Is Alcohol Dependence a Disease?
While some people are able to drink and use drugs occasionally without experiencing any noticeable alterations to physical and psychological health, other drug and alcohol users experience health problems at at early stage of exposure and use.
This has led to questions about the origins of the problem, and how much genetics are a factor. One of the significant questions in the world of addiction treatment is: is addiction a disease, or is it a bad behaviour?
Self-help groups like Alcoholics Anonymous and Narcotics Anonymous support the disease model and advocate that the disease of addiction can only be cured through active participation in a program and working the 12 steps. Therefore, a person is never fully “cured,” but rather can learn to live with their disease and manage it by attending meetings.
Other programs, like SMART Recovery, believe that addiction is a bad habit that sticks over time because it is reinforcing and pleasurable. An addicted person is rewarded every time they take a drink or drug because they are able to experience the euphoric effects of the substance. These two contrasting views have led to tension in the addiction treatment field.
Researchers have been eagerly studying this phenomenon for decades. Recently, brain imaging has allowed us to delve deeply into the effects that alcohol use has on the brain.
One of the significant findings has been the fact that heavy amounts of alcohol use over time can actually result in changes in the brain.
For example, heavy amounts of alcohol have been found to affect the cerebellum portion of the brain, which is responsible for movement and coordination. Therefore, alcohol use can change the structure and function of the brain, but can the brain cause the addiction problems? Proponents of the disease model have looked to twin studies to confirm their findings.
Studies of twins separated at birth have found a strong link between both twins having a drinking problem. When one twin has a drinking problem, the other twin is significantly more likely to also. This is convincing evidence considering twins separated at birth do not have the same environmental influences.
Regardless of your view on addiction as a disease, alcohol dependence is a diagnosable disorder. Medical and mental health providers use the Diagnostic and Statistical Manual of Mental Disorders to diagnose their patients. One such diagnosis is alcohol dependence disorder.
According to this text, alcohol dependence includes tolerance for alcohol over time, withdrawal symptoms, drinking in larger amounts than intended, trying to cut down but being unsuccessful, giving up important activities as a result of drinking, spending large amounts of time recovering, and continuing to drink despite having health and psychological problems.
While there are conflicting arguments for whether or not addiction is genetically determined, there is substantial evidence that addiction and alcohol dependence create problems for users. In order to effectively treat those with alcohol dependence, diagnosing them with such a label is important.
This promotes better treatment because providers are able to pinpoint exactly what to treat. What do you think? Is addiction a disease that we are born with, and do people who are addicted deserve to be labelled?