Addiction is not a disease

The statement in the heading of this article generates a lot of heated debate and backlash when I say it. My intention is not to be inflammatory but to educate people about the true origins of addiction, which leads to more effective treatment models for it. 

The ‘Disease Model’ was developed in the late 1930’s from the twelve-step community and was an advancement from the view of alcoholism being a moral failure. What this assessment did have correct was addiction is associated with the brain becoming disordered. 

Identity and Shame

In addition to the importance of having the right cause to create the right treatment, I have seen numerous individuals and families suffer due to believing addiction is a chronic disease you can never fully recover from. In laymen’s terms, YOUR SCREWED.

This leads to having to spend your life in constant fear of relapsing and identifying as an addict or alcoholic for the rest of your life. Some individuals carry a tremendous sense of shame due to wrapping their identity around the fact they are an addict. Moreover, I have also witnessed many who struggle with addiction engage in a type of reverse discrimination. 

Due to the shame they carry, they then isolate themselves in the recovery community and judge those who are ‘non-addicts’, or in recovery community language ‘normies’. They assert you cannot understand us or have any valuable feedback to add to our situation, which in my opinion is complete B.S.

A New Paradigm

I am not an opponent of twelve-step programs and regularly put clients in contact with twelve-step sponsors I believe can add tremendous value to what they are doing in their work with me. However, after working with thousands of recovering addicts and researching addiction science for the last fifteen years, I have come to realize how addiction develops in the brain and how you can recover from it. 

Unfortunately, as in any field or industry, getting others to make changes and catch up with new paradigms takes time and creates a great deal of resistance. There are as many ‘sacred cows’ in the therapeutic and scientific community as the religious community I have come to find. 

Nonetheless, I have been increasingly encouraged over the last couple of years in people’s openness to hear me out and a handful of cutting-edge scientists and researchers blazing new trails when it comes to addiction treatment. If you are interested in some of the things I am saying, I would recommend reading  Maia Szalavitz’s book, Unbroken Brain

A Developmental Learning Disorder

What the latest neuroscience reveals is addiction in essence is a developmental learning disorder. There is no addiction that can take place outside of learning. If a baby is born addicted to heroin or cocaine, once they withdraw from those drugs they will have no more desire for them than any of the other babies in the nursery. They have not learned or made an association that these drugs can relieve or shift a certain emotional state. 

The initial genetic research around addiction, filtered through the disease model, overexaggerated the genetic influence of addiction. This was true of much of the early gene research in other areas as well. Since that time, we have come to learn genes are very complex and are turned on or off in reaction to environmental stimulus. There is a whole field of gene research called Epigenetics that shows you are not just locked into a helpless heredity. 

The Myth of The Addictive Gene

The largest genetic influence I have read in any research is fifty percent, and that does not take into account epigenetic possibilities for change. Now there is no doubt there are additional things that influence addictions and put one at risk, such as trauma, poor social skills, lack of ability to manage stress, environment, and mental health issues. 

However, as mentioned before, addiction must manifest itself through learning. At the end of the day, there are only two ultimate reasons individuals become addicted to using a substance or compulsive behavior: to regulate an emotional state; or a stimulus has become conditioned or associated. Both of these are the result of learning. 

Addiction and The Adolescent Brain

90% of all addictions have their origins in adolescence. This is the brain’s largest restructuring time outside of infancy. Anything that gets learned during this period imprints deeply in the brain. This is also the period where we ideally begin learning how to manage emotions and stress in a more effective manner to prepare us for adulthood. 

In my experience in working with clients struggling with addiction, the vast majority began at least experimenting with substances and compulsive behaviors at this time. Now I also want to clarify the majority of adolescents will experiment with substances at some point during these years and not become addicted. 

Drugs Are Not That Addictive

Research shows us drugs are actually not that addictive. This statement is usually where I get another round of eggs and tomatoes thrown at me. However, the stats back up what I am saying. Here is a list of the three major substances used and abused and their approximate statistics for how many individuals will become substance dependent: Alcohol 10%, Cannabis 9% Cocaine 20%, Opiates 30%. 

Yes. That’s it. If view or read any media outlet you would believe this rate is much higher. Again, I wish to clarify where I am coming from or what I am attempting to convey. For those who become addicted, it is devastating for them and their families. I have dedicated my life to helping those suffering from addiction heal and recover. 

The Need For More Effective Models

Furthermore, I am not advocating recreational drug use or a return to it for those who have recovered. My primary motivation is to help spread what we have learned through science and research about addiction so we can develop more effective models for helping people recover and transform their lives. 

