Addiction Isn’t A Brain Disease, Congress
Sally Satel and Scott Lilienfeld wrote an op-ed in Slate about Sen. Joe Biden’s bill — the “Recognizing Addiction as a Disease Act of 2007. They argue:
Characterizing addiction as a brain disease misappropriates language more properly used to describe conditions such as multiple sclerosis or schizophrenia—afflictions that are neither brought on by sufferers themselves nor modifiable by their desire to be well. Also, the brain disease rhetoric is fatalistic, implying that users can never fully free themselves of their drug or alcohol problems. Finally, and most important, it threatens to obscure the vast role personal agency plays in perpetuating the cycle of use and relapse to drugs and alcohol.
I don’t think it’s false to say that personal agency is at the heart of whether or not someone gets treatment and stays on course, but that doesn’t mean alcoholism and addiction aren’t diseases. There is personal agency involved in getting treatment for most mental health issues. Plus, if you count a “brain disease” to be a physical condition, like a chemical imbalance, than addiction would definitely fit in the category (the desire to have another drink, take another pill, etc, comes from that chemical imbalance.)
Where do you guys weigh in on this?
Addiciton Isn’t A Brain Disease, Congress
-AK
liz | 5:22 PM | Uncategorized
I think this is just another attempt to “moralize” the conception of addiction… for some reason, even though tons of “physical illnesses” such as heart disease, stroke, diabetes, and cancer, involve decisions of the sufferers themselves, and becoming well from any chronic illness involves tremendous personal agency of the sufferer, people cling to the idea that addictions are “different”. People like to think that addicts have “made bad choices”, that they could “stop if they wanted to, if they tried hard enough”, and that it won’t happen to you if you mind your P’s and Q’s”. Personally I’m tired of this attitude. People make all kinds of “bad choices” about their health, why do we demonize the people whose choices involve substance use? Also, it is unfair to say that addictions are not brain diseases – substance use DOES cause brain change and it DOES create addiction where there originally was none, and these brain changes make addictions phenomenally difficult to combat. But, in American politics, it will always be easy and popular to say that addictions (and mental illnesses in general) are “different” from “proper medical illnesses that have no moral connotations”.
~Adam
Sally Satel is a female E. Fuller Torrey. She is wrong about everything. However, not all users of drugs are addicts. I think the disease model has some pitfalls but then I also think what she says about schizophrenia is dead wrong, and I would imagine if I knew more about it and checked with folks diagnosed with MS, I’d disagree with her about that too.
Hi Liz. Well, there was a time when, not getting much into drugs or alcohol myself, I thought this was slander of those of us with mental illness – to say addicts had mental illness. The thing is, mental illness has now come to mean mentally retarded/challenged, addicts, sociopaths, psychopaths, sexual deviants, the socially inept, posttraumatic stress, psychotics, people with rage issues, etc., etc. I mean, really, in the end, I think the DSM is going to include everyone who isn’t perfect.
Sometimes I think of psychiatrists as the modern-age priests, and because they have such a thorough list of questions that includes the entire inner and outer being, it is only psych patients who tell all and eventually get a diagnosis. I mean, if EVERYONE told all, we’d find some dirt on everyone. I mean, just maybe the whole world is nuts according to the DSM.
But that’s not to dismiss the reality of mental illness. If only you could take a peek into my head. LOL!
Take care. Thanks for posting this info.
A good number of physical illnesses (stroke, diabetes mellitus, heart disease, etc.), are often caused by poor lifestyle choices – yet we still consider them diseases.
A good number of physical illnesses (stroke, diabetes mellitus, heart disease, etc.), are often caused by poor lifestyle choices – yet we still consider them diseases.
Oops, Adam already beat me to it and a lot more eloquently I might add.
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