Pleasure Unwoven I: Is Addiction a Disease?

https://www.youtube.com/playlist?list=PLA8F89537FD4C3FD1

The most important question is whether addiction is a disease.

The Choice Argument: All behaviors are choices and addicts (including alcoholics, pot-heads, etc.) can quit if they really want to if they are motivated to make the right choice. A strong enough threat will change behavior. There is a distinction between behavior and symptoms. People have perfect free will.

But neuroscience reveals the fatal flaws in the choice argument. The capacity for choice, it turns out, is far more Addiction is a disease of choice, of the very parts of the brain we need to make decisions.

The Disease Argument: the behavior of addicts can be frustrating but that doesn’t necessarily mean that there is something unchanging which is constitutes a moral failing or a personality disorder. There is a long history in medicine of making the mistake of assuming these immutable flaws. Bad acts do not necessarily imply a bad actor. It is a question of causality: what is the ultimate cause of the bad behavior?

The modern model for disease (any disease) started 100 years ago with microbiologists such as Louis Pasteur and posits three things which must be present for something to fit the definition of a disease:

1. An organ

2. A physical/cellular defect with that organ

3. Signs and symptoms

Before the disease model, medicine was focused on treating symptoms and not underlying causes. The Disease Model doubled the human lifespan within 100 years. With addiction, the organ is the brain. The question is what are the brain defects involved if addiction is a disease. From the perspective of the Choice Argument the symptoms of addiction just look like badness. See the next post for the answer…