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Addiction as a Brain Disease by Rebekah Boesch

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Addiction is complicated and multifaceted and has been argued back and forth as to whether or not it is a choice or if it is truly a disease. Insurance companies prefer to argue that free will does exist and that punishment and coercion are the best options to change an addict. However, with more and more research, it has been proven to be a fact that addiction is not an excuse for rebellious and selfish behavior, but a clear-cut disease. The simple disease model includes an organ, the defect of that organ, and symptoms of the disease. Addiction satisfies this model with the brain as the organ. The defect is more difficult to understand because it is not a physically visible malfunction. But to understand this, a general knowledge of the brain is imperative.  The midbrain or limbic system works as the unconscious aspect of the brain. This is associated with the basic human instinct for survival. Stress plays the role of the causal agent in addiction. When an addict is beginning to crave a high from their drug, it causes the same severity and pattern of stress within their midbrain. In an addict’s brain, this becomes a threat to their survival.  When the cortisol is increased, the levels of dopamine become decreased.

The other important aspect of addiction in the brain revolves around hedonism. In Greek, hedonic translates to “pleasure.”  When one becomes addicted to a substance, the high they experience when they use resets their pleasure threshold. The bar is set much higher than when any other happy experience occurs. The opposite of pleasurable feelings is anhedonia, which causes emotional numbness. Situations and feeling from the past no longer stimulate happiness among the addict because the brain’s bar of pleasure is so high that only their drug is able to get them to that place of pleasure.  The addicts begin to feel emotionally numb to everything excluding their drug use.

The model of disease is relevant to addiction because the brain, specifically the midbrain, serves as the organ. The defect is the stress or the craving. Finally, the symptom (just one of many) for the defective organ is the loss of control and persistent use despite the consequences on the individual.

Not everyone is ready to accept the proven fact that addiction is, without a doubt, a disease. No one would ever argue the legitimacy of diabetes or cancers. Yet, there are actually many similarities outside of the Medical model for the disease.  The process of treatment can differ for every individual.  Like most diseases, heredity can play a major role in whether or not one is likely to develop breast cancer or become an alcoholic.  In a case such as cardiovascular disease, stress is one main contributor, similar to addiction. To prevent or avoid drug abuse, the recommendations are identical. Exercise, developing coping strategies, seeking treatment, and most importantly knowing family history is incredibly important when dealing with addictions, but also diseases such as Cardiovascular disease.  An individual does not consciously make the decision to develop heart problems or become an alcoholic. However, being aware of one’s personal health and history may help one to avoid such diseases.

The most astounding statistics in comparing diseases to addiction are the relapse rates for chronic illnesses. One major argument for addiction becoming a choice is that the addict continuously makes the decision to use substances over and over again, even after medical and psychological attention. 40-60% of drug addicts will relapse. However, 50-70% of patients with asthma relapse along with 30-50% of all type two diabetics.

With modern research, there is no debate; addiction is a disease. Like many other diseases, it has a high fatality rate. However, if society and doctors were to treat it strictly as a disease, we would have a lot fewer addicts in unnecessary places such as prisons, and a lot more addiction facilities that make a difference to millions of addicts’ lives.




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