If I’ve said it once, I’ve said it a thousand times: addiction is not a disease. 

Aside from the growing body of scientific evidence, I am also confidant of this because I myself have beat my own addictions several times throughout my life:

I quit nicotine (both cigarettes and chewing tobacco) some 25 years ago; I was tired of feeling like it was controlling me, tired of spending the money, and, as I approached the age of 30, the social acceptance aspect faded with my own maturity, and I simply quit.

I quit drinking alcohol 8 years ago, after addictive drinking destroyed my life and nearly killed me. Though I attended AA meetings during the height of my crisis, I never truly embraced the program, because I never bought into in the disempowering premise that it’s a disease. I wanted, needed, something more empowering than that. So I researched, studied, soul-searched, and eventually figured out the underlying causes of my addiction, addressed those, and eliminated the impulse altogether.

More recently, I’ve beaten some more mild addictions such as diet soda (once I learned how unhealthy it is, it was just a matter of finding a replacement that I enjoyed drinking), and yes—even social media. Once I recognized the signs, I changed my thinking, redirected my behavior, and eliminated the problem.

So my own experience indicates that addiction is, in fact, beatable—which also indicates that it is not, in fact, a disease from which we are helpless to recover.

But for over 80 years now, traditional 12-step programs have treated addiction as a disease, as if the addiction itself is the problem (it isn’t), and continue to boast a dismal success rate (estimated to be in the single digits, or approximately 5%).

In fact, a few years after the American Medical Association (AMA) declared that alcoholism was an illness in 1956, AA founder Bill Williams disputed the claim, giving the following reply when he was specifically asked about alcoholism as a disease at the National Catholic Clergy Conference on Alcoholism in 1960:

“We have never called alcoholism a disease because, technically speaking, it is not a disease entity. For example, there is no such thing as heart disease. Instead there are many separate heart ailments, or combinations of them. It is something like that with alcoholism. Therefore we did not wish to get in wrong with the medical profession by pronouncing alcoholism a disease entity. Therefore we always called it an illness, or a malady—a far safer term for us to use.”

In my opinion, the consequences of labeling addiction as a disease have been both good and bad; on the one hand, it has helped to alleviate the inherent stigma, thus enabling more people to pursue treatment without the fear of losing their job, their relationships, their self-respect, their position in the community, etc. But on the other hand, I believe it ushered in the expectation of insurance companies (or government programs) to foot the bill for treatment, which, as is the case with most third-party payer systems, enabled treatment facilities to vastly increase their fees, resulting in the skyrocketing cost of treatment and rehab—even though they are based on the free 12-step programs, and can still only realistically claim the dismal single-digit success rate.

Today, new science is emerging concerning addiction (referring to the general behavior, not just alcohol/drugs, but gambling, food, internet, sex, shopping, porn, work, exercise, religion, statism 🙂 , etc., across the spectrum) as pioneers in the field are developing a new understanding of addiction, and debunking the disease myth promulgated by the traditional 12-step programs:

Dr. Gabor Maté discusses a deficient dopamine system—essential to feeling love/loved, connected, happy, and also linked to motivation—which is underdeveloped during childhood due to absent, disconnected, or abusive parents (this also helps explain the “genetic” theory, with addiction “running in the family,” as those with underdeveloped dopamine systems will often be absent, detached from, or even abusive to their own children, thus perpetuating the cycle). Alcohol and other drugs act on the dopamine receptors, so when an addict first tries them—BAM! For the first time in their lives, they feel love, connection, happiness…i.e., for the first time in their lives, they feel normal. Now how addictive would that be? And what do you think they’re going to do from then on? Of course, they’re going to return to the drug again and again, regardless of negative consequences in their lives.

Dr. Lance Dodes discusses the specific psychological process that addicts go through immediately preceding the decision to indulge in the addictive behavior, which is identical across the board, regardless of the form of addictive behavior itself: a feeling of helplessness, powerlessness, being overwhelmed, or experiencing loss of control; the decision to indulge in the addictive behavior then instills a false sense of regaining control.

Dr. Stanton Peele discusses some alternative approaches to addressing addiction,  such as Moderation Management and Harm Reduction.

But in this TED Talk, entitled Everything you think you know about addiction is wrongJohann Hari, author of Chasing The Scream: The First and Last Days of the War on Drugs discusses the environmental and social aspects of addiction.

He speaks of the famous “Rat Park” experiment conducted by psychologist Bruce K. Alexander, in which rats living in a cage will choose the drugged water over the clean water until they die of overdose (leading to the belief that the drug itself is addictive), while rats in a natural, enjoyable, social environment ignore the drugged water and prefer the clean water—going from a nearly 100% addiction rate to 0% simply due to healthy, positive changes in their environment.

He touches on the well-known study of US soldiers returning from Vietnam, known as Operation Golden Flow. As many as 20% of those soldiers used heroin daily while there, and self-identified as heroin addicts. But upon returning after the war, 95% of them stopped completely, no treatment needed. Again, simply due to a positive change in the environmental aspects of their lives.

In addition, he discusses the many patients routinely given morphine for long periods of time while in the hospital, who stop abruptly when they leave and never become addicted.

All of these examples suggest that the drugs themselves aren’t necessarily addictive, but there are other factors involved in people’s lives that lead them to an addictive behavior or addiction lifestyle.

But most importantly, he discusses the social aspect (or, more properly, the lack thereof) wherein drug addicts don’t feel connected to people, to society, so they end up connected to their drugs instead, and how the world-wide treatment of addicts—aka the war on drugs—has the exact opposite impact than intended. The reality is that the harsh treatment of addicts—persecuting them, prosecuting them, jailing them, cutting them off from society and even gainful employment via criminal records—just makes them feel even more disconnected, more unsocial, more unaccepted by others, thus actually worsening their addictive behaviors.

Simply put, the war on drugs is the worse possible thing, the exact opposite thing, that could or should be done to curtail addiction and its related problems.

Then, in closing, Hari discusses Portugal’s shift in its drug policy, and the fact that after the country decriminalized all drugs across the board in 2001, all of the related problems plummeted.

Worth a watch: