Why Addiction is a Disease, Not a Disorder

Wednesday, June 22, 2016 | By JP Emerald Coast

compulsive drug use

Despite addiction impacting more than 21 million people in the United States alone, there is still much that is not commonly known about addiction and why it is labeled as a disease. Many people struggle to see addiction as a disease, as there is still a substantial stigma surrounding those who are hooked on drugs and alcohol. Arguably the biggest misconceptions about addiction are that addicts and alcoholics want to keep using and that they chose to do so. It is extremely difficult to accept that most users do not want to nor choose to keep abusing drugs and/or alcohol, especially when addiction is directly impacting a person. That is because addiction quickly becomes personal, and seeing past emotions like anger, sadness, and frustration in an effort to understand addiction as a disease can be nearly impossible. 

The truth of the matter is, addiction is a disease. In fact, it is one of the most common diseases in the United States. Take into consideration that the top disease in the country is heart disease, which affects approximately 28 million people. Addiction is not far behind, with more than 21 million affected. 

When addiction is understood as a disease, it allows people to realize that addiction is far from a choice or a continued desire. 

Regardless of what classification of addiction you subscribe to, those who suffer from compulsive drug abuse, as well as their family members, need exposure to treatment options. If you are suffering from an addiction, alcoholism, substance abuse or substance abuse disorder, you can get better through comprehensive, quality addiction treatment.

addiction is a disease

History of Addiction Classification

In the past, one reason holding back the labeling of addiction as a disease was due to the fact that the defect in the brain where the addiction arose was never found. When specialists couldn’t actually show the physical defect in the brain, they couldn’t classify addiction as a disease, like cardiovascular disease, for instance, that clearly can be seen on x-ray and imaging studies.

Early on, immaturity, intrinsic badness and/or irresponsibility were considered to be symptoms of a person who was addicted. The argument against labeling addiction as a disease was that users made the choice to use drugs and that their inability to stop using was immature and irresponsible behavior.

Today, however, after at least a decade has passed, a lot more is known about the brain and its relationship to addiction. Now, specialists know about a physical defect associated with addiction, and where it is located.

They know that there is a hedonic system (pleasure system) deep in the brain area that also handles basic survival. This defect causes the person addicted to unconsciously think of the drug being life itself.

For example, heroin is not just heroin. The user needs heroin in order to deal with life, and they actually crave it when it is unavailable. While the user can make a choice as to whether or not to use heroin, they don’t have a choice as to whether or not they crave heroin. While no one chooses to have a drug addiction problem or heart disease, they may choose behaviors that lead to these diseases.

For this reason, addiction is now widely viewed as a chronic, complex brain disease that causes compulsive drug-seeking behavior, despite the harmful — and sometimes fatal — consequences to the addicted person.


The terms “disease” and “disorder” are many times interchanged with one another, however, they mean two very different things. Each is defined in the following ways:

Disease: A disorder of structure or function in a human, animal, or plant, especially one that produces specific signs or symptoms or that affects a specific location

Disorder: A physical or mental condition that is not normal or healthy

Diseases arise from physical structural changes of functional parts within the body. For example, someone with heart disease experiences physical changes in their heart and/or cardiovascular system that compromise its regular function, such as narrowed blood vessels and changes in the tissue around the heart. Those changes are reflected in symptoms, such as shortness of breath and chest pain, to name a few. When someone has developed an addiction to drugs or alcohol, his or her brain has experienced structural changes that do nothing but increase one’s desire to keep using. 

How Substance Abuse Alters the Brain

Drugs are chemicals that alter your brain’s communication system, leading to a disruption in how your nerve cells typically receive, send and process information.

The drugs can do this in two main ways:

  1. They overstimulate your brain’s reward circuit.
  2. They imitate your brain’s natural chemical messengers.

There are many parts inside your brain that work together, and these parts coordinate and perform specific functions. The important areas of the brain can be altered by drugs, which can be problematic since they are vital for life-sustaining functions and can accelerate addiction or compulsive drug abuse.

