Is Addiction a Brain Disease?
Is Addiction a Brain Disease?
Addiction, it is all around us, affecting people from all walks of life, it is not limited to certain social classes or lifestyles. It is found in every ethnic group, regardless of gender or age. It affects our neighbors, our friends, and our family either directly or indirectly. Although substances such as alcohol and illegal drugs are two of the most common addictions we hear about, there is a wide range of substances and even activities such as gambling and shopping. There is some debate whether addiction is a brain disease or a choice. This controversy has been going on for years and a decision whether or not addiction is a brain disease has yet to be reached. According to a publication Is Addiction a Brain Disease? (1998) , by two psychiatrists, Sally Satel, M.D., and Frederick K. Goodwin, M.D., both argue “the virtues of thinking about addiction as a primary, though modifiable, behavioral phenomenon, rather than simply as a brain disease”.
That is, addiction is a function of a person, rather than simply a physical state” (Satel, Goodwin, 1998, p. 3). According to a publication by the National Institution of Drug Abuse (NIDA, 2007), “addiction is a chronic, relapsing disease characterized by compulsive drug seeking and use despite harmful consequences as well as neurochemical and molecular changes in the brain” (NIDA, 2007). For the purpose of this paper the focus will be on the substance of drugs of abuse when discussing ‘addiction’, but before getting into the two controversial sides another definition we can look at outside of these two opinions is taken from textbook, Psychology 10th Ed, by David G. Myers: “Addiction is a compulsive drug craving and use, despite adverse consequences” (Myers, 113).
PRO: Drug Addiction is a Brain Disease.
The National Institute of Drug Abuse (NIDA) explains that addiction is a brain disease. The initial decision to take drugs is a person’s voluntary choice. However, once a person takes that drug of abuse it can effect “the pleasurable area of the brain” (NIDA, 2007), in which, addiction takes over the person’s capability of self control, which can result in harmful actions. Thus, when a person uses drugs over a long period of time the brain structure and the way it operates changes resulting in harmful effects and actions. Addiction is tied to changes in brain structure and function, basically making it a brain disease. Furthermore, all drugs of abuse have common affects one way or another within the brain, which activates “the pleasurable area of the brain” (NIDA, 2007).
Drugs of abuse reward our normal actions, therefore, if the brain gets a lot of stimulation it produces pleasant feelings, which drives a person to continually use drugs over and over. NIDA also points out that from science research “brain-imaging studies from drug-addicted individuals have shown physical changes in areas of the brain that are critical for judgment, decision making, learning and memory, and behavior control” (NIDA, 2007) which indicates that once those areas of the brain are disturbed so is a person’s capability of freely choosing not to take drugs, leading to negative actions.
Additionally, science research shows that these changes alter the way the brain functions, which may explain the uncontrollable and negative actions of a person. Furthermore, according to NIDA addiction can be treated and managed successfully since it is a chronic disease and research has shown that combining behavioral therapy with medications is the best way to ensure success for most patients with this chronic disease indicating that it is a treatable and manageable similar to other brain diseases.
CON: Addiction is not a Brain Disease.
According to a publication retrieved from Ethics and Public Policy Center (EPPC) “Is Addiction a Brain Disease?” two psychiatrists, Sally Satel, M.D., and Frederick K. Goodwin, M.D., they do not agree with NIDA’s claim that “addiction” means compulsive drug-taking driven by drug-induced brain changes. They believe “addiction is a function of a person rather than simply a physical state and a person is in voluntary control of their decision and actions” (Satel, Goodwin 3). If a person can make the choice to take drugs then they can also make the choice to stop taking drugs, especially during those times in between when they are not taking drugs. For a person to voluntarily continue taking drugs of their own accord then they should be held accountable for their addictive behavior and not use brain disease as an excuse.
Further, circumstances such as economical, health, or personal issues resulting in a person’s choice to take drugs ironically can be the same reasons for them to either change their pattern, stop taking drugs, or get help versus the unavoidable, involuntary effect of a diseased brain. Additionally, those that choose to continue being addicted over a long period of time illustrates that by making that choice they are not helpless compared to a person who has a chronic disease. “Rather than being the inevitable, involuntary product of a diseased brain, these actions represent the essence of voluntariness. The addict’s behavior can be modified by knowledge of the consequences. Involuntary behavior cannot (Satel, Goodwin, 1998, pg. 5). As a result of that knowledge the addicted person is in control and can take be in charge of their actions to change the cycle and make a deliberate effort to change.
My position is optimistic on the subject Is Addiction a Brain Disease? Addiction is a primary, progressive, and chronic disease of the brain, which creates physical, emotional, and spiritual impairments. I have seen this disease affect people close to me and can only have hope that someday there will be a treatment. First hand, I have seen three families, with different backgrounds, affected by addiction. Two lost a loved one to the overdose of drugs and the other is struggling along with their loved one, who is addicted, to defeat it. One mother wanted to know how this could have happened to her son, how he could lose control of his life and eventually lost the battle of addiction. I do not believe that a person voluntarily WANTS to be addicted, or that they even realize what addiction truly is prior to becoming addicted. However, I do agree with both sides that a person does voluntarily make the choice to take a drug of abuse. But have given more thought into it about why a person can’t just stop taking the drug when they know it is harmful and changes their behavior.
