Addiction is either a brain Disease or a Moral Failing. Or is it?

addiction: brain Disease or a moral failing

If you’re reading this, you’ve probably been touched by addiction and pondered whether it’s a disease or not. Some believe it is. Others think it’s a matter of self-discipline. Philip Seymour Hoffman’s abrupt death rocked the foundation of the addiction community when he overdosed. His death by addiction underscored that relapse can happen to the brightest of us, and at any point of recovery. The fact PSH had every reason not to use drugs reinforces my belief that addiction is a brain disease, not a moral failing.

what’s your history with addiction?

Maybe you lived with an alcoholic parent growing up. Perhaps your brother is a wake-and-bake weed smoker. You recall your binge-drinking bunkmate having black-outs which you all shrugged off as another crazy night in college. There’s a friend of yours who always seems to get a little too drunk a little too frequently. The co-worker who is constantly chiding the crew to go to happy hour that lasts all night.

i’ve studied addiction, and I’m still confused

I’ve lived with individuals addicted to alcohol for the majority of my life. I believe I’ve dealt with the chaos of addiction in as many ways possible over the years. I have ignored, obsessed about, and denied it. I’ve experimented getting really fucking mad, becoming resolute, and sympathizing with it. Over the years I’ve also hidden, empathized with, tried to help, and broadcast it. I went through phases of bargaining, acceptance, and repudiation. I’ve given ultimatums, cried amidst the disruption, and literally divorced myself from addiction.

I’ve devoted a lot of energy to studying the brain disease or a moral failing dilemma over the course of my life. One aspect I haven’t mastered is understanding it. Not fully, anyway. Despite first-hand observation, researching and reading about addiction for years, addiction still befuddles me. One nagging concept impeding that understanding may be shame. Of one thing I’m certain: shame sucks ass.

“Using drugs or not isn’t about willpower or character. Most problematic drug use is related to stress, trauma, genetic predisposition, mild or serious mental illness, use at an early age or some combination thereof.”

-David Sheff, Author of clean

enough already

Quoting David Sheff: “Most drug use is about coping with life, not about the drugs.” Do you think at the end of a harrowing day at the office or wrangling children that you deserve a drink to relax? That’s about dealing with stress. It’s not about how much you love the taste of wine.

Being in the throes of dealing with the chaos an addict creates, it’s hard to see the disease clearly. Anger and disappointment may cloud your understandably warped lens. Addiction is unlike any other disease. You would never consider screaming at a cancer patient for not responding well to chemotherapy. Moreover, you wouldn’t think, “If they just stopped stressing about having cancer then it might stop growing inside. Just will your cells to respond and have a positive attitude!” Regardless, those with addictions are kicked out of rehabilitation programs every day for succumbing to their disease. Tough love doesn’t treat drug relapse any more than it’ll treat cancer.

please don’t misunderstand me

I’m not advocating that anyone stay with an Addict regardless. Thinking of addiction as a disease without choice is not mutually exclusive to living with an Addict no matter what because they are ill. What I am advocating is that we don’t associate addiction with weak moral character. It’s not shameful, or at least it shouldn’t be. Trying to shame addicts won’t help them stop using. Rather, it will give them another reason to use. Addiction is confusing and complex. An Addict can be a complete asshole and you would be justified to distance yourself from the asshole.

We still haven’t discovered a program that overwhelmingly helps Addicts. Relapse is rampant. With addiction, the questions are different than with other diseases: “Why can’t [the addict] see what they are doing to those around them?” “Why are they choosing vodka over me?” “How could they be so damn selfish?” It takes a lot to convince the loved-ones suffering along with the Addict that the Addict isn’t choosing drugs over them. A Father would never choose drugs over watching his children grow up. That’s absurd. Yet it happens every day when Addicts feed their addiction. They isolate so they can continue using.

“When an addict takes drugs, it appears to be a choice. One of the reasons people reject the idea that addiction is a disease is the mistaken belief that people don’t cause or contribute to ‘real’ disease. But they do. Eating fried chicken contributes to heart disease progression. Smoking leads to lung cancer. The stop system isn’t working in those who are addicted, which is why they don’t consider consequences while they are taking drugs.”

-David Sheff, author of Clean

does it matter if addiction is a brain disease or moral failing?

I think it does. Addiction makes more sense to me when I liken it to obsessions with food. Laziness and/or poor character does not singularly explain obesity. The same holds true for anorexics and bulimics. Vanity doesn’t make them starve themselves. Mental illness does. All these people are dealing with life through indirect means. There is something about their heredity, environment and/or genetic make-up that pre-disposes these individuals to not be able to hit the “off” button in their consciousness. They have to be taught how to manage manually what those of us with different physiologies do inherently. To be rational and stop doing that which makes us sick.

Who is the addict in your life? What are you doing to cope with him or her?

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  1. agwinam

    Thanks Jen, the addict in my life, or at least the most important one, is my brother. I have grown exhausted with trying to help him, you and others have coached me and I have coached and supported him. I can’t fix him and sometimes I think he’s seeking new lows just to push away the people who love him. There is no doubt in my mind that my brilliant and motivated brother has a physical condition that keeps him from dealing with life in healthy ways. Just wish I knew how to help him. Lately my attitude can be summed up like that song that says “say something, I’m giving up on you.”

  2. Ann

    I couldn’t agree with you more.
    Jen, thank you. Your brave words make it easier for others to share their experiences.

    Sadly, addiction, like all mental illness, still faces it’s biggest challenge: denial.

    Who wants to admit they’re living with depression or bipolar disorder or anxiety?? Everything I’ve read about addiction points to the drinking and drug use as symptomatic behavior of the underlying “problem.”

    That problem is about as easy to understand as tax code for those who just don’t get math.

    I have lived with depression for nearly two decades. To be truthful though, that’s when it was first diagnosed as “situational depression,” but there were episodes long before then. It wasn’t until a relative of mine and I were talking about depression that we realized mental illness could be traced back several generations in our family. No one talked about it.
    It was a family secret that became disguised as alcoholism or dramatic personalities.

    It was and has always been a very difficult thing for me to admit that I have major depression. There are many reasons, but it really comes down to a fear of judgement from people who are either unkind or just don’t know the facts about mental illness.

    There’s also a lot of judgement about addiction. I try not to judge, but I will admit there was a time I was really, really angry at the addict I lived with. Now I think I understand what it means to “hate the disease, but love the person.”

    Sadly, my marriage didn’t make it and our children and many others were affected by that loss. For years I tried to assign blame for that failure. The truth is nobody is to blame. It’s a waste of time and energy to blame the addict or the person who is depressed (bipolar, schizophrenic, anxious or whatever) when really we should try to put our energy into finding better treatment options or having an open dialogue on what plagues so many of our families.

    There is hope.

    There are many more treatment options now than ever before. There are more people living with mental illness. And there is power in numbers.

    In my experience, the first step is acknowledging, changing behaviors and realizing that this is most likely a disease you’ll be living with for the remainder of your life.

    Too often, it takes many years of suffering; going on and off Meds, continuing to stay in unhealthy relationships and struggling to survive before finally accepting this is not going to go away like a cold. And it’s something you have to actively treat through whatever healthy (and legal) means work for you.

    Maybe it’s not something for us to understand Jen, but rather to accept.

    Acceptance may one day lead to a more compassionate world. Maybe then we’ll be able to work towards a cure.

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