The "Disease Model"

I would have to say that I have been doing a lot of reading since school has started. I remember in college and even in nursing school that I really didn't want to read much. I don't know if I am more interested in the subject or if being sober has allowed me to have an attention span greater than a 2 year old. Either way, I am really learning a lot of things about addiction, recovery and mental health. I guess that $400 I shelled out for books is worth it after all.

I think I had posted a blog about addition being considered a disease. In some ways, I don't like that because I believe people will not take any accountability for their actions. "I am sick, so deal with it." On the other hand, when I look at diseases like diabetes type 2, in which people's behaviors can play a role in developing and managing the disease, I can see obvious parallels. There is certainly a chronic state about this disease. There are very distinct behavior problems that erupt when addiction is present. Both diabetes and addiction need constant daily monitoring and behavioral interventions to change the course of the disease.

I think I have read about 10 different articles now about addiction as a disease. I found that most researchers feel the same way I do. The research is indicating a potential genetic component. The best anyone can estimate, it plays about a 40-60% role in the development of addiction. In the AA Big Book, addiction is defined as an allergy of the body. Alcoholics don't react the same way to alcohol. We literally can't stop at one. The mind becomes obsessed. There was some literature also suggesting that the reward center of our brains is hooked up wrong. We react incorrectly or exaggeratedly so to chemicals. I agree with all of it, actually.

I do think when I entered into inpatient treatment, I was told that I had a disease. In fact, now that I think about it, I believe they compared it diabetes. Anyway, did that make any difference in my shame and anger? No, not really. I believed at some level I just lacked the willpower. It took me a long time to KNOW, I mean really ADMIT that I couldn't stop on my own. I knew I had a problem but I just thought I was never trying hard enough to quit. Then I would be in denial mode (also considered a part of the disease process) "I could stop if I wanted to but I love it. I don't want to stop."

I guess the question I am thinking about today, does it make a difference how we look at it? If I had to describe being an alcoholic, I would agree that there are some disease traits I experienced. Hiding bottles, disregarding family and friends concerns about my drinking, continuing to drink despite major consequences (i.e. divorce, loss of friend, having to frequently change jobs), doing things I would never had done had I been sober.....the list could go on for an eternity. Do I believe in the genetic component, yup. Do I believe there are environmental aspects at play? Yup. Does it make a difference in my recovery? Not really. In one of the articles I was just reading, it stated, yes you have a disease, why you have the disease doesn't matter, let's move forward and manage the disease. Asking how or why isn't going to do anyone any good. Bingo. I agree.

Calling addiction or alcoholism a disease in the 1930s was extremely profound. It made addiction less about the annoying, puking drunk standing in front of you. It was a disease, the only way to get better was to stop. In my experience as nurse, addiction has always been referenced as a disease process. I think I grew up with knowing it was a disease. But when it came to me personally? I didn't have a disease, I was a moron, a shame to myself and my family, pathetic, lacked willpower or common sense. I remember telling my intake coordinator, "I can tell you that YOU have a disease process but when it comes to me, I am just a fat, lazy stupid drunk". Harsh? Yes, but that is how I felt. We reviewed the fact that I have a disease, blah, blah. Didn't do much at the time to make me feel better.

I am wondering how other addict feel about this? Does it make any difference to you at all if you are considered a person with a disease? My first instinct was to say that I feel like it's a cop out to say I have a disease. My addict mind starts to think "Hooray! I have a disease, that's why I drunk drove and avoided seeing my friends. I have a condition! That's what I will tell everyone. It's not my fault, it's my DISEASE...." I do know at this point in my recovery, disease or not, if I don't go and try to make my wrongs right, I will have no quality of life. I would never experience a life without shame and guilt. I made horrible decisions and I hurt you. I am really sorry for MY ACTIONS, (not my disease's actions)."

Maybe it's the spiritual component that is throwing me for a loop. I doubt that my doctor would walk into the room and say, "well, you don't believe in God today. I am going to diagnose you with Atheism. Take 2 tablets of LSD twice a day until you see God." The American Society of Addiction Medicine came out earlier this spring and tried to identify this component in the disease process: a spiritual deficiency of sorts. Critics were pretty quick to jump on this. "Leave God out of" your disease model. If people need a relationship to God to get well, great, but not everyone does. So don't alienate your addicts out there by saying they are spiritually devoid as well.

Anyway, I am glad to know that this questions is every bit as complex as I perceived it to be. There are benefits to a disease model process. It explains some things. I suppose it could have helped me not feel totally insane when I couldn't stop. That is part of the disease process. But I really don't want to be absolved of my responsibility for my actions. But I have to be careful not to shame myself to death either....yup complex.

XOXOXOX