Character Flaw, Disease, or Habit: The Addiction Debate

There is no known cause of addiction.

Though researchers have tried for centuries to pinpoint a reason why some people can recreationally use drugs and alcohol and never have a problem, and others will develop a life-altering addiction, they have only been successful in identifying potential links and risk factors that may contribute to the development of an addiction disorder.

Thus the debate has been evolving and ongoing for centuries: Is addiction a moral concern, a lack of integrity, a weakness? Or is it a medical disorder that requires medical and psychotherapeutic treatment and care – something that has nothing to do with choice? Or is it something else entirely?

Risk Factors for Addiction Development

Though a person has to choose to first use drugs or alcohol, there may be some of issues or events that contribute to the development of a drug or alcohol dependence in one person over another. These include:

• Co-occurring mental health problems
• A family member with an alcohol or drug addiction issue
• A permissive environment for drug and alcohol use
• Early age of first use of drugs or alcohol
• Difficult or traumatic childhood
• Trauma (e.g., sexual or physical assault, grief, etc.)
• Biology (e.g., differences that occurred in utero, due to accident, or for no known reason)

In treatment, these contributing factors may be addressed directly, thus empowering the patient to overcome and transcend the obstacle without turning to drugs and alcohol.

Habit Not Disease

According to a neuroscientist named Marc Lewis, author of the book The Biology of Desire: Why Addiction is Not a Disease, addiction is neither a moral issue nor a medical disorder. According to Lewis, a former addict himself, addiction is a habit – a physically and medically harmful habit, admittedly, but not an irreversible disorder the way that some people define it.

In his book, Lewis writes: “…the brain changes with addiction. But the way it changes has to do with learning and development — not disease.”

According to Lewis, the brain’s ability to adapt and create habit are the secret to the development of the addiction – and to stopping the use of drugs and alcohol as well. Any changes in the brain created by drug use do not have to be permanent, says Lewis, and though these changes are dangerous, they are not unusual, either. A move away from addiction is entirely possible, and an addict can make more changes to the brain that are positive with perseverance through treatment.

Avoiding ‘Recovery’

Lewis isn’t a fan of the word “recovery” because he believes it implies that the addict will return to the life he was living prior to addiction. This is problematic for many people after active addiction because, for many, their use of drugs and alcohol was triggered by the state of their life at that time. Many people first used substances to “self-medicate” untreated mental health symptoms or to escape the uncomfortable feelings caused by difficult issues in their lives (e.g., divorce, job loss, financial difficulty, etc.). No one wants to return to that, which is why Lewis prefers not to infer that addicts should want to “recover” their old lives.

Rather, treatment offers patients the opportunity to address all the issues that were underlying their use of drugs and alcohol, and create a better life for themselves – with all the coping mechanisms they need to handle any struggles healthfully and without drugs and alcohol of any kind..

Does It Matter?

At the end of the day, does it really matter whether or not an addiction is a habit or a medical disorder? Scientific research has shown via brain scans that drug use creates real changes in the brain; thus, it is clearly not a moral issue or a character flaw of any kind. So does it matter if those changes indicate a formed habit that can be broken or a medical disorder that can be treated?

It may. Currently, there is a heavy focus – especially in the 12-step community – on identifying alcoholism and drug addiction as a disease and thus out of the control of the addicted person. While the disease model absolves the patient of blame for having developed the addiction in the first place, and may make it easier for them to accept treatment, it also may have the effect of removing any responsibility for future choices, including relapse. This can be problematic if the addicted person adopts a “I can’t help it” attitude about relapse and assumes that treatment just “didn’t work” for them and they are doomed to a life of drug use and addiction.

On the other hand, the habit model may be an effective tool in framing an addiction experience and enabling the acceptance of treatment as well as empowering the addicted person to “break the habit” of use of drugs and alcohol. But is this a correct assessment? The debate rolls on.

Treatment Works

Ultimately, there are a number of different treatments that have been proven to be effective in helping people to stop using drugs and stay clean and sober. Whether it is a habit that must be broken or a disease that can be treated – or a combination of both – there are treatment methods that are hugely effective in helping patients to stop using all substances safely and to learn how to live a new life in sobriety.

What Do You Think?

Do you think that addiction is a habit that can be broken or a medical disorder that requires medical intervention? Does it matter as long as the person seeks help? Leave a comment and share your thoughts.