Did You Know That Addiction Is Not a Disease?

By Karla Hardin, MS LPC

Addictions in our culture are rampant.

Food, porn, alcohol & drugs, gambling, gaming & social media addiction - to name some of the obvious. But we can’t exclude addiction to exercise and even addiction to emotions and achievement. The list can go on!

The cycle of addiction only requires Strong Attraction-> Repetition of action -> Deep Learning

*And we only get addicted to things that give us a hit of dopamine (that feel-good neurochemical) when we get it.

Let’s face it. We all struggle with addiction.

As a counselor, I have seen addiction in all shapes and sizes.

Alcohol is probably one of the most prevalent -though it is so culturized that no one thinks they are addicted. During the Pandemic the rise in alcohol addiction was undeniable. The toll it takes on marriages and families is tragic and yet those losses don’t seem to help us turn the tide away from this relationship-killer.

Living with a raging person is so damaging, but sitting with the person who is the ‘rage-er’ tell me they get a “release” and a “high” from raging explains to me why they have such a hard time stopping.

Our definition and typing of addiction over the years has really painted a bleak outlook for those who struggle with it. The medical model considers addiction a disease that is located in the brain and is defined as this: “Substance addiction is a chronic, relapsing brain disease that is compulsive seeking to use”.

The assumption is that the drugs themselves produce the addiction. But with recent advancement in scanning the brain, it has now been shown that behavior addictions have almost an identical brain map as do substance abusers. Therefore, we need to consider a different paradigm for substance abuse and addiction.

This new information challenges the disease model of addiction. Along, with the disease model are several assumed realities that I find disempowering to the person who is fighting addiction.

The disease model calls for medical treatment as the primary intervention
“Medicalization” makes addicts into “patients”
Patients hand over control to professionals
Belief in chronicity
Loss of empowerment
Fatalism and surrender

Even though the plus of the medical model was to take the “shame” out of addiction I believe it creates a sense of hopelessness, sadness and striving to resist the inevitable, that can be even more damaging.

So, what is another model of addiction if the medical model is antiquated?

In his book, The Biology of Desire, cognitive neuroscientist and former addict Marc Lewis, PhD makes a convincing case that addiction is not a disease and reframes addiction as an unintended consequence of the brain doing what it's supposed to do -seek pleasure and relief -in a world that's not cooperating.

To watch Dr. Lewis present his case: click here.

Brains are designed to restructure themselves with normal learning and development, but this process is accelerated in addiction when highly attractive rewards are pursued repeatedly.

In other words, Addiction is a highly developed SKILL of the brain.

Lewis shows how treatment can be retooled to achieve lasting recovery, given the realities of brain plasticity.

How to Break the Cycle

So, if we are going to break the cycle of addiction, we have three specific hurdles that must be navigated in order to realign this “brain skill” called addiction. They are:

1. THE TRIGGER

Since the brain has developed a belief that triggers lead to a “feel good” it’s seeking, it is very quick to scan and locate them. When found they will immediately produce craving. Craving that dopamine hit fires up the imagination which enhances the expectation of how that “feel good” is going to feel. This intensification magnifies the trigger which increases the craving, which is intensified through more imagining - It keeps looping.

2. NOW APPEAL

The second hurdle is true for all mammals. We all value the immediate over future goals. This hyper focus on the immediate is built into the dopamine system because the short-range seems “worth more” than future happiness. This is why an addict thinks the “high” is worth losing his job or family – because they are in the “future”. The Now appeal keeps addicts living in the present moment – not aware of the devastation of the past or impending loss of the future.

3. EGO FATIGUE

This last hurdle in breaking the cycle of addiction is where so many addicts experience shame and self-loathing after they experience the loss that inevitably comes after the “feel-good” wears off.

The normal response is “I have to stop! I have to never “use again”, “rage again”, binge again” and so on.”

But research has showed us that you can’t keep trying to NOT do something. It is not sustainable. The brain fatigues and it is only a matter of time before you DO the very thing you are trying not to do.

With the low success rates offered by conventional rehabilitation programs, I believe we need to look at a more effective and lasting strategy that takes in to account these three hurdles in order to break the addiction cycle.

A successful recovery from the power of addiction will include:

1. The hope of full recovery. Not a hope that is based in idealism, but rather is based in the reality that the brain is always changing and it can be truly redirected and that it takes practice over time. And even more compelling is the eternal hope that was bought for us by the God of redemption and restoration.

2. A commitment to “express” not “repress” the truth. The power of sin along with addiction is so often found in fighting our battles in secrecy. Battle fatigue is guaranteed when you try to go it alone.

But expressing the triggers/temptations that are “common” to man with fellow co-strugglers is the invitation to find the power God promises in Eccles. 4:9-12 which says we are strengthened when joined by others.

3. Replacing addictive goals with your goals. Remember your addiction is a highly skilled at reaching the goal of a dopamine hit to bring you pleasure. It’s time for you to value yourself as the “rightful” goal setter in your life versus your primitive brain as the lead. Part of our dignity of being created in God’s image is the freedom to dream and choose.

4. Envision the future. Since addiction keeps us trapped in the present, we need to reclaim the joy of envisioning our future. And part of envisioning the future is to be able to also reclaim and value the past.

One tangible way to do this is to begin to tell your narrative story. Addiction demeans our stories to a series of wrong behaviors. It depersonalizes and devalues the reality of learning and gaining wisdom from the failures in our lives.

I love so much that scripture is full of “stories” of real people’s struggles and how they learned from their willful past and surrendered their egos and found freedom and hope as they looked to the future. The apostle Paul proudly proclaimed his “broken” narrative and the ensuing hope as he looked to the future.

Secondly, write the future you envision –journal.

All in all, let’s reclaim the hope, power, freedom and the future addiction has robbed so many of.

Let us stand firm in Galatians 5:1:

“Christ has set us free to live a free life. So, take your stand! Never again let anyone put a harness of slavery on you.”

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Karla Hardin is a Licensed Professional Counselor and Trauma Specialist for Hardin Life Resources

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