The American Medical Association did something very important for the recovery community over 40 years ago, when they publicly declared that alcoholism, and by association, drug addiction, were in fact diseases. Of the many stigmas that the addict has to live with, there is the assumption that they are people who make very bad choices over and over again. Admitting addiction into the category of disease does not take away all their responsibility for their actions, but should put the behaviors into a new light, and help us to understand what the options are for treatment, and more about what the stakes actually are. What’s the importance, then, of the disease model, rather that considering it to be a compulsion of the mind?

A compulsion almost always suggests that the root of the problem is one of will-power. The addict has to simply decide to be done with the drug, or the alcoholic with the drink, and then it’s a matter of getting help to get through the detoxification period and go on to live a normal life. There are plenty of studies now, and in the past, that suggest that something very particular happens to the brain chemistry of an addict after they’ve used drugs for a long period of time. It becomes altered in such a way that it is programmed to work with the drug in its system, and to revolt when the chemical is not present.

This does suggest that the addict or alcoholic is really not in control over their own brains. It’s not simply a matter of compulsion, and finding ways to keep the compulsion away. In these cases, the compulsion is actually a physical reaction in the body chemistry, and it seems as though once it has woken up, it never really goes to sleep. This is one of the reasons why it is so difficult for people who are close to addicts, because the capacity for irrational behavior is very high. However, treatment and recovery are ways of putting this chronic disease into submission, so that it can be possible to live a very full and healthy life. Thinking of this disease just as we might high consider high blood pressure, or perhaps even cancer in remission, then it’s possible to conceive of living with an addiction, and to be able to look at addicts, and ourselves, with more compassion. That’s one of the great gifts that came from the AMA’s decision.

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