Addiction is not a Disease. It's an Injury.
A Reflection, and a Theory
In the midst of a never-settled debate about whether addiction is a disease, I stumbled onto a theory of my own. It occurred during therapy, where it was well-received by my mentor. My friend, an ER doctor, is ambivalent about it. Two other people have given me friendly push-back.
I find the idea useful, if not promising, and I would like to share it here:
Addiction is not a disease. It is a (brain) injury.
The disease model has always been problematic. Addiction does not behave like diabetes, cancer, or tuberculosis.
Mitch Hedberg Seemed to Be Aware of the Issue
It does, however, behave like an injury in several ways1. What addiction basically is is a re-wiring of the brain due to a behavior or consumption of a substance. If the individual is predisposed to be hijacked (which comes in the form of a hybrid between genetics and environment, nature and nurture) the new jostling of chemicals such as dopamine teach the brain that this new substance or behavior are *exactly what it’s looking for*.
I consider this rewiring to be a brain injury. Like an injury in sports, the behavior led to a muscle being seriously damaged, and continuing to play the sport without healing that harm will aggravate it and cause further decay. In this case, however, there’s no real way to ultimately heal the injury. It will effectively always be there. Refraining from the behavior for long enough will allow the organ to more or less function properly in daily use, but a return to the behavior will tear the tissue and cause the hurt to flare up insufferably — and worse than it’s ever been before.
I’m certain there is a fair amount of quibbling which could go into the analysis, and I welcome your comments! That said, I consider myself to be in retirement from the drinking game and, honestly, there’s a lot I can do in my old age which is frankly more interesting and, in significant ways, more pleasurable.
It’s been great writing for all of you. I know that this is a short post. I’m one day away from completing a copy-writing course which is bringing me a lot of hope and pleasure. Because of this (and with all of the other social media work I’m doing — including on LinkedIn), I’m just the teensiest little bit taxed.
Thanks for everything, and enjoy the United States’ birthday this weekend!
Amiably,
Aaron
One could just as easily call it a “disorder” but, for the purposes of continuity, I’m eschewing this avenue in this piece.