Prefrontal cortex

The prefrontal cortex is located at the front of the brain and is responsible for things like planning, thinking, problem-solving, decision making, and self-control. Being addicted to drugs and/or alcohol causes damage to this part of the brain, compromising one’s ability to make decisions, maintain self-control, and think clearly, to name a few. Since the prefrontal cortex is the last part of the brain to fully develop, teenagers and young adults are at risk for stunting the development of this area of the brain if they abuse drugs and/or alcohol prior to full development. 

Basal ganglia

Procedural learning, voluntary motor movements, motivation, cognition, and emotion are all connected to the basal ganglia in the brain. This part of the brain is often referred to as the brain’s “reward circuit”. The regular abuse of drugs and/or alcohol triggers this area of the brain to the point where the brain struggles to produce feelings of reward or other functions without the presence of the addictive substance. 

Extended amygdala

Emotions like stress, irritability, and anxiety come from the extended amygdala. When drugs and/or alcohol are abused, this part of the brain becomes highly sensitive and users continue to use in an effort to fight the over-development of these upsetting emotions.

Brain stem

The brain stem is connected to more physical functions, such as breathing, heart rate, and sleeping. Abusing drugs and/or alcohol compromises the brain stem’s function, which in turn comprises the parts of the body it is responsible for controlling.

Other components of the brain, such as dopamine and serotonin, are also altered by addiction. For example, someone who is addicted to meth can deplete his or her brain’s ability to produce dopamine and serotonin on its own, meaning that when they stop using, they struggle to feel happy or content on their own. This is a long-term effect that can stand a lifetime. 

When a person stops abusing drugs and/or alcohol, his or her brain can restore itself to an extent, and that extent depends on factors such as how much was being abused, what type of substance was being used, and how long was use occurring for. Long-term heavy drinkers, for instance, often experience a depletion of white matter in their brains, which is designed to help the brain connect nerve impulses in the brain. Without healthy, functioning white matter in the brain, people can experience difficulty with balance, depression, and doing more than one thing at a time, such as walking and talking. 

When all is said and done, a disease can only be classified as a disease if it alters areas within the body like the brain. A disorder, such as generalized anxiety, does not produce those effects. Instead, a disorder is characterized by:

  • Persistent, relapsing, remitting, or single-episode symptoms
  • Causing significant distress
  • Impairing one’s ability to function in one or more ways
  • Increasing risk of death, pain, or disability
  • Dysfunction in cognition, emotional regulation, or behavior

While a disorder might not cause structural changes to one’s brain or other areas of his or her body, it often develops because of a pre-existing imbalance of poor functioning of something in one’s brain. Disorders can also develop in response to an experience, such as posttraumatic stress disorder or an anxiety disorder. For example, an event like trauma can change the way in which the brain functions, aiding in the development of a disorder. While disorders are often results of psychological complications, diseases tend to be more physical in nature. 

contributing factors of addiction


It can be difficult to understand why some people become addicted to drugs and/or alcohol while others don’t. One person might be able to drink responsibly while another simply cannot control how much he or she consumes. Most of the explanation as to why this is is rooted in the two main risk factors of addiction: genetics and environment.


The saying “addiction is a family disease” has more than one meaning, as genetics play a major role in one’s propensity to develop an addiction to mind-altering substances. Certain genetic characteristics, such as novelty-seeking behavior and impulsivity, can increase one’s odds of experimenting with drugs and/or alcohol or making quick, poorly thought out decisions like experimenting or using too much at one given time. These qualities can be hereditary, as can mental health conditions. There is a strong genetic link between mental illness and addiction, as people who inherit mental illnesses from other family members are more likely to turn to the use of drugs and/or alcohol to cope with symptoms.


One’s environment can shape the way he or she feels, functions, and makes decisions. Some of the biggest environmental factors that lend themselves to the development of addiction include:

  • Violence in the home or the community
  • Sexual, physical, mental, or emotional abuse
  • Neglect and abandonment
  • Substance abuse in the home
  • Financial struggles

When environmental issues like these occur, especially at a young age, a person can struggle to develop positive self-esteem, self-worth, confidence, security, and happiness. It can be easy to turn to the use of drugs and/or alcohol to help drown out those issues or to help boost self-esteem and happiness — even if just for a temporary period of time. If the environmental issues one experiences do not get resolved, he or she can continue to abuse drugs and/or alcohol to the point where his or her brain begins to change, introducing the disease portion of this problem. 

