Disease model of addiction
Encyclopedia
The disease model of addiction describes an addiction
as a lifelong disease
involving biologic and environmental sources of origin. The traditional medical model
of disease
requires only that an abnormal condition be present that causes discomfort, dysfunction, or distress to the individual afflicted. The contemporary medical model attributes addiction, in part, to changes in the brain
's mesolimbic pathway
. The medical model
also takes into consideration that such disease may be the result of other biologic, psychologic, or sociologic entities despite an incomplete understanding of the mechanisms of these entities.
Within the disease model of addiction, a genetic predisposition
is believed to be present. An environmental event is also felt likely to be required. These hypotheses would explain the result of adoption and twin studies that have been carried out, indicating that twins separated at birth have a higher likelihood of concordance for addictive disease than would be expected were there not a genetic component, and indicating that these twins have a lower likelihood of concordance for addictive disease than do twins who remain together in identical environments.
argue that labeling people as addicts keeps them from developing self-control and stigmatizes
them. As noted by harm reduction
specialist Andrew Tatarsky:
Substance dependence
The section about substance dependence in the Diagnostic and Statistical Manual of Mental Disorders does not use the word addiction at all. It explains:...
as a lifelong disease
Disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...
involving biologic and environmental sources of origin. The traditional medical model
Medical model
Medical model is the term cited by psychiatrist Ronald D. Laing in his The Politics of the Family and Other Essays , for the "set of procedures in which all doctors are trained." This set includes complaint, history, physical examination, ancillary tests if needed, diagnosis, treatment, and...
of disease
Disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...
requires only that an abnormal condition be present that causes discomfort, dysfunction, or distress to the individual afflicted. The contemporary medical model attributes addiction, in part, to changes in the brain
Human brain
The human brain has the same general structure as the brains of other mammals, but is over three times larger than the brain of a typical mammal with an equivalent body size. Estimates for the number of neurons in the human brain range from 80 to 120 billion...
's mesolimbic pathway
Mesolimbic pathway
The mesolimbic pathway is one of the dopaminergic pathways in the brain. The pathway begins in the ventral tegmental area of the midbrain and connects to the limbic system via the nucleus accumbens, the amygdala, and the hippocampus as well as to the medial prefrontal cortex...
. The medical model
Medical model
Medical model is the term cited by psychiatrist Ronald D. Laing in his The Politics of the Family and Other Essays , for the "set of procedures in which all doctors are trained." This set includes complaint, history, physical examination, ancillary tests if needed, diagnosis, treatment, and...
also takes into consideration that such disease may be the result of other biologic, psychologic, or sociologic entities despite an incomplete understanding of the mechanisms of these entities.
Within the disease model of addiction, a genetic predisposition
Genetic predisposition
A genetic predisposition is a genetic affectation which influences the phenotype of an individual organism within a species or population but by definition that phenotype can also be modified by the environmental conditions. In the rest of the population, conditions cannot have that effect...
is believed to be present. An environmental event is also felt likely to be required. These hypotheses would explain the result of adoption and twin studies that have been carried out, indicating that twins separated at birth have a higher likelihood of concordance for addictive disease than would be expected were there not a genetic component, and indicating that these twins have a lower likelihood of concordance for addictive disease than do twins who remain together in identical environments.
Criticism
Critics of the disease model, particularly those who subscribe to the life-process model of addictionLife-process model of addiction
The life-process model of addiction is the view that addiction is not a disease but rather a habitual response and a source of gratification and security that can be understood only in the context of social relationships and experiences....
argue that labeling people as addicts keeps them from developing self-control and stigmatizes
Social stigma
Social stigma is the severe disapproval of or discontent with a person on the grounds of characteristics that distinguish them from other members of a society.Almost all stigma is based on a person differing from social or cultural norms...
them. As noted by harm reduction
Harm reduction
Harm reduction refers to a range of public health policies designed to reduce the harmful consequences associated with recreational drug use and other high risk activities...
specialist Andrew Tatarsky:
See also
- AlcoholismAlcoholismAlcoholism is a broad term for problems with alcohol, and is generally used to mean compulsive and uncontrolled consumption of alcoholic beverages, usually to the detriment of the drinker's health, personal relationships, and social standing...
- Disease theory of alcoholismDisease Theory of AlcoholismThe modern disease theory of alcoholism states that problem drinking is sometimes caused by a disease of the brain, characterized by altered brain structure and function. The existence of alcoholism as a disease is accepted by some within the medical and scientific communities, although critics...
- Life-process model of addictionLife-process model of addictionThe life-process model of addiction is the view that addiction is not a disease but rather a habitual response and a source of gratification and security that can be understood only in the context of social relationships and experiences....
- Harm reductionHarm reductionHarm reduction refers to a range of public health policies designed to reduce the harmful consequences associated with recreational drug use and other high risk activities...
- Drug abuseDrug abuseSubstance abuse, also known as drug abuse, refers to a maladaptive pattern of use of a substance that is not considered dependent. The term "drug abuse" does not exclude dependency, but is otherwise used in a similar manner in nonmedical contexts...
- Sexual addictionSexual addictionSexual addiction is a popular model to explain hypersexuality—sexual urges, behaviors, or thoughts that appear extreme in frequency or feel out of one's control...
- Substance dependenceSubstance dependenceThe section about substance dependence in the Diagnostic and Statistical Manual of Mental Disorders does not use the word addiction at all. It explains:...