In May of 2006 HBO, USA Today and The Gallup Poll established that three quarters of American adults, who had an immediate family member with a drug or alcohol problem, thought of addiction as a disease. Seeing addiction as a chronic illness may be a hotly debated topic, however if it makes addiction treatment more accessible and helps patients get into recovery, surely it makes sense to regard addiction as analogous to a disease?
There are common myths regarding addiction treatment which make the rapid access of treatment for addicted people more difficult than it needs to be.In spite of the value judgements some people put on addiction it has striking similarities to other chronic illnesses like diabetes, hypertension and heart disease.Adherence to treatment and rates of relapse for addiction, diabetes, hypertension and heart disease are also similar, so the belief that addiction treatment is generally unsuccessful is wrong, and seems more associated stigma than reality.
One of the best indicators of treatment success is adherence to a prescribed treatment plan and for patients with chronic illnesses this is difficult. Statistics show that not only can addiction be treated effectively, addiction treatment is often more effective than treatment for other chronic illnesses.
Not sticking to the treatment plan results in 50% of diabetics needing to be treated again within one year of diagnosis and their first treatment. Similar statistics hold true for other chronic diseases. Around 40% of hypertension patients will need emergency medical attention for episodes of severe high blood pressure, and only about 30% of adult asthma patients take their medicine as prescribed. Although addiction treatment is statistically more successful than treatment for other chronic diseases, addicts do relapse during treatment.
This is not indicative of treatment failure, but rather a sign that further treatment is necessary. The difficulty in following a treatment plan and handling the stress of a chronic disease shows how complicated changing human behavior is.
Addiction – An Involuntary Disorder?
Some people argue that addiction is self inflicted. Although it is true that the initial choice to try a substance is voluntary, experimentation and testing limits is a normal part of growing up.
Addiction is a bit like the lottery, we really have no way to accurately predict who will become addicted through ‘normal’ alcohol or other drug use. Peer pressure and availability of drugs influence young people; although not all people exposed to these two factors go on to become addicts. And once addiction develops drug use is compulsive and not voluntary. Some say that the reasons for initially trying drugs are hereditary, however generally those who experience extremely enjoyable responses to the substance are more likely to use again, until the addictive cycle kicks in. At what point the addictive cycle kicks in is dependent on what drugs are being used, so particularly for youth experimentation is with drugs is very risky as we have no way of determining who is more likely to become addicted.
Unfortunately drug addiction causes changes in the brain pathways that continue long after substance abuse has ended making it impossible for that person to effectively control their intake of alcohol and other drugs.
Once addicted, there are many factors that have considerable influence on the addict and their need to continue ingesting the alcohol or other drugs. Medical science has made huge advancements over the last years and our knowledge of why people become addicted, but also once people are addicted to alcohol and other drugs – what makes them continue to drink alcohol and use drugs despite the negative consequences is now clearer.
Addiction as Compared to Other Chronic Disorders
Many chronic illnesses require changes to patient behaviour and lifestyle as well as lifelong treatment. With diabetes, hypertension and asthma there are external factors which influence the effect it has on the sufferer. The same holds true of people addicted to alcohol or other drugs. Factors such as parenting practices, stress in the home environment and behavioural aspects like exercise and nutrition influence the severity of the disorder. We all known people who are trying to lose weight and yet they persist in poor eating habits and a sedentary lifestyle.
We know that people who eat an unhealthy diet and do not exercise regularly have a higher risk of heart disease, yet when they have a coronary we don’t berate their poor decisions and lifestyle, we do the opposite. We help them as best we can towards making healthier choices and changes to their behaviour to better enhance their recovery. Certain choices play an important part in the onset and severity of these chronic illnesses. These disorders require constant treatment for improvement. In most cases the disorders are managed, rather than cured.
Because of the influencing factors and the high rate of relapse in addiction, management of addiction and improvement of symptoms is a realistic goal, although the journey to recovery can be fraught with failure, that doesn’t mean that treatment is unsuccessful.
Successful Addiction Treatment
Treatment which is considered successful has a vast improvement in the following three areas:
- Reduction of drug and alcohol use;
- Increased personal health and social functioning;
- Reduced threat to public health and safety.
There seems to be a strange phenomenon where certain drugs and certain subcultures have better addictions treatment outcomes than others. For example those addicted to opiates who are professionals seem to do better than those who are unemployed with little education, even though the addiction is with lesser amounts of the opiate. Another way that addiction treatment is successful is that it saves money in the long run. The costs of the actual substance as well as the consequences of addiction are appalling.
Although treatment costs seem initially expensive, the long term savings are well worth it, not to mention the quality of life improvement for the addicted person and their family. Being able to engage with life again in a normal, productive and meaningful way is priceless.
Addiction treatment which is assisted with medication usually has a greater success rate. Medication is used as a substitute to the drug and administered in reduced dosage, making withdrawal a lot less stressful. It allows the addict to continue with everyday life in a normal fashion, much like a diabetic using insulin and a hypertension patient using beta blockers.
Much of the success of addiction treatment comes through treatment compliance. The combination of educational programs, counselling and medication is essential to recovery.For a variety of reasons, sometimes due to socioeconomic status and the lack of family or social support addicts do not continue with the treatment program and end up relapsing. Believe it or not, many patients with the more mainstream and socially acceptable illnesses, like diabetes, hypertension and asthma, (all illnesses that need continued care throughout the patient’s life for treatment to be successful) do not stick to their treatment or make the necessary life changes for their successful recovery for the same reasons that the people addicted to alcohol or other drugs did not succeed.
Whether you agree or disagree alcoholism was first recognised as a disease as early as 1785, by Dr. Benjamin Rush, signer of the Declaration of Independence and physician of George Washington’s Army.
In his widely dispersed essay on “the effects of ardent spirits,” Rush clearly called intemperance a disease and, an addiction. Addiction treatment is worth structuring as a chronic illness as it helps people in treatment recover. Considering addiction a disease may not meet the rigid classification of a disease. We’re gaining new information all the time and the anecdotal evidence of recovering people has pointed towards addiction to alcohol and other drugs being a disease for many decades now.
The weird thing is it seems like medical science is catching up with all those addicted people’s perceptions and proving it true!