Recent Study Shows Pitfalls of The Disease Model of Addiction

A girl addict feels upset.

Over the last 50 years, the way we look at addiction has evolved. Then, as in earlier times, it was seen as a moral failing or weakness. Individuals who found themselves addicted felt they had nowhere to turn for help, and the social stigma of addiction created barriers to those desperately trying to find recovery.

Along the way, we took a well-intentioned but no less wrong turn and labeled addiction as a disease. The hope was that by calling addiction a disease it would become accepted by the public and with the stigma lessened, more individuals would seek treatment. It was a noble idea but in hindsight, it has utterly failed to prevent wave after wave of various “epidemics.” From the crack epidemic that spawned the war on drugs in the ’80s to the meth wave of the late ’90s, it can start to appear as though the label of “disease” has given many people an excuse to escalate their drug use instead of encouraging them to seek treatment.

Don’t get me wrong, there is certainly a medical component to addiction. The body develops tolerance to the drug and more must be used to achieve the same effect. As the dosage increases, the cravings produced as the body grows dependant on the substance can be incredibly intense. At this point, it’s nearly impossible for an addict to stop using on their own.

It’s this progressive nature of addiction that some would say qualifies addiction as a “disease”, and if we look at the end result, it often appears as though the addict had no choice in the matter, and just like diabetes, we label addiction as a disease. However, at earlier stages addiction is more behavioral, it’s a learned response to stress in the environment. It begins as a choice, and it’s this choice that represents the greatest dilemma when treating addiction. If addiction is truly a disease and addicts are all simply victims, then what motivation do they have to stop using?

Look at it this way: If your doctor told you that you had a chronic illness, a disease that you were going to have for the rest of your life, how optimistic would you feel about trying to treat it?

When We Label Addiction a Disease, Addicts Give Up Hope

Hopeless husband is drinking in front of his family.

In my ongoing research into the field of addiction, I came across an eye-opening report published by North Carolina State University. The story talked about medical research recently published by a team of researchers at that university. The research sought to determine how an addict’s overall understanding of addiction played into nis or her feelings towards getting treatment.

This is one of the first studies of its kind. It’s a little bewildering that more studies like it have not been done yet. The likely answer is that the medical industry does not want to turn away from the “addiction as a disease theory” because then we cannot medicate it. And medication is where both the medical and pharmaceutical industries have their respective cash cows.

The study proved that addicts who are taught that addiction is a disease are more pessimistic about their habits and less interested in getting help than addicts who are taught that their dependencies are behavioral struggles that can be overcome with professional assistance, effort, and a fair degree of commitment and personal resolve.

“When we began talking about addiction as a disease, the goal was to decrease stigma and encourage treatment. That worked, to an extent, but an unforeseen byproduct was that some people experiencing addiction felt like they had less agency.…”

According to Dr. Sarah Desmarais, coauthor of the research paper, “When we began talking about addiction as a disease, the goal was to decrease stigma and encourage treatment. That worked, to an extent, but an unforeseen byproduct was that some people experiencing addiction felt like they had less agency; people with diseases have no control over them.”

The research was straightforward. The researchers took 214 participants and split them into two groups. One was taught that addiction was something that various factors can contribute to, but something which can be overcome when hard work and expert treatment methods are brought to bear on it. The other group was convinced that addiction was a disease due to changes in the brain which take place during drug use.

At the end of the indoctrination, both groups were surveyed, and the group which received the non-disease model of instruction reported a more positive response, were more optimistic, and were more desirous of treatment and motivated towards getting treatment. The group which received indoctrination on addiction as a disease were more pessimistic, more disinterested in making any real changes in their lifestyle, and not as desirous of seeking help.

We don’t want addicts to give up hope. That takes us in the wrong direction, and it merely fuels the continuation of their dwindling spiral. It is the wrong path to take. We want to inspire hope in addicts because hope is the first step that any addict must take on the road of commitment and steadfast dedication to positive change.

The Importance of Properly Defining Addiction

Addiction is best defined as an affliction of the mind and body. It is a struggle of the mind and body, a physical difficulty as well as a mental, personal, and spiritual conflict. Addiction is all of these things and more, but this research shows that looking at it as a disease may, in fact, be making it harder to treat.

We have to correctly label addiction because our basis for resolving addiction and freeing people from the clutches of chemical dependency begins with possessing a firm, irrefutable understanding of what addiction is. If we understand and agree on what addiction is, we can move towards treating it. If we are in constant disagreement on what addiction is, we’ll be forever divided on the best methods for resolving this harsh problem.

Addiction does not need to be labeled as a disease for addicts to recover and people who struggle with addiction do not have to be addicts for life. By that same token, addiction is a perilous and self-destructive behavior compounded by physical cravings, both of which require residential treatment and a great deal of professional help and guidance. But when addiction is labeled as a disease, that opens the door to treating that “disease” with more drugs and closes the door to true recovery.

Narconon graduation.

All of this culminates into why residential drug and alcohol rehab centers are so helpful. Even the most heavily addicted individuals, struggling with multiple drug habits, years of chemical dependency, and a whole slew of underlying issues can still find relief and freedom from their crisis with the help of residential treatment.

If you know someone who is struggling with a drug habit or alcoholism, don’t tell them they struggle with a disease or that their problem is a lifetime crisis that they can never break free from. Instill hope in them, but remind them that getting clean is going to take effort and commitment. They have to want it. Then do your best to get them into a residential drug and alcohol treatment center.


Reviewed and Edited by Claire Pinelli, ICAADC, CCS, LADC, RAS, MCAP



After working in addiction treatment for several years, Ren now travels the country, studying drug trends and writing about addiction in our society. Ren is focused on using his skill as an author and counselor to promote recovery and effective solutions to the drug crisis. Connect with Ren on LinkedIn.