by Michael Patrick

Created on: December 07, 2008

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

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