Addiction is a brain disease.  The early symptoms of the disease are behaviors (Physical symptoms can accompany the disease, but not always at the beginning).  That can make it tough to diagnose.  Even worse, it can make it hard to treat.  

Early on in my journey I asked a friend (A different friend then before), if people are using drugs to self medicate, why are we treating addiction when it’s really something else?

My wonderful, thoughtful friend said:

“There they go again, not calling it a disease…”

The disease of addiction has a long and difficult history and even today we don’t not fully understand it.  Along the way our understanding evolved and got mixed in with other diagnoses and diseases to muddle up things.  Some examples:

• 65% of Addicts have co-occurring disorders that lead to their current addiction
• All addicts have trauma in their past that causes them to use drugs

In other words addiction not a disease brought on by exposure chemical substance, rather it is a symptom of other underlying diseases and if you address those, then the addiction symptom will subside.  While there may be other co-occurring disorders and diseases someone with the disease of addiction may have, they still need to treat, get counselling and support for their disease of addiction. Without addressing their disease of addiction, they may address their co-occurring problem, and then have their disease of addiction relapse.  Worse, this relapse could undo the work and healing of the co-occurring problem.

Beyond misunderstanding the disease itself, addiction is a disease that affects the brain.  That can make it hard to diagnose, hard to understand and difficult to help.  

Diseases of the brain are challenging for our society which values freedom and individual rights.  If someone wants to live a certain way, who are we to impress our values and perceptions on that individual? Without direct knowledge of their improper use of chemical substances, it can be hard to determine eclectic behaviors from addictive behaviors.  Not all of the symptoms point directly to a disease or even to the disease of addiction. Where to draw that line is difficult for a layman and sometimes even challenging for a professional.  

People affected by the disease of addiction sometimes do things that defy logic or common sense (That’s what made us start wondering, Right?).  They may neglect themselves and those around them.  They may make poor decisions that cause hardship for themselves and their loves ones.  With these behaviors, it is difficult to understand why someone, in a position of responsibility, surrounded by loved ones, would cause harm and hardship to themselves and the ones they love.  Judgement, blame, hurt and guilt quickly follow clouding our ability to rationally perceive the underlying cause of the behaviors and thus diagnose the disease of addiction.

Even if the diagnosis is straightforward, with direct knowledge of substance use and a strong indication of the disease of addiction, understanding can be very difficult for the person with the disease and the people trying to help them.  As you can read in “Why is Addiction so Misunderstood?” and the rest of this blog, people in active addiction have difficulty making choices.  While their disease is active, all of their choices center around their disease and finding that stimulus their brain craves.  As you can read in “How addiction affects the brain” in a person in active addiction, the primal “Need” centers of the brain are running the show and telling the reasoning part of the brain: “Do whatever it takes to get me more stimulus!”.  This includes having your own brain lie to you.  Therefore, a person in active addiction, can reason away all proof and even just choose to not believe (See they can’t make a choice!).  

Meanwhile, loved ones, friends and coworkers are confused by the behavior of someone who should know better, frustrated by the lack of understand of their circumstances and befuddled with the resourcefulness of person with the disease to deny, delay and obstruct the attempts to help them.

This is important to understand, because legally, it can be hard to help someone who doesn’t want help.  In the eyes of our judicial system, you can’t make anyone who is not a minor do anything they don’t want to.  There are exceptions to this, someone is convicted of a crime, someone who is a danger to themselves (Casey’s Law).  Without those exceptions, we are limited to convincing, cajoling, intervening, tricking and many other methods, to get someone to go to treatment.  Don’t be discouraged, these methods work.  There is professional help and it can work too.  

Most importantly, if you want to help a loved one, friend or coworker active with the disease of addiction, see the page “Getting Help” and remember, what St Paul said:

4 Love is patient, love is kind. It does not envy, it does not boast, it is not proud. 5 It does not dishonor others, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. 6 Love does not delight in evil but rejoices with the truth. 7 It always protects, always trusts, always hopes, always perseveres.

1 Corinthians 13:4-7 New International Version (NIV)