Addiction Chronic Illness

When a loved one is addicted to drugs or alcohol, it is natural to feel frustrated and helpless. You may wonder, “Why can’t my loved one simply stop using drugs or alcohol?” In reality, quitting drugs takes more than willpower. Drug addiction is a complex disease and quitting can be extremely difficult, even for individuals who are ready to start a new, sober chapter in their lives. When we accept that addiction is a chronic disease, it is easier to understand why quitting drugs or alcohol can be so difficult, why relapse occurs, and how you can best support your loved one through this process.

Understanding Addiction and Substance Abuse as a Chronic Disease

The National Institute on Drug Abuse defines addiction as a “chronic, often relapsing brain disease that causes compulsive drug seeking and use, despite harmful consequences to the addicted individual and to those around him or her.” (National Institute on Drug Abuse, Nov 2012). A chronic disease is one that cannot simply be cured, but must be treated, managed and monitored over a lifetime.

Other chronic diseases include cardiovascular disease, diabetes and asthma. Addiction is also a primary disease, according to the American Society of Addiction Medicine. This means that addiction is not the result of other causes, such as emotional or psychiatric problems, although addiction may co-occur with these conditions.

When you see a compulsive, damaging behavior in friends or family, it’s easy to focus in only on the drugs or alcohol abuse and think of this as a moral, social or even criminal problem. In reality, the forces underpinning addiction are much more complex. According to Dr. Michael Miller, a past president of the American Society of Addiction Medicine, “the disease is about brains, not drugs. It’s about underlying neurology, not outward actions.” (Science Daily, Aug 2011)

Recent advancements in research focused on the biological basis of behaviors shows that the addiction is a disease affecting the brain’s neurotransmitters. Addiction changes how the brain’s reward circuitry works. This means that addictive behaviors – like the memory of using drugs or alcohol – can supplant normal, healthy behaviors. Continued use of drugs and alcohol trigger cravings for more of this substance and feeds the cycle of addiction. This chronic disease distorts thinking, feelings, and perceptions. Addiction drives individuals to behave in ways that seem irrational to others who are not also addicted to drugs or alcohol.

Addiction & Relapse: Why a Chronic Disease Requires Ongoing Care

Since addiction is a chronic disease, this means that there is no single “cure”. Individuals who are struggling with addiction must continually choose recovery over unhealthy behaviors. Since addiction fundamentally changes the brain’s reward circuitry, making this choice can be extremely difficult.
In his interview with Science Daily, Dr. Miller emphasized the importance of not judging or blaming individuals for addiction.

“We have to stop moralizing, blaming, controlling or smirking at the person with the disease of addiction,” Dr. Miller told Science Daily. “(We need to) start creating opportunities for individuals and families to get help and providing assistance in choosing proper treatment.” (Science Daily, Aug 2011)
You can help by supporting your loved one’s journey to sobriety and understanding that relapse is not a sign of failure. It is simply a sign that your loved one could benefit from additional treatment. This is similar to the management of other chronic diseases like asthma, for example. There may be times when asthma is under control and other times when an individual may need to use an emergency inhaler or seek additional medical care. The same goes for the treatment of addiction. If your loved one relapses, rather than pointing fingers or assigning blame, help your loved one get the care he or she needs to refocus on sobriety. Additional substance abuse treatment can help your loved one get back on the path to long-term sobriety.