual where that individual's conduct must be changed in order to solve a problem. This is not a question of going to your doctor's office for a vaccination or going to the hospital for an operation. The solution to the problem is under the control of the patient. If guilt and shame seem likely to hobble or prevent that patient from dealing with addiction, then the medical model is a good way to proceed. If guilt and shame are NOT a problem, as with Popskid, the doctor and patient can work out another effective way of proceeding if that is what they decide.

Popskid may well have a genetic tendency toward addictive behavior. But remember, all we inherit in terms of behavior are "tendencies," i.e., not the rigidly fixed behaviors that animals have. Humans do have a choice whether or not to follow their inherited tendencies. Many do not so choose. But in choosing not to follow inherited tendencies an individual has to work, consciously or unconsciously. It's tough. So, ultimately, whatever the source of the behavior, Popskid has chosen his model (the responsibility model, let's call it) and been successful in changing his behavior, always a difficult and highly commendable thing to do. The actual work would have been exactly the same under the medical model, but the manner in which the work was approached would have been different.

Accordingly, both the medical model and the responsibility model are helpful, some with certain patients, some with others, all depending on those patients' individual personalities. Neither model can be said to be "superior" to the other, except in terms of one individual patient and his/her personality. Neither is truly "scientific." Neither is more "morally correct" than the other. Take care.

[Popskid]

I really appreciate the idea here that the cause isn't nearly as important as focusing on a solution that works! I guess I really should learn to "live and let live." If the medical model works for some people- then what is the harm in it? I think I get defensive sometimes because I have been told on several occasions that I can't claim to be clean if I still drink, usually based on the medical model and the idea that one drink will inevitably lead to out of control use. This is not what I experience. I suppose in my emotional reaction what is important gets lost. People, whatever their beliefs about addiction, do get sober and get better!

[Ygrec23]

Popskid said: "People, whatever their beliefs about addiction, do get sober and get better!"

And live happy and fulfilling lives!

Take care.

[madisgram]

Originally Posted by Popskid

Am I the only person who hates and disagrees with the idea of addiction as being a disease? I know that I chose to use and to keep using. I know that today I can choose not to use or drink. I don't blame myself, that just makes me feel ashamed and guilty, I just don't blame anything else. I made many bad choices, but I don't have to make bad choices in the future if I don't want to. Does this make sense to anybody else? By the way- I drink a couple of times a month, but after years of heavy use I have been completely clean from all drugs for 14 months. Anyone willing or able to point out scientific articles or research that validate the disease theory would be welcome. I like to be well informed!

well that is like the question, which came first? the chicken or the egg? for those of us that struggled with addiction, be it alcohol or drugs or both, it really doesn't matter once you arrive at that point. abstinence is the best/easiest solution to get on with one's life.
question: why do you feel you need to know re bad choices or the disease concept? are you intellectually curious and that's all?
i found if i went in that direction re my addictions i was
overanalyzing the problem. perhaps that's not you but i needed to pose the question.
you may find it helpful to google your question. there's a lot of good info out there.

[madisgram]

Originally Posted by Ygrec23

I think it's possible that everything said on the subject of addiction by both J.O.M. and Popskid is correct. To read their posts, one gets (perhaps I'm misunderstanding) the idea that there is some kind of bright line different for different people.... ETC....A certain percentage of people may have "addiction" in their genes, while others learn addiction from their environment, and some have both. Further, do not forget that a substantial amount of addictive behavior
Popskid may well have a genetic tendency toward addictive behavior. But remember, all we inherit in terms of behavior are "tendencies," i.e., not the rigidly fixed behaviors that animals have. Humans do have a choice whether or not to follow their.... ETC.. The actual work would have been exactly the same under the medical model, but the manner in which the work was approached would have been different.

Accordingly, both the medical model and the responsibility model are helpful, some with certain patients, some with others, all depending on those patients' individual personalities. Neither model can be said to be "superior" to the other, except in terms of one individual patient and his/her personality. Neither is truly "scientific." Neither is more "morally correct" than the other. Take care.

you have an incredibly gifted mind. well said and helpful too!

[madisgram]

YOU BET!..and a good life it is.