The view I have taken for many years is that addiction is a complex illness involving many factors.
These factors include:
- the effects of the drug itself;
- the response of the brain to the drug – with resultant neurochemical and biological changes after prolonged exposure;
- the hereditary and genetic makeup of the individual – there is strong evidence that genetic factors predispose an individual to addiction and increase the person’s vulnerability;
- psychological factors;
- and socio-cultural factors.
In order to simplify the message, I think of a triangle where the three points are the drug, the person (biology; psychology) and the environment (price; availability; peer influences; education; occupation).
In this way, according to a previous definition, addiction is a biopsychosocial disease. I think there is no doubt that it also has a spiritual dimension (dishonesty, selfishness, the moral and spiritual consequences of the lifestyle).
Understanding addiction as a disease is not a cop-out for taking responsibility for one’s recovery. In fact because it is a chronic progressive and potentially fatal condition it is all the more necessary that the individual take full responsibility.
Alcoholics Anonymous itself has always spoken of an illness but there is a greater understanding now of how the brain’s reward centres and neural circuits are hijacked by long exposure to significant drug levels.
For further reading on this subject I recommend the American Society of Addiction Medicine’s definition of addiction.