Disease Model of Addiction

The disease model proposes that addiction involves an abnormality of structure or function in the central nervous system that results in impairment (West & Brown, 2013).

Proponents of the Disease Model

The disease model proposes addictive behaviours stem from; biological, neurological, genetic, and environmental aetiologies.

Common Assumptions

The common core assumptions of the disease model include:

• Addiction is a discrete diagnosable medical condition with characteristic symptoms, among which tolerance and withdrawal are fundamental.
• Loss of control is the defining observable pathology.
• Addiction is chronic, progressive, incurable and irreversible (but can be controlled by lifetime abstinence).
• Addiction requires specialised medical treatment.

Influence on Policy

Since being endorsed by the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in the 1990s, the disease model has had significant influence on drug policy, addiction treatment and research (NIDA and NIAAA fund approximately 90 percent of addiction research worldwide).

Variations of the Disease Model

Variations of the disease model include exposure and susceptibility.

Exposure Model

This model holds that the disease is acquired as a result of prolonged and excessive exposure. Also referred to as the “brain injury” position, this is based on the belief that the disease occurs as a result of damage to the brain caused by excessive and/or prolonged alcohol or other drug use.

Susceptibility Model

Do genetics play a role in addiction? This model holds that people have the disease, or, are in some way vulnerable or susceptible, before they are ever exposed. The major emphasis here is that some people are born with a predisposition due to heredity, though some argue that the predisposition could also result from some form of early childhood experience.

However, there is no scientific evidence to support the key concept of the disease model, this is supported by the following quote;

‘The ability of many addicts (sic) to decide to quit and to be responsive to contingencies generally is an inconvenient fact for those who wish to conceptualise addiction as purely a brain disease. People do not stop being diabetics (sic), for example, simply by deciding that their pancreas should produce more insulin nor does cancer abate because people have good reason to be free of this terrible disease’ (Morse, 2006, p. 169).

References

Morse, S.J., (2006). Addiction, genetics and criminal responsibility. Law & Contemporary Problems, 69(1/2), 165-207.