Abstract
Alcohol addiction has been referred to in print as a disease since the end of the 18th century.1 By 1956, the American Medical Association (AMA) had endorsed the disease model, and the view has since received public and unequivocal endorsement by numerous influential medical organizations, including the World Health Organization.2 Researchers commonly use a variety of methodologies that rely on the disease model to attempt to understand various aspects of addiction, and several methods that have been used to study addiction suggest that the disease model is a good one. For instance, twin studies and adoption studies have provided evidence that genetics plays some role in addiction. Moreover, molecular biology explains certain phenomena that occur in the brain with repeated exposure to addictive drugs. These findings seem to make sense of the compulsive element that is associated with many cases of addiction, at the very least suggesting that something other than simple choice is involved. Nevertheless, much care must be taken to situate the cart relative to the horse in this research, and to disentangle the many and diverse threads of addiction research, if we are to evaluate the contention that addiction is a disease.
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Notes
It was so characterized by T. Trotter in 1788. Reproduced in An Essay, Medical, Philosophical, and Chemical on Drunkenness and its Effects on the Human Body, ed. R. Porter (London: Routledge, 1988), and by B. Rush, an American physician, in an 1808 book, An Inquiry into the Effects of Ardent Spirits upon the Human Body and Mind: With an Account of the Means of Preventing, and of the Remedies for Curing Them (Philadelphia: Thomas Dobson, 1808), according to
M. Valverde, in Diseases of the Will: Alcohol and the Dilemmas of Freedom (Cambridge: Cambridge University Press, 1998), 2. According to the Baldwin Research Institute, Rush also believed that dishonesty, political dissent, and being African American were diseases.
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As we will see below, it is not just the amount of pleasure that one experiences that provokes repetition of use or gambling but also the pleasure that one anticipates. See Hans C. Breiter, Itzhak Aharon, Daniel Kahneman, Anders Dale, and Peter Shizgal, “Functional Imaging of Neural Responses to Expectancy and Experience of Monetary Gains and Losses,” Neuron 30 (May 2001): 619–639. In some cases, anticipation seems to play an even more provocative role. In some problem gamblers, almost winning may lead them to gamble even more than winning does. See
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© 2016 Candice L. Shelby
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Shelby, C.L. (2016). Addiction and the Individual. In: Addiction. Palgrave Macmillan, London. https://doi.org/10.1057/9781137552853_3
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DOI: https://doi.org/10.1057/9781137552853_3
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