My conclusion is that addiction is caused by drugs that are induced with one or more certain types of chemicals that travel through the brain and have an effect on the area of the brain where we feel pleasure and joyful feelings. Also, some people are more susceptible than others to becoming addicted to drugs of abuse than others because their brain reacts differently to the chemical(s) in a drug. Furthermore, addiction has signs and symptoms and a predictable progression and it is apparent that the characteristics of the disease and the approaches to treatment is not any different from other chronic brain diseases. Addiction is a brain disease since its causes are complex but its results are clear. I’m in agreement with NIDA that an 6 addicting substance changes the way the brain works over a long period of time, which leads to the activities of what we recognize as addiction and like most other brain diseases, addiction can be treated. Although treatment can be long and difficult and there are often relapses, it can be successful if people acknowledge it as such and treat it accordingly.
Addiction affects, if not to all, most countries and cultures. According to the annual report of the UN International Narcotics Control Board (INCB), the estimated number of drug abusers worldwide in 2009 was between 172 million and 250 million people. Varying by different narcotics, the 2007 report national rates range from 0.8% to 11% overall with the highest rates in Italy, Spain, and the United Kingdom and the lowest rates recorded in Romania, Malta, followed by Bulgaria, Greece and Sweden (INCB, 2007, pg. 98). Although we come from different cultures, most of the world shares common diseases and since most countries are affected by addiction the sharing of awareness, knowledge, and research information between cultures could have a huge positive impact on the world.
NIDA’s position of “Yes, Addiction is a brain disease” is based on their commitment of continued studies and research into drugs of abuse, addiction, backing up their argument that addiction is within the brain not the individual. Satel and Goodwood’s position of “No, Addiction is not a Brain Disease” is based on their conclusion, according to their research into other’s researches and their knowledge in the positions they hold as psychiatrists that addiction is an individual’s choice not a disease within the brain. Both are able to support their claims by information provided through research.
Besides the known fact that millions of people around the world are directly or indirectly affected by addiction, it has a huge impact on our society. Not only with the economical costs involved for medical and healthcare, there is the cost of crime as a result of consequences from addiction, loss of productivity in the workforce, and many deaths that result from complications of addiction and overdose. By being aware and informed of addiction, citizens can be supportive and helpful to those battling addiction and help prevent others from getting the disease. They can also help by being understanding and supportive to those who are addicted and encourage them get the treatment they need to battle it.
Another way to lend a hand is citizens can get involved within their community and promote physical and social activities for all age groups. Citizens can make a difference just by starting somewhere instead of doing nothing and thinking “oh that’s their problem” or “it will never affect me” or worse “it is their fault they are addicted”. It is happening, it can happen to anyone directly or indirectly, and it isn’t anyone’s fault. We need stricter laws on drug making and trafficking to help our society, otherwise we will become an addictive society. Our leaders can invest in continued and advanced scientific research for prevention and treatment.
Clearly with as much research as there has been on this topic there is a huge interest and concern of what is happening in our society. By upholding moral values we can consider others opinions with an open mind on topics such as this knowing that while we carry our own values, we must encourage those values as a society to help combat addiction and by being open to the opinions of others we can all come together to battle this disease. With NIDA’s investment into research and treatment it shows they have a special interest and concern on the value of life and our society. It appears the opposing side would rather dispute the issue and disregard it as a disease, but rather the behavior of a person.
NIDA is known as being one of the largest supporter’s of the world’s research on drug abuse and addiction. Government funds are used for scientific research by tracking emerging drug use trends, understanding how drugs work in the brain and body, developing and testing new drug treatment and prevention approaches, and disseminating findings to the general public and special populations (NIDA, 2007). They claim that the Science of Addiction has evidence backing up their argument that addiction is a disease of the brain.
Psychiatrists Satel and Goodwin, claim that based off biological studies and scientific findings there are not sufficient facts to back up NIDA’s claim that addiction is a brain disease, supporting their argument that addiction is not a brain disease.
After completing my research, it was not a surprise to find there are differences of opinion on this topic and understandably so. This research and my experience of having observed the affects of addiction first hand have not only driven my passion to understand addiction and the brain, but strengthen my position that addiction is a brain disease. By keeping an open mind allows me to learn and recognize the views of others. Addiction is a common disease we all share directly or indirectly, it is an International problem. The more people know and understand addiction the chances they will be open to looking at it differently. Knowledge and understanding are two biggest parts of moving forward in taking this disease more seriously.
It does no good to blame the abuser My hope is that people will look at addiction and take it more seriously if it is considered a brain disease and put more time and money into further research to find out what is actually causing the addiction in the brain and why some people are more susceptible than others. One may lean more toward the idea of addicts choosing to be addicts and that they have complete control over their actions; however, if the addict chooses a path to moderation, they face medical complications associated with withdrawal.
The physical effects of withdrawal can become severe enough to cause death and require medical treatment, thus suggesting addiction is a form of disease. No matter what side you choose on this debate, you should expect to run across supportive evidence of the alternate side while arguing your point. It is a choice to try a substance, but it is not a choice to become addicted. Although this brain disease does not remove an addict from their responsibility for their behavior it does explain why many addicts cannot stop using drugs by strength alone.
1. Satel, S., & Goodwin, F.K. (1998). Is Drug Addiction a Brain Disease?, (9th edition). Upper Saddle River, N.J. Pearson Prentice Hall. Retrieved from http://www.eppc.org/publications/bookID.19,filterID./book_detail.asp 2. National Institute of Drug Abuse. (2007). Is Drug Addiction a Disease? Unknown. Retrieved from http://www.drugabuse.gov/publications/topics-in-brief/drugs-brains-behavior-science-addiction
3. Myers, D.G. (2011).Psychology. (10th edition). New York: Worth Publishers
4. International Narcotics Control Boars (2011). Report of the International Narcotics Control Board for 2011 Unknown. Retrieved from http://www.incb.org/incb/en/publications/annual-reports/annual-report-2011.html
University/College: University of California
Type of paper: Thesis/Dissertation Chapter
Date: 21 December 2016
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