I recently wrote an article saying that alcoholism and substance abuse are problem behaviors, not diseases. A disease, I wrote, is something that can only be stopped by passive submission to medical intervention such as surgery or some sort of pill. A problem behavior, on the other hand, is something that can only stop – with or without outside help – once one commits to stopping.
I knew this simple yet obvious concept would strike a few nerves, and indeed it did. One irate reader wrote: “I find it disturbing that your opinion of addiction is put forth so aggressively when it is in fact so uninformed and narrow-minded. Your argument is based on what “a number of emails affirmed that addicts buy into political correctness” and they are “waiting for a promised fix that will never happen.” Where are your sources for this profound knowledge you are sharing here? Who do you know that promised a FIX, you? Believe me, they better than anyone know there is no FIX! The idea that addicts “use” the medical, or rather physical component of their disease as an “excuse” to continue abusing is ludicrous.
I’ve been writing this column in the Delaware Wave for over 17 years, and these sorts of responses often “quote” things that I never even wrote. I never said there’s a “fix.” This responder never read the entire article. It’s an occupational hazard for any writer. What I did write was that the only fix is the substance-abusing person, not some external agent. Even daily visits to AA or NA amount to only an hour or two. The person with the problem is still living with him- or herself 24/7. I also did not write that all addicts use the medical model of addiction as an excuse. Sadly, some therapists and/or doctors do, because of their ideology. But that has nothing to do with facts, reason or science.
The vast majority of addicts, in my experience, actually do not like this “disease” model. The writer above describes herself as a psychotherapist (yikes!) with multiple degrees. She offers these as evidence to counter the logic and facts I describe. But none of that alters the fact that nobody is putting the substance into the addict’s body other than the addict himself. If this isn’t a choice, then what is it?
The writer calls it “narrow minded” to place the addict in charge of his or her own recovery. I call it cruel and inaccurate to label addiction a disease. When you finally admit that you’re doing the damage to yourself, then you don’t have to look at yourself as a victim. There are steps you can take. No, it’s not easy. But many people who stop drinking or drugging have, in fact, attained and maintained their sobriety. They are to be congratulated.
Yes, I’m placing the blame for the problem on the person who engages in the self-destructive behavior. But by the same logic, I give lots of credit on those who save themselves. The writer’s view of “You can’t do it; let someone else take care of you,” is narrow minded, inhibiting and frankly wrong.
There’s no proof that brain chemistry forces anyone to put anything into one’s body. The brain sends us signals, and it’s true that the brains of some people process alcohol. But the brain cannot force you to pick up a glass or a syringe. If this were true, nobody would be able to stop their behaviors – though millions of substance abusers have done just that.
How can a “disease” be cured without medical intervention? Talk therapy, AA/NA, rehab programs, etc. have helped many, but these are not medical interventions. In fact many people stop without any non-medical interventions. In my experience, those who are serious about quitting neither want nor expect someone to do it for them. They might want someone to coach or guide them, but they understand that it’s ultimately up to them to make the commitment to not just stop, but to live sober and purposeful lives after they do.