What If… Addiction Isn’t Really a Disease?


Almost 28 years ago, on July 18, 1987, I decided to stop my addiction and begin my recovery in earnest.

I started by going to daily meetings of both Narcotics Anonymous and Alcoholics Anonymous – sometimes three meetings a day, when I was feeling particularly at-risk for relapse. From there, I gravitated into the rooms of Al-Anon, Adult Children of Alcoholics (ACOA), and Codependents Anonymous (Coda). Although I consistently struggled with feelings of not fitting in (one of the stories of my life), there was definitely something comforting about being in a room of people who were experiencing many of the same problems as I was.

At the time, I’d had Crohn’s Disease for 14 years, having been initially diagnosed in 1973. After taking addictive medications prescribed to me by physicians for all that time – as well as some other substances that I self-prescribed – I found myself at a massive, suicidal bottom. Those 12-Step meetings quite literally saved my life.

I think I stopped going to meetings somewhere around my 10th year of recovery. It wasn’t so much that I felt I didn’t need a program of recovery anymore – although by that time, I was quite solid in my choice to continue living the new life I’d been creating for myself. I knew that if I ever felt like I needed a 12-Step meeting, I’d go to one.

In those early days, I tried to go along with everything I heard in the meetings because I really, really wanted to recover. But I have to admit I had trouble with some of it. The concept I had the most problem with was the notion that addiction is a disease just like other medical diseases.

The most recent argument in favor of this comes from the understanding that there is brain involvement in addiction. As fascinating and useful as much of this current research is, I know that there is also brain involvement when I lift my little pinky – there is brain involvement in everything we do, that’s how we’re wired. For me, this is not a particularly compelling argument for addiction being included in the medical model of illness.

I have a medical illness. I can’t just say, “Gee, I think I won’t have Crohn’s Disease anymore.” Neither can someone who has cancer or diabetes or any illness like that. But we can do exactly that with addiction – and millions of recovering addicts the world over are proof of this. Addiction can be arrested and recovery is then possible.

Of course, it’s not that easy – invariably there is some difficult, uncomfortable inner work required in the process. However, in my own experience, as well as the experiences of so many of my clients, going inward in this way often creates an amazing personal journey that leads directly into a much better life.

It is true that some people don’t end up recovering from addiction – and some of them use the ‘disease’ excuse to sidetrack themselves. “I have a disease,” they claim, “I can’t help it.”

Yes, you can help it – of course you can ‘help it’ – but only if you choose to. When I discovered that I was an addict, I was actually relieved. I’d had no clue about what was going on with me, but once I understood why I was doing what I was doing, I could change it – and I was ready to be done with that miserable life I’d been living.

Ultimately, addiction is a choice, as is recovery. Even though addiction has brain involvement, even though we may have a genetic predisposition to it, even if we learned to use addictive behaviors in our family homes when the going got rough – underneath all of that, addiction is a choice. We all choose, at every given nano-second, whether we are going to face life on life’s terms and deal authentically with our reality or we’re not.

And regardless of whether the addiction is to TV, heroin, chocolate, or any other possible manifestations of the way they choose to hide from reality, as soon as addicts decide they are no longer going to handle life in a healthy way, off they go into that netherland of the infamous ‘slip’, which stands for “Sobriety Loses Its Priority.” Once we decide that sobriety from addiction is no longer a priority in our lives, we relapse and start to use again.

How can that be anything less than a choice?