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i've always wondered why addictions are considered in the psychiatric community, and by insurance companies, to be a disease.

maybe this is because i've never been an addict.

i was born bipolar. that is a disease. there isn't a thing i can do about it.

someone, while maybe genetically more prone to falling into a trap once opening it, is not being forced to get drunk or high. that is a choice.

so i don't really get where everyone is coming from who says that it is a disease. how can a choice be a disease? every time that person drinks or uses, that person is making the choice to do it. when i have a mania, that is not a choice.

can someone explan?

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Hi Loon

I am far from an expert on the subject but I think the use of the term "disease" applied to addictions has to do with changing attitudes toward their treatment. They have become increasingly medicalized, in no small part due to better efforts to intercede via medications (as opposed to more traditional behavioral methods).

But someone else should correct/amend here . . .

cheers

-blackie

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I'm on the fence.

Addiction changes your personality, your values, your sense of right and wrong, your ability to make rational decisions. The substance thinks for you. Once you're an addicted it often stops being a choice. Mothers trading their babies for a substance? That can't be a choice. Think about it.

You don't have to born with something for it to be a disease. Nobody is born with AIDS or cancer either. That doesn't mean they aren't diseases.

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so i don't really get where everyone is coming from who says that it is a disease. how can a choice be a disease? every time that person drinks or uses, that person is making the choice to do it. when i have a mania, that is not a choice.

can someone explan?

I have always found the "disease concept" of addiction objectionable, as do many of my fellow addicted people. I prefer to think of my *problem* with cocaine, meth, et al., as an "allergy." Just like being allergic to bee venom, if I introduce certain substances into my body, I have a terrible allergic reaction characterized primarily by the inability to stop using said substance. But the first hit, shot, drink whatever is definitely a choice once you are clean or dried out or whatever

I'm sure calling it a disease from the insurance angle makes it easier for treatment, but IMO, they allow far to many trips to detox and rehab. If you've heard it once, you've heard it enough. The message on how to abstain with some contentment in your life hasn't changed much in 80 something years.

Nothing annoys me more than an alky who's been sober forever and still excuses their obnoxious behavior on their "disease", my father would be a good case in point. Meh.

S9

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Webster's--"disease:an abnormal bodily condition that impairs functioning and can usually be recognized by signs and symptoms". While I dislike the concept of alcoholism/addiction as a "disease", it rather fits the bill, no? I do think these are self-created, much as emphysema and lung cancer in smokers. All diseases, all began with a choice to partake of whatever substance. And yeah, I think blaming the "disease" for actions/behaviors is boorish. It ain't a "get out of jail free" card, this description, it's merely one way to look at addiction.

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i was born bipolar. that is a disease. there isn't a thing i can do about it.

someone, while maybe genetically more prone to falling into a trap once opening it, is not being forced to get drunk or high. that is a choice.

While it is usually a choice to drink or drug, most individuals' first exposure comes at an age when mature

processing of risk vs. reward is not available and when the ability to resist social peer pressure is also

poorly developed. i.e., pre-teens and teenagers are not adults and it is foolish in the extreme to expect

them in retrospect to have always made "mature" decisions just like someone more experienced and

self-supposedly wiser. Afterwards, once the (genetically) potential addict finds out the potential risk

is a certain reality, it's a little damned late - and s/he may STILL not be mature enough to make the

appropriate remedial decisions even without a substance-addled head.

And it's NOT like you are born knowing that you will be addicted if you partake.

so i don't really get where everyone is coming from who says that it is a disease. how can a choice be a disease? every time that person drinks or uses, that person is making the choice to do it. when i have a mania, that is not a choice.

You have a choice to seek treatment before a mania or depression gets too severe for you to function.

How can you call bipolar disorder a disease when you have that choice available? No one is forcing you

to refrain from seeking the necessary treatment, and it's readily available if you are responsible enough

to earn enough money to afford it...

The same logic you would apply to an addict applies to your own actions - when in doubt, blame the

person who's already down and short on resources.

But it's simple really. For whatever reason, an addict has a hell of a lot harder time staying away from the

booze/drugs/sex/gambling/etc. than a non-addict. Just like you have a hell of a lot harder time staying

on your meds and the meds adjusted to maintain you at an emotionally stable midpoint. And each time

either of you falls off your personal wagon, it's that much harder to get your act back together.

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And each time either of you falls off your personal wagon, it's that much harder to get your act back together.

Christ do I know about falling off the wagon and getting myself back together numerous times!

