Fellow Odyssey contributor Brianna Lyman graced social media platforms with her opinion piece about those suffering from Substance Use Disorders. In order to understand my reaction to Lyman’s opinions, check out her article, “Stop Calling Your Drug Addiction A Disease”.

Now, I have no problem with someone practicing their right to share their personal opinions. Brianna, you have every right to disagree with the perspective that drug addiction is not a disease, and even to view addiction as a choice. I actually understand how one could side with that argument. I’m not going to pick apart your article word-for-word because my problem is not with your differing opinion or even you as a person.

I was interested in hearing you out and learning some counterarguments to the popular concept that addiction is a disease. However, your lack of research on the matter and your tone throughout this article just backs up my idea that ignorance surrounding Substance Use Disorders is still a major issue within our society.

Illnesses come in unlimited varieties because each person is different, each body reacts to disease in a unique way and modern science continues to improve at an insanely rapid rate. In fact, Brianna, you bring up a great point that the majority of the disease-inflicted populations do not usually choose to be sick. But, this is not a competition and matters of a human being’s health aren’t simple enough to make comparisons between cancer and drug addiction.

I will point out the Models of Addiction; the first of which follows the apparent tone of Lyman’s article.

The Moral Model of addiction does not consider biology or genetics when looking at a cause for addiction. The Moral Model focuses on the idea that addiction is a “human weakness” and that the substance users lack willpower and a “defect in character”. This theory for addiction is essentially the model that supports the “choice” perspective of drug use. However, this is the least popular Model of Addiction because it perpetuates the stigma attached to drug dependence, causing little-to-no chance of recovery and favors punishing users over rehabilitating them. Also, please consider the countless strong-willed people in the world, who also have battled addiction and the fact that this theory originated amongst religious advisors who didn’t conduct actual studies to support their argument.

The Disease Model (or Medical Model) of addiction supports the theory that substances chemically alter physiological aspects of the brain and the body. Lyman argues, “That child in the cancer ward didn’t choose to do something that brought on their cancer…” In no way am I downplaying the seriousness of cancer, especially cancer in children, but scientifically speaking, ongoing chemical use does change the brain chemistry of the user. This results in a shift from recreational use to compulsive use because your brain is searching for that rush of excess dopamine and your body becomes dependent on the effects of your high. At some point in the addiction, the user continues the behavior mainly to stop the physical effects of withdrawal.

In the brain, we look at the orbitofrontal cortex to study addiction. This region of the brain controls compulsive behaviors, which offers some explanation to the overwhelming drug seeking that many seasoned addicts exhibit. Also, Lyman points out the very-accurate fact that addicts of all types (not just those searching for a drug or alcohol-infused high) are feeling the pleasurable effects of dopamine, a neurotransmitter involved in the reward system of our brains.

The point in which reward seeking becomes dangerous and unhealthy is when you are incessantly searching for that rush of feel-good chemicals to your brain. The Medical/Disease Model of addiction describes the drug addiction as a symptom, not the actual disease.

As was the case for the Moral Model of addiction, there are some issues with the Disease Model. Lyman’s main complaint against drug addicts appears to be the fact that this theory gives substance users a free pass for their behaviors. Maybe this idea contributes to the number of addicts who refuse to seek treatment because they think, “What’s the point, if it isn’t my fault?” And, yeah, on some level, I agree with the fear that some may use this concept as an excuse, but I have met more addicts who have taken full responsibility for their actions in so many more ways than any addicts who use the Disease Model as an argument for drug abuse.

The Bio-Psycho-Social Model (or Learning Model) of addiction is probably the best explanation to chemical dependency. This concept is one of the most studied, especially now that we understand that addiction is much more complex than choice versus disease.

This model takes into account the many threads of the addiction web and looks at environmental factors along with physiological explanations. The Moral Model and Disease Model of addiction do not even look at the individual’s background, life experiences, genetics and what kind of environment they were brought up in.

The Learning Model takes into account that we learn from those around us what an acceptable way to behave would be. If you come from a dysfunctional household, then you begin to learn that dysfunction is normal behavior. We are naturally expected to learn how to self-soothe in healthy ways, but self-soothing can be mistaken for self-harming by some people. Some experiences completely alter how you perceive reality and wanting to find an escape from that reality may lead to addiction.

Genetics has also been believed to play a role in addiction due to the possibility that certain neurotransmitters may be passed from parent to offspring. Doctors also believe that mental illnesses can be genetic, causing children to inherit their parents’ similar chemical imbalances within the brain. An example would be depression, considering many suffering from depression tend to turn to self-medicating to feel better.

Not one of these models will completely solve the endless questions we may have to addiction, but they can certainly put into perspective just how difficult treating the underlying causes of addiction are.

And, to you Brianna Lyman, please try to take a step back and look at drug addiction from a different perspective. Assuming all addicts chose to become dependent is just really ignorant and absolutely false. Most addicts I have worked with have expressed wanting so badly to stop using and rebuild their life, sober. I have seen people in groups you would never have imagined to have a Substance Use Disorder. I have seen such a wide range of people share their personal journeys of recovery and where it all began. I have seen genuine pain and anger turn into learning experiences and motivation to recover.

And yes, Brianna, I have seen some addicts make terrible decisions and face the consequences.

But one thing I haven’t seen: any person in recovery say they were so glad to make the choice to experiment with drugs and alcohol. Clients have never mentioned how proud they are of themselves for losing their job/family over their addiction.

Whether you believe this is a choice or not, stop comparing other illnesses to addiction and then downplaying the seriousness of chemical dependency. Cancer patients die and that is heartbreaking, but please try to look at a parent, child, sibling, spouse or close friend who have ever lost a loved one to addiction and tell them that life didn’t matter based on the assumption that all addicts chose a life of physical, mental and emotional pain.

*and just by seeing some addicts act a certain way doesn't mean all addicts*

If anyone would like to read more about how modern medicine is tackling addiction, please see one of my previous articles, Let's Learn How To Be Human Again, to learn about a guy who tickles rats to study how to treat addiction.