Other Factors

There are other factors that weigh-in on addiction as well, and these include:

  • A reward circuit function biological deficit, such that you prefer and seek behaviors and drugs that enhance your reward function.
  • Repeated addictive behaviors and drug use that causes neuroadaptation in your motivation circuitry, which leads to a lack of control over engaging in addictive behaviors — like drug abuse.
  • Affective and cognitive distortions that compromise your ability to deal with your emotions and impair your perceptions, which leads to substantial self-deception.
  • Issues in interpersonal relationships and lack of healthy social support that impacts your resiliency or development.
  • Distortion in purpose, meaning, and values that guide your thinking, attitude, and behavior.
  • Distortion in how you connect with yourself, others and the higher power.
  • If you have a co-occurring psychiatric disorder.

What About Obsessive Compulsive Disorder and Addiction?

Over 25 percent of people who look for OCD treatment end up meeting the criteria for substance use disorder, according to the Journal of Anxiety Disorders. If you experience OCD symptoms during your adolescence or childhood for the first time, it’s possible you’ll develop a drug issue typically to cope with overwhelming fear and anxiety. Trying to treat an addictive disorder before the emotional OCD symptoms are addressed often proves ineffective.

It can be tiring having to cope with OCD obsessions. When you self-medicate with drugs, though, you are only giving yourself a short relief. However, because of this, it’s extremely tempting to repeat the use of drugs as your urges or unwanted thoughts arise. Your addiction to drugs can form with enough abuse and time.

OCD, Addiction and Social Isolation

When OCD leads to social isolation, it can also lead you to abuse drugs and become addicted. If you suffer from OCD, you might realize that your compulsions and obsessions do not make any logical sense. You might feel shame for acting or thinking the way you do.

Obsessive-compulsive disorder, like being addicted to drugs, can leave you feeling isolated from the world outside. You might avoid social settings and important people to keep your compulsions and obsessions private. This loneliness, shame and physical isolation can easily lead to you abusing drugs.

Treating both these disorders together (dual-diagnosis) is the key to beating OCD and co-occurring addiction effectively. Cognitive Behavioral Therapy (CBT) is the gold standard for treating OCD, with or without a substance abuse addiction. Keep in mind that your addiction is indeed a chronic illness. You can have your OCD symptoms treated with medication, but continued therapy will be required to overcome your addiction and keep you from relapsing.


Addiction is a fatal disease if it is left untreated, which is why it is so important to obtain the right professional care to stop this dangerous, insidious cycle. Treatment for this particular disease includes a combination of detoxification, therapy, and aftercare services.


Detox is the first step in the addiction treatment process, as it is designed to clear the system of drugs and alcohol entirely. At this time, a person is not using at all and is receiving around-the-clock care from a team of medical and psychiatric professionals. Detoxing at a treatment center is advised for many reasons, specifically because detox can be fatal (in some cases) and withdrawal symptoms can be overwhelming to the point where a person just goes back to using. Depending on the needs of the patient, medications may be prescribed to help curb withdrawal symptoms and cravings.

Treatment and Therapy

Once the patient has detoxed, he or she can dive into therapy. The majority of his or her treatment will be completed in therapy, where he or she can address the underlying causes of his or her substance abuse, as well as the issues that have developed in response to the addiction. Common therapies participated in at this time include the following:

  • Individual therapy
  • Group therapy
  • Cognitive behavioral therapy
  • Dialectical behavioral therapy
  • Experiential therapy
  • Motivational interviewing

The length of time that one remains in therapy will depend on his or her needs. For some, therapy can last a few weeks, while for others, therapy can last a few months. 


When a program has been completed, patients will benefit from the aftercare services that are usually provided at the time of their departure. This includes recommendations such as where to continue therapy on an individual basis, what meetings to attend, and how to maintain a sober lifestyle. Treatment programs also typically encourage patients to remain connected to the center and its alumni services as a source of support. 


If you are struggling with addiction or know someone who is, reach out to JourneyPure right now. You do not need to continue to abuse drugs or alcohol just because you are seemingly trapped in a continuous cycle of abuse. By calling us right now, you can find out more about how we can help you immediately. 

So, do not wait. Call us today. We can help.

Learn About

What Makes Emerald Coast Different