I prefer to think of alcoholism as a 'disorder' not a disease. And in my case I was an 'instant alcoholic' - addicted from my very first drink. When I was 12 years old, I started drinking alcoholically. I agree with Saturnine though, the endless rehabs are useless, if you've heard it once you've heard it a million times and you know what to do. At the end of the day self-control and will-power are the things that are going to get you sober, the medical profession can wean you off booze or heroin but they can't keep you away from the pub or the dealer. As a recovering alcoholic who has been sober for 11 months I find myself getting impatient when I see other alcoholics moaning about their addictions on chat shows etc. I want to scream 'wise the hell up!'. I have suffered from eating disorders, depression, psychosis and I have never wanted to yell 'wise the hell up!' at anyone who suffers from these illnesses but at the end of the day I think only alcoholics can save themselves and the power lies within. So yeah it's a disorder but one in which self-help and will-power is the only cure.

blackbird (speaking as one who has tread the addiction path many times over) x

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I have always found the "disease concept" of addiction objectionable, as do many of my fellow addicted people. I prefer to think of my *problem* with cocaine, meth, et al., as an "allergy." Just like being allergic to bee venom, if I introduce certain substances into my body, I have a terrible allergic reaction characterized primarily by the inability to stop using said substance. But the first hit, shot, drink whatever is definitely a choice once you are clean or dried out or whatever

someone, while maybe genetically more prone to falling into a trap once opening it, is not being forced to get drunk or high. that is a choice.

(pardon that this post is replying to two people and so isn't replying to each person as well as i should)

i know my mother is an alcoholic. does that mean i should never have taken the risk of having a drink ever? my father isn't an alcoholic. i have had binge issues but they were more about wanting to self destruct than addiction. am i wrong because i did have that first drink? because i drink a glass of wine a few nights a week? i didn't get addicted right off the bat, and i got lucky genetically. but there are people who get addicted right off the bat. and there are people who don't realize that addiction is genetic, or don't realize their parents are addicts.

i knew that my family had a history of mental illness but i wasn't prophylactically put on medication.

i'm being a bit heavy handed with my points here.

thing is i consider my mental health problems to be issues of disease and also to be issues that are problems that i have a degree of control over in that i have the choice to seek treatment, the choice to take my medications as directed, etc. and if i don't do all that i can to care for myself then i have made a choice and am culpable for what happens. (too bad meds and treatment aren't perfect but still, you know what i mean.)

Nothing annoys me more than an alky who's been sober forever and still excuses their obnoxious behavior on their "disease", my father would be a good case in point. Meh.

i have done a lot of really asinine things before i got the right meds and the right therapy. (ok, i'm still an ass but that's different...) just because i was sick doesn't mean i am not culpable for the pain i caused. even if it wasn't my "fault" that i wasn't dx'd right, had the wrong meds and wrong therapy, i still did those things. i can forgive myself for what i have done because i wasn't in my right mind and because i have tried to make things right. and i am thankful that my family has forgiven me, but i was the person who did those things and so it is my responsibility to make things right. mental illness explains my behavior, but no disease excuses hurting other people.

some people will just look for anything to excuse their behavior because they aren't strong enough to own their behavior. don't need a disease to be this brand of asshole.

---

on a different note, the fact that there are genetic predispositions and the fact that some people process substances differently leads me to believe that is less cut and dry than saying it's a choice (and thereby somewhat implying weakness or lax morals). i still think my mother has chosen the path she is on, but i also recognize that native americans have issues with alcohol for more than societal reasons and so it is harder for her to avoid booze than it is for me to not eat the dairy i'm allergic to. i would never give up my cat let alone my own daughter for a slice of cheese.

---

and i appreciate that the insurance industry recognizes it as an illness and often pays for treatment. i'd hate to be someone who had to go through detox alone because insurance wouldn't help, yanno? rehab is more than just hearing the schpeel, for a lot of things there are physical risks with detox. (now, if you're an alcoholic asking for your second liver transplant, then you can just fuck off in my book.)

of course i may cut someone out of my life for one too many failed rehabs, or for not even trying rehab in the first place, but can we as a society give up on people? if so, after how many failed rehabs? and what do we do with them?

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so i don't really get where everyone is coming from who says that it is a disease. how can a choice be a disease? every time that person drinks or uses, that person is making the choice to do it. when i have a mania, that is not a choice.

So, if you've never been an addict, how do you know that it's a choice?

For people like me, it's not a choice. I've spent thousands of dollars in detox and rehab and I'm here to tell you, calling it a choice is bullshit. Why would anyone with half a brain keep making the same "choices"?

