Are Addictions a Disease?

Drugs. Alcohol. Gambling. Food. Sex. Shopping. Chances are if you have never struggled with an addiction yourself, there is someone in your immediate circle of friends or family who has either battled one or is in the midst of the fight right now.

A widely-held belief in modern-day drug treatment and psychology is that addictions are a disease. Most major medical plans even include coverage for the treatment of addictions, similar to the coverage provided for the treatment of a traditional illness or injury. While many advocate and work towards helping others attain successful treatment for the “disease” of addiction, the bad news is that, in this addictions-as-a-disease model, there is no true cure. Like cancer, this disease requires intensive initial treatment, lifetime maintenance thereafter and, if left untreated, there is a high likelihood that the “disease” of addiction can be terminal. While there are certainly some truths to be found in this philosophy, at its core it misses the whole reason that Jesus came to this earth and died – to set the captives free (Luke 4:18).

The belief
Outside of Christian circles, this disease model is the belief when it comes to the diagnosing and treatment of addictions. The addict is told that he has a serious sickness, called addiction, and that he must receive extensive (and usually very expensive) treatment in order to become well again. He is often prescribed various medications to treat his depression, anxiety or other mood disorders and put on a structured road to recovery that can include inpatient treatment (in serious cases), outpatient treatment (in less serious cases), as well as various other activities and programs designed to help modify his behavior. In layman’s terms, he is in “rehab,” just like someone who has injured a limb and goes through rigorous and regimented exercise to restore the injured appendage back to full strength and range-of-motion once again. The addict is treated clinically, with a focus on changing his external behavior, with no real remedy given for the issues of the heart that drove him to his addiction in the first place.

The science
In a June 11, 2012 press conference at the Betty Ford Center in Palm Springs, California, Gil Kerlikowske, the director of the National Drug Control Policy, announced that the White House would make an increasing shift towards treating addictions as a disease and not a moral failing, further bolstering the validity of the disease model of treatment. However, psychologist Lance Dodes, M.D. points out the gaping holes in the disease model in a December 2011 article published in Psychology Today. Dodes says, “Addiction has very little in common with diseases. It is a group of behaviors, not an illness on its own.  It cannot be explained by any disease process. Perhaps worst of all, calling addiction a ‘disease’ interferes with exploring or accepting new understandings of the nature of addiction. This becomes clear if you compare addiction with true diseases. In addiction there is no infectious agent (as in tuberculosis), no pathological biological process (as in diabetes), and no biologically degenerative condition (as in Alzheimer’s disease). The only ‘disease-like’ aspect of addiction is that if people do not deal with it, their lives tend to get worse.” In short, the disease metaphor for addictions falls flat when compared to true physical illness.

The problem
From the onset, problems arise when treating an addict as a sick person with a disease. The addict, who is already a master at blame-shifting and avoiding responsibility, has just found the perfect scapegoat. He now says, “I didn’t want to lie, cheat, steal, abandon my family, etc. My addiction made me do it!” An addict who believes that his self-destructive behavior is the result of a sickness beyond his control develops a victim mentality, and has a convenient way to absolve himself of any personal accountability for his choices. After all, someone who is diagnosed with cancer certainly does not hold themselves responsible for the debilitating symptoms and possible death caused by their disease.

When that logic is carried over to the world of addictions, the selfishness, deception and reckless behavior that characterize addictions become the disease’s fault instead of the addict’s fault. The bottom line is that, in this addictions-as-a-disease model, people are told that they are not bad, they are just sick.

The Bible
The reality is that, according to scripture, people are bad (Romans 3:10). In fact, we are so bad, God had to come down here in the flesh to save us from the depths of our badness. The disease view of addictions does well in pointing out a sickness, but the sickness has spread much deeper and broader than to those who struggle with substance abuse or compulsive behaviors. The sickness is called sin, and it has infected all of humanity from the Garden of Eden until today.

Addictions are not some special kind of sickness, but just one manifestation of the sickness of sin and idolatry that infects each and every person walking the planet. Our hearts are made to be satisfied in God alone and, without God filling the void, every man will attempt to fill his with the idol of his liking, whether that be money, sex, power, drugs or a whole host of other false gods that promise satisfaction and fulfillment. As Christian counselor, author and addictions expert Ed Welch says, “Addictions are slavery; but it is a voluntary slavery.”

The incredible news, for addicts and idolators alike, is that there is a cure and his name is Jesus. In 2 Corinthians 5:17, it reads, “This means that anyone who belongs to Christ has become a new person. The old life is gone; a new life has begun!” We who were once spiritually dead and slaves to sin are now alive in Jesus and set free from the controlling power of sin in our lives. Additionally, Romans 6:6-7 tells us, “We know that our old sinful selves were crucified with Christ so that sin might lose its power in our lives. We are no longer slaves to sin. For when we died with Christ we were set free from the power of sin.”

Will we still sin every day until the day we die? Yes. But the power of sin that once controlled us has now been broken. Now that we are truly alive in Christ, we can be set free to worship him instead of worshipping drugs, alcohol or any other addictive behavior that once controlled us. In Christ, we no longer have to willingly give ourselves over to the voluntary slavery of addictions. In the disease mindset, the addict’s success depends on manmade behavior improvement programs that can only bring about external compliance. In Jesus, his power, love and newness fills the addict’s heart and frees him once and for all. As Jesus himself said, “So if the Son sets you free, you are truly free” (John 8:36).

Justin is a staff writer for the Good News. Email him at [email protected] or follow him on Twitter at @thejustinyoung.

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