Criminal justice systems, for example, may benefit from such a distinction, which may aid the correct legal approach of addicted offenders. The World Health Organization (WHO) classifies addiction as a chronic disease that affects both brain function and behavior. It acknowledges that addiction leads to harmful and compulsive actions, indicating a medical condition rather than merely poor choices or moral failings. This perspective emphasizes that addiction is rooted in complex interactions of genetic predispositions and environmental influences.

• Whether this is true will vary depending on the drug, the consumption method, and (importantly) the ability of the agent to access the drug safely and reliably.
• Finally, we argue that progress would come from integration of these scientific perspectives and traditions.
• Evidence of generally intact decision making does not fundamentally contradict addiction as a brain disease.
• Addiction is characterized by changes in the brain’s reward system, specifically the release of dopamine.
• Uncover five simple yet impactful ways you can guide your teen to build resilience, make smart choices, and steer clear of the dangers of substance abuse.

What is the World Health Organization’s stance on addiction as a disease?

Thus, the requirement that addiction be detectable with a brain scan in order to be classified as a disease does not recognize the role of neuroimaging in the clinic. Much of the critique targeted at the conceptualization of addiction as a brain disease focuses on its original assertion that addiction is a chronic and relapsing condition. Epidemiological data are cited in support of the notion that large proportions of individuals achieve remission 27, frequently without any formal treatment 28, 29 and in some cases resuming low risk substance use 30.

What are the main arguments for and against addiction being classified as a disease versus a personal choice?

Were that the intended meaning in theories of addiction—which it is not—it would clearly be invalidated by observations of preserved sensitivity of behavior to contingencies in addiction. Indeed, substance use is influenced both by the availability of alternative reinforcers, and the state of the organism. The roots of this insight date back to 1940, when Spragg found that chimpanzees would normally choose a banana over morphine. However, when physically dependent and in sober house a state of withdrawal, their choice preference would reverse 102.

Research suggests that genetic factors can account for about 40-60% of a person’s vulnerability to addiction. It’s like some people are born with kindling in their brains, just waiting for a spark to ignite. To that extent, my claim that addiction is not a brain disease may seem to change nothing, compared to the situation that would prevail were the scientists’ claim that it is a brain disease to be accepted. Though the overlap between the two accounts is important, there are some important differences. On the basis of this kind of evidence, many researchers have come to believe that the mesolimbic system is a reward prediction system (Montague et al., 1996; Schultz et al., 1997).

Is Addiction a Disease or a Choice? Debunking Common Misconceptions

As individuals continue to use these substances, a phenomenon known as tolerance occurs. Over time, the brain’s sensitivity to dopamine diminishes, meaning that users must consume increasingly larger amounts of the substance to attain the same pleasure they initially experienced. This cycle reinforces addiction, as the individual seeks to regain those high levels of enjoyment. Engagement in treatment is also seen as vital, with calls for more accessible outpatient care rather than reliance on often expensive rehabilitation that may not be effective.

Does Alcoholics Anonymous consider addiction a disease?

Human neuroscience documents restoration of functioning after abstinence 40, 41 and reveals predictors of clinical success 42. If anything, this evidence suggests a need to increase efforts devoted to neuroscientific research on addiction recovery 40, 43. The debate over whether addiction is a disease or a choice is a complex and often polarizing topic in the realm of mental health and substance abuse. On one side, some argue that addiction is a choice, not a disease, emphasizing personal responsibility and the role of individual decision-making in initiating drug use. However, this perspective often overlooks the intricate psychological and biological factors that contribute to addiction. The opposing view, which considers drug addiction a disease, highlights how addiction can alter brain chemistry and function, suggesting that it’s not merely a matter of choice.

That act applies to the tax code, and since that time the Federal response to drug abuse has been the purview of the Treasury Department, rather than the Department of Justice. The Drug Enforcement Administration (DEA), the successor to the Bureau of Narcotics and Dangerous Drugs (BNDD), is an arm of the Treasury Department. The activities of that organization and the criminal-justice system help to establish the current situation in which societally imposed penalties are applied to those said to be suffering from a disease.

• The analogy of somebody hanging onto a cliff is often used, indicating that the individual can only hang on for so long before their strength is completely depleted and she has to let go 37.
• Thus, as originally pointed out by McLellan and colleagues, most of the criticisms of addiction as a disease could equally be applied to other medical conditions 2.
• As a scientific construct, drug addiction can be defined as a state in which an individual exhibits an inability to self-regulate consumption of a substance, although it does not have an operational definition.
• Today, I spend probably half of my time just as engaged in the health care community as I am in the criminal justice community.

At the same time, to say that substance use disorders are “all biology” is an over-simplification. Clearly, there are people on the mild end of the spectrum who have the ability to choose to stop or cut back. For these people, when the rewards of not using outweigh those of using, they stop.

It is not trivial to delineate the exact category of harmful substance use for which a label such as addiction is warranted (See Box 1). Throughout clinical medicine, diagnostic cut-offs are set by consensus, commonly based on an evolving understanding of thresholds above which people tend to benefit from available interventions. Because assessing benefits in large patient groups over time is difficult, diagnostic thresholds are always subject to debate and adjustments. It can be debated whether diagnostic thresholds “merely” capture the extreme of a single underlying population, or actually identify a subpopulation that is at some level distinct. Resolving this issue remains challenging in addiction, but once again, this is not different from other areas of medicine see e.g., 12 for type 2 diabetes. Longitudinal studies that track patient trajectories over time may have a better ability to identify subpopulations than cross-sectional assessments 13.

Symptoms of Addiction

She advocates for an understanding that takes into account cultural and social contexts, which may provide a more nuanced perspective on addiction and recovery. The WHO stresses the need https://northiowatoday.com/2025/01/27/sober-house-rules-what-you-should-know-before-moving-in/ for early intervention and comprehensive care strategies. Effective management of addiction usually requires multiple episodes of treatment, as the chronic nature of the disease often leads to relapses. They advocate for harm reduction strategies, such as the use of naloxone to reverse opioid overdoses, reinforcing the idea that proactive measures can minimize health risks and support long-term recovery. Initially, the perception of addiction was framed as a moral failing, but over the decades, it has shifted towards a medical understanding. For instance, the American Medical Association classified alcoholism as a disease in 1956 and extended this classification to addiction in 1987.