Alcohol is a poison. I know this but I still do it. Why? Because I have a disease that's why.

Unless you have experienced what addiction is like, calling it a choice is ignorant.

I apologize for being an asshole here, but my addictions are not choices.

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don't need a disease to be this brand of asshole.
Penny, I liked this. In the rooms we call it simple "asshole-ism". Or we'll say, I have "alcohol-ISM," not "alcohol-WASM."

p.s. I never think you are prickish or dickish, and I have issues out the a-hole with my father's addictions and the consequences that rage on 24 years since he's picked up a drink.

I don't believe there are any definitive answers in the realms that we're talking--addiction (which some believe in and of itself is a mental illness) and our various and sundry MIs. Well, few definitives. That is just in my experience and opinion ONLY.

S9

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I don't speak from any kind of experience... I'm not an addict, nor (to the best of my knowledge) is anyone in my family or close friends.

Disease, disorder... whatever. It's all semantics. I have a really hard time believing it's a choice.

That doesn't mean I believe addicts shouldn't be held responsible/accountable for their behavior to pretty much the same degree as everyone else. Whatever disease or disorder you may have, if your behavior is a threat to the safety of others, you need to (at a minimum) be kept away from those situations - forcibly, if necessary.

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i like the way you explained in sunshine- that it is something that effects the safety and wellbeing of others, and gets to the point where it isn't a choice, and people have to be kept away from it forcibly if necessary. make sense to me. thanks!

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My brother is an ex-crack addict, 6 years on the street, i have a history of alcoholics in my family. Sometimes its in the genes, but yes its a choice one makes in ones life. Once you let the alcohol/drugs control u then its too late and your an addict, and its a whole new love affair/obsession. I lost my mother she was an alcoholic and was killed in a head on collison. Being an addict is a lifetime disease, in any moment a person can go back to it, ruins your family, your job, and your morales. Being Bipolar I love to party hard, dance, drink, smoke a spliff, but have made the choice not to. Damm, now I feel like a goodie 2 shoes!

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I think it's impossible for anyone who's not an alcoholic or drug addict to truly understand alcoholism or drug addiction the same way I think it's impossible for anyone who's not MI to truly understand what it's like to be MI. That said, I'm an alcoholic, a drug addict, and MI. It's a disease. It changes the chemistry of your body and mind. Once those changes have occurred, there's no choice anymore. Believe me.

Millie

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Sure, to have that first drink or to inhale that first time or to shoot up a first time IS a choice. For some people, it turns into an addiciton. You never really know if you will fall into that trap before you're there. Your body becomes dependent on a substance, and the cravings are usually so strong it's not a matter of choice to stop.

I have an alcoholic friend. Every time I see him drunk, I know it's not his choice. He doesn't want to drink, he knows how much it screws everything up for him. But the addiciton, the "disease" is always there with him.

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that is so hard to answer I guess it comes down to WHY you crave it and then what your brain tells you to do once you start craving it. If you crave it and can behave sensibly then it's one thing but if you crave it to the point where everything goes nuts and you feel as if you absolutely cannot stop-even unto death then I'd worry about the brain chemistry/genetic part. I think for some it's environment/stress/etc and I think for others it really is a disease because who would really choose to lose a kidney or liver or whatever else when what they have to do is stop (especially when there are no other illnesses present like being mentally interesting) and have means to stop. Or those that DO lose a kidney, liver etc and continue to drink.

It's difficult- I think it's part of one for part of the alcoholic population and part of the other for the other part

lilie

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My friend Loon-a-tik,

Are you a 12-stepper? You say you've never been addicted, so I guess not! Correct me if I'm wrong, (maybe I'm cross-addicted) but addictions seem pretty darn manic. Telling someone that they do not have a disease because they have been denied mental health services and instead indulge an addiction- seems off.

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I'd like to throw in a random question

haven't read the wholeSmoley thread

but

for those who fight alcoholism or drug addiction

is there

anything

a loving friend, family/member can do

to help?

is the co-dependent ever helpful

to an addict/alcoholic?

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disclaimer -- this is just my experience

One of the worst things a family member/concerned friend can do is baby the addict or alcoholic and constantly pick up the pieces after him/her. It's called enabling. As long as you keep providing a cushion you're preventing the addict from encountering the consequences of addictive behaviour. The best move - and I know it's damn hard - is to back off and take care of yourself first.

I speak from both sides of the spectrum - addict and sister of an alcoholic.

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