Okay. Let’s get down to it. Despite the vulnerabilities mentioned earlier, addiction is a developmental learning disorder that highjacks the brains learning and reward system. The brain wants to put as many things on automatic pilot as possible to conserve energy. This is beneficial for survival. However, addiction utilizes a type of memory system that makes it automated and bypass conscious control. 

How Addiction Highjacks The Brain

Addiction either bypasses or basically shuts down parts of your prefrontal cortex. This is the part of your brain that would stop, reflect, and say things like, “I don’t think this is such a good idea.” Think of the experience of driving your car and listening to the radio. You suddenly become aware of the fact you have not noticed driving for the last few miles. This is my drive to work every day. You think to yourself, “How have I been driving and not smashed into someone. 

This is what is referred to as procedural memory. It is the same type of memory I have been using as I type this article. I could probably only tell you consciously about where four to five letters actually are on the keyboard. Now when I learned how to type, I could have recalled many more of them. In that instance, I was using what is known as declarative memory. 

Not A Disease But A Disorder

Procedural memory imprints in your body and is what people often refer to as muscle memory; it gets into your bones. You don’t really have to think about it anymore. This is one of the influences of how you become addicted to something: You take a substance or engage in a behavior that helps regulate or relieve an emotional state, and you do this with enough repetition until it encodes in procedural memory bypassing conscious control. 

Yes. Addiction is no doubt a brain disorder, but it is not something you are born with. People will often assert, “Addiction runs in my family,” or, “I have an addictive personality,” which is a complete myth. On the surface this appears logical. However, what runs in these types of families is trauma and lack of emotional development that is handed down intergenerationally. What some refer to as an ‘Addictive Personality’ is just a lack of ability to regulate one’s emotions, which results in compulsive use of whatever you do. 

Alteration of The Reward System

Addition also takes over your reward system. One of the primary neurochemicals triggered by our reward system is dopamine. Dopamine is also associated with learning. When we learn valuable information or things that were difficult, we get rewarded with dopamine. Moreover, dopamine loves novelty and when things are betting than expected. Evolution did not anticipate synthetic drugs. They are much better than anticipated and they also release dopamine due to their chemical makeup. 

This also causes a restructuring of the level of importance of survival needs. Nature uses dopamine to help us pay attention to what matters most for survival. When you combine how the dopamine hit shifts a substance or compulsive behavior to a survival need of the utmost importance and automatic learning takes place over whatever drug or behavior regulates an emotional state, you can see how the core of addiction is truly a learning disorder. 

Emotions and Neuroplasticity

This leads to a treatment model that is more accurate and advanced than believing you have a chronic disease, such as diabetes or an autoimmune disease, you will have to just manage the rest of your life. The current neuroscience research does not back this up. What has to occur is using experiential therapies that trigger neuroplasticity to erase this old learning and development of new behaviors that create more effective learning of how to regulate one’s emotions in a more effective manner. 

In addition, two areas that are often overlooked in addiction treatment are health and wellness and increased relationship skills. Many of the contributors to emotional dysregulation are being unbalanced and deficient in essential vitamins and minerals, genetic abnormalities, gut problems, and hormone levels. These areas are given little to no attention in most treatment programs. 

The Importance of Secure Attachment

Furthermore, learning how to emotionally connect to others in a healthy way is crucial in developing emotional regulation skills. We also learn best in a safe, supportive environment. Treatment programs need to stop viewing addicts as a bunch of lying, stealing, antisocial individuals who need to be confronted harshly to break through their denial. 

I am not naïve and have worked with clients who have engaged in these behaviors. However, the majority of the clients I have worked with who have struggled with addiction are largely good people with tremendous intelligence, talents, and abilities that need to be identified and encouraged. It’s time for a change. We have a greater understanding than ever before and are learning more every day. 

You Can Recover

At minimum, I hope this article has made you think. You may not agree with everything I’ve had to say or any of it. That’s fine. But millions of individuals and families are struggling with addiction, and we can do much better. We have to be willing to come together and let old paradigms go when new evidence shows their flaws or they no longer serve us. 

People can recover and lead full lives that were greater than anything they’ve ever dared to aspire to. Don’t buy the lie you are doomed to a chronic disease you can never heal from. Yes. There is a period when you are completing this process you need to be vigilant about relapse as you are rewiring your brain and learning new skills. But don’t let outdated ideas cause you to carry shame or hold you back from creating the life or your dreams. 

Contact us at 561-468-6464 to schedule a session today.

Boynton Beach Counseling Center
Gateway Counseling Center
1034 Gateway Blvd. #104
Boynton Beach, FL 33426
Phone: (561) 468-6464
Phone: (561) 678-0036

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