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| Yes | 65% | 622 votes | Total: 964 votes | |
| No | 35% | 342 votes |
Yes
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Add to FavoritesThere are two types of people in this debate. Those who know what they are talking about and those who don't.
Those who don't may certainly hold their opinions genuinely. But the mere fact that they passionately believe what they say they believe does not mean their opinions should be given equal weight as those based on research and established facts.
And those point conclusively to alcohol and drug addiction being diseases.
Critically, such addictions are clearly shown to be passed down generation to generation. As Cotton pointed out in 1979, the lifetime risk for children of alcoholics is 20-30% as opposed to 5-10% for the general population, and the risk is decidedly greater for males than females.
But, of course, faced with this fact someone will immediately leap in and cry out "it's just the environment they're brought up in! If only they were strong-willed enough, they could resist the failings of their parents!"
So leaving aside entirely any discussion of whether social conditioning can create something identifiable as a disease (which would be an interesting debate in itself) let us also note that studies of twins and their drinking habits show conclusively that there IS a genetic pre-disposition to alcoholism.
Most twins (not all, but the vast majority) are brought up together. And if "environment" was the major factor in determining whether the children of alcoholics would in turn become alcohol abusers, then the rate of alcoholism in fraternal (non identical) twins who have been raised together should be very similar or identical to that of identical twins.
Now fraternal twins share about half their genes, but identical twins share all of them.
In many studies (the evidence is all over the internet), it is clear that genetically identical twins share a much higher chance of developing alcoholism inherited from their parents. Kaij (196) showed this to be about a 54.2% chance as opposed to about a 31% chance for fraternal twins.
So if people are genetically pre-disposed to drink, (or abuse other mood altering substances), does that make their abuse of these products an inescapable doom?
No, of course not, or no alcoholic would ever quit drinking, no crack addict would ever get clean.
What it DOES mean is that people who are prone to this illness deserve the provision of a range of supportive measures and an atmosphere of public debate that does not grow out of facilely condemning them as "weak willed" or somehow "bad".
Studies also show that it seems very likely that substance abuse is also associated with the way the brain works, in particularly its susceptibility to problems of anxiety.
Put simply, people will other brain issues tend to "self medicate" with drugs or alcohol.
Yes, of course, it might be that this is not the wisest decision they could take, but in all likelihood their substance abuse is developed over time in response to growing anxiety - which could be anything from "nerves" about their social abilities right up to a full-blown and crippling anxiety disorder - and that the disease has taken a considerable hold, surreptitiously, by the time the addict realises that he or she is in deep trouble.
Or as someone once said, "I used to drink to drown my sorrows. Then I woke up one morning and realised they'd learned how to swim."
The "cure" for such diseases? Ah, now THAT is a much more contentious issue. Many different styles of "treatment" have their supporters, and some of these do, indeed, depend on the addict "taking charge" of their life - an act of willpower, if you like - and seeking control of their addictive urges through diversion, substitution, or avoidance.
But the fact that they are ILL, not merely BAD, is undeniable. They did not choose their problem, it chose them, in the womb.
And that should frame our response to their situation, every time.
Learn more about this author, Stephen Yolland.
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No
In the strictest medical sense, no, substance abuse isn't a disease so much as it is overindulgence to the point of physical impairment. Diseases are treatable by antibiotics whereas compulsive behaviors tend to be symptomatic of emotional distress or simple choice.
There are medical, psychological and economic issues underlying the contention that drug addiction is a disease, let alone addictions to gambling or shopping.
I'm not a knee-jerk novice about this. As a young man in pursuit of my Masters in Cognitive Psych, I counseled drug addicts in Los Angeles. Ten years later, I struggled with my own substance abuse before coming to my senses. Twenty years after that, one of my daughters fell into drug and alcohol abuse and I'm still trying to figure that one out.
This is a complex debate with responsible arguments on both sides. Many of us suffer contraindications of substance abuse, whether prescription drugs and alcohol or fast food and sugar. All of those are legal, I might add, and any one of them is benign in moderation and life-threatening if taken to excess.
There are three contributors to the problem:
1. A cornucopia of "feel good" drugs promoted by the pharmaceutical industry.
2. Too many "corrective" drugs dispensed to "manage" emotional problems.
3. A culture of self-gratification that promotes a "better living through chemistry" attitude.
Not long ago (the 1930s Depression, for example, and certainly before), folks who exceeded their capacity to manage their addictions were abandoned. Everyone was in survival mode and there was no patience for self-destructive personalities. After WW-II, we prospered as a nation and had more time and resources to attend to those less fortunate than ourselves. Advances in medicine seemed able to cure all disease and correct all maladies. The "science" of psychology became equivalent to physical medicine as we learned more about psychosomatic health. It seemed that any problem, whether polio or schizophrenia, could be cured with a simple injection.
By that time, health insurance was a fact for everyone who worked for a living. If we broke an arm or needed surgery, our insurance covered it, but mental health remained a hidden shame brutally depicted by Mary Jane Ward's 1947 novel, "The Snake Pit." The first Diagnostic and Statistical Manual of Mental Disorders was published in 1952 and was helpful in bringing treatment of the emotionally disturbed into mainstream medicine. In 1966, Jacqueline Suzanne's shocking "Valley of the Dolls" exposed "mother's little helpers" and the advent of suburban drug abuse, formerly considered the sole purview of jazz musicians and Asian opium dens. The incidence of substance abuse grew in tandem with general prosperity but hospitals and doctors complained that mental health issues weren't recognized or covered by insurance leaving needy patients under-treated or rejected for cost. A decades-long struggle between medical and psychiatric practitioners and the insurance industry led to the redefinition of mental problems as diseases comparable to smallpox and heart transplants that would be covered by health insurance.
For a while, this compromise made everyone happy. That is, until the mental health industry began defining everything from day-dreaming to impudence as a treatable disease with an acronym ending in "D" for disorder. It didn't take the insurance industry long to figure out that while a broken arm healed in six weeks, it could take decades of treatment by teams of expensive psychiatrists, therapists, and pharmacologists to get Uncle Joe to stop drinking himself to death with shots of Quervo Gold.
Today, unless one pays monthly premiums equivalent to the mortgage payment on a two million dollar home, health insurance for substance abuse is denied to everyone who needs it most. Regardless of what doctors and psychologists purport, the clear and unequivocal stance of the health insurance industry is that it's a personal problem, not a disease.
I tend to agree, but I believe that whether emotional or physical, healthcare should cover both.
Learn more about this author, Michael Patrick.
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