Alamy – Drug Addiction Concept
Hit after hit, the agonizing, insatiable urge never ceases. According to the NIDA, addiction is a chronic disorder that’s “characterized by compulsive drug [and alcohol/medication] [mis]use despite [knowing] adverse consequences” (NIDA- Drug Misuse and Addiction). I believe calling addiction a disorder undermines the severity of its physical effects… ones that do more than just “disrupt normal body functions” (verywellhealth). Let’s take a deeper look into addiction: disease vs disorder, shall we?
Following in Vesalius’s footsteps, “pathologists” Bonet and Morgagni were critical in the development of nosology away from religion, toward pathology. Bonet’s contributions to abnormal anatomy were pivotal in creating Morgagni’s “Seats and Causes of Disease” (Pathology In Pre-Modern and Modern Eras) which connected disease to physical anatomical changes deviating from normality (Pathology In Pre-Modern and Modern Eras). Modern pathology not only looks at a specific anatomical/bacteriological disease elements, but the cause and effect. For substance-use addiction, dopamine is fired in the brain, creating euphoria that reinforces the consumption of the substance enticing it (NIDA – Drug Misuse and Addiction).
CSUH – Substance Use Costs In Canada 2020
When classifying disease, the Hippocratic triangle (representing a disease concept) teaches us that amongst the 3 facts of disease (illness, patient, and observer) (Disease Triangle), the observer has most importance in defining the condition (Pathology From Antiquity To the Renaissance – Dr. Duffin). Dr. Duffin states how pathologists discover diseases by recognizing symptoms, assigning an anticipated cause and finding a treatment/prevention or outcome (Pathology From Antiquity To the Renaissance – Dr. Duffin). All these can be identified for addiction. Encouraging more dialogue in the medical community can help those who have power to reconsider their definition and shine a spotlight on the severity of addiction, saving lives.
Alongside helping, medical professionals can delay constructive action when physiological cause-based theory is used to describe addiction. It encouraging patient blaming and stigma propagation with terminology like junkie, or clean instead of not using (Stigma of SUD – Drug Misuse and Addiction PHAR100). Such language causes isolation and societal shame when asking for help, thus preventing outreach (Theories of Disease). Labelling addiction as a disease would bring validity to concerns, and courage to the afflicted for self-advocation. With 47000 deaths linked to substance abuse yearly (addictionhelp – Canadian Addiction Statistics), defining it as a disease can help change attitude toward its seriousness; improving treatments, saving lives and uplifting voices reaching for support.
When looking at why substance-use addiction shouldn’t be considered a disease, let’s understand why people misuse. Neuroscientist Carl Lewis states that addiction isn’t a disease, but rather “deep learning triggered by stress or alienation… unlearned [with] stronger synaptic connection[s]” (NDARC UNSW Sydney). I can mostly agree with his belief, as it essentially states that ontological cause-based theory contributes to addiction (Theories of Disease). External (ontological) factors like abuse, isolation, and peer pressure increase your likelihood of developing substance-use addictions (Mayo Clinic – Drug Addiction). Regarding internal genetic factors, Professor of health Dr. Suzanne Fraser states, “geneticists… acknowledged that genes [are] too complex to [be addiction’s main] cause” (NDARC UNSW Sydney). It’s possible that social issues encouraging addiction are too interwoven to understand, so we overstate genetic contribution to stop people from feeling guilty. Tackling instead the social issues that encourage addiction is more proactive in its treatment/prevention and possibly, wholistically better for the afflicted.
statcan – Primary Health Care Providers
In 2023, the Canadian government pledged $359.2 million over 5 years for a “renewed Canadian Drugs and Substances Strategy” (Government of Canada). Before we rush to put more money into research/awareness for addiction, we must ensure current resources are adequately distributed to necessary levels of our health care system for everyone. Did you know that almost 15% of Canadians claim to not have a regular primary physician (Statistics Canada)? Classifying addiction as a disease could put excess strain on the system, decreasing quality of care for others. Organizations like CAMH devoted to addiction research/treatment/social destigmatization while calling it a disorder, further shows me the unnecessity of labelling it a disease. Some professionals claim addiction’s “cause” to be a dopamine hypothesis (Dopamine Hypothesis – Drug Misuse and Addiction PHAR100) meaning that since it isn’t a definitive cause, addiction can’t be a disease. Furthermore, addiction being self-inflicted and not necessarily having a physical cause (a tumor, virus, etc.) denies it disease classification (Is Addiction A Disease of a Choice? – americanaddictioncenter).
CBC News – Thousands of Canadian drug users dying as government red tape limits help, advocates say
Regardless of it being a disease or disorder, addiction causes serious suffering to millions of Canadians yearly. I see the physiological cause-based theory hurting people by instilling stigma, while recognizing that addiction is already medicalized (Medical Model of Disease Today), and support systems are currently in place for willing participants. I also understand the limitation of protecting 47000 lives lost yearly, to the immorality of sacrificing healthcare quality for 40 million people. Overall, the continual rise of substance misuse (increasing incidences of addiction/death) (NIH – Drug Misuse In Canada), makes considering it a disease the right choice. However, instead of stretching an already tight budget, let’s expand the wallet and fill it with societal reform and monetary contributions for research/treatments. Changing mindsets is something we can start today, so let’s get to it!
One reply on “Blog 3- Substance-Use Addiction”
Excellent discussion on classification of addiction as a disease. Introduction was clear and concise. Arguments were logical and well supported. Graphics were appropriate. No significant concerns.