In the DVD Pleasure Unwoven, Dr Kevin McCauley, a medical doctor, claims that addiction is a disease.

In the video he argues against the choice model, and explains the neuroscience of addiction

I found nothing in his arguments convincing. There seems to me to be a gap between the explanations of the science of how addiction works and the claim that it is a disease. That is, every part of the changes made by chemicals on the addicted brain seem to be changes that are expected and predictable. Even changes to the so-called pleasure centers of the brain seem in his own words to be the results of the brain during allostasis. Hence there is nothing in his arguments that demonstrate evidence of a disease.

I'd like to know if there is compelling accepted evidence that addiction is a disease.

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    I am nervous that this question is (a) ultimately about definitions, and (b) has been controversial for decades largely because of the way the different words make people feel and react, by default. The reasons for accepting or rejecting that addiction fits into the definition of disease may be more about the consequences of that decision rather than than any objective truth. – Oddthinking Sep 14 at 11:34
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    I think this is going to have a large element of opinion associated with it. You can make a decent argument either way (for: It has signs and symptoms, a predictable progression, a prognosis and possible treatments, against: it's not caused by an infectious agent or a physiological failure of the body, it's not infectious, it doesn't cause physical harm directly, etc). This potentially make this an inappropriate question for Skeptics. – GordonM Sep 14 at 11:35
  • @OddThinking I think you're right. In the case of McCauley, he's selling his DVD and is deliberately vague. I don't recall him ever clarifying what definition of addiction he refers to. I was hoping for some kind of evidence that might me either way, but maybe its unanswerable in that sense. As for me, I prefer to see it as a behavioural disorder. – Jerome Viveiros Sep 14 at 13:19
  • @Fattie, yes, I get that now... I think the question should be closed because the answer is really that it is defined as a disease, not that evidence supports this or that the definition of a disease is based on evidence. – Jerome Viveiros Sep 17 at 12:39
  • A fairly balanced discussion: drugabuse.gov/about-nida/noras-blog/2018/03/… And for the opposing POV, a better source is americanscientist.org/article/is-drug-addiction-a-brain-disease – Fizz Sep 18 at 2:33
up vote 12 down vote accepted

Yes

https://www.centeronaddiction.org/what-addiction/addiction-disease

Addiction is defined as a disease by most medical associations, including the American Medical Association and the American Society of Addiction Medicine.

Like diabetes, cancer and heart disease, addiction is caused by a combination of behavioral, environmental and biological factors. Genetic risks factors account for about half of the likelihood that an individual will develop addiction.

From American Medical Association:

Addiction is now recognized as a chronic disease, attributable in part to long-term changes in the patterns of neuronal activity and connections.

From American Society of Addiction Medicine.

Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.

Regarding treatment

You say...

[The] claims of addiction being a disease seem at odds with treatment for addiction, which often involves 12 step programs and woo. One does not treat a disease by talking to other sufferers of the same disease, surely.

Just because a disease is real and seen as such has never stopped woo-woo and nonsense from being pushed at those afflicted by the disease. This is an ongoing discussion: which is more important? That the treatment must be proven considered effective and safe before it is used, or that the patient (and to a lesser degree: the medical professional and the providers of the treatment) gets to have free want and say in the matter? The debate continues... amidst much grumbling and gnashing of teeth on all sides of the argument.

P.S: Good job on getting free, and much sympathies and cheering on for your future.

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    There is no unambiguous, identifiable physical property that makes something a disease, or otherwise: it's not possible to develop a machine which by physical tests determines diseaseyness. Something is a disease if it's defined as a disease, and that the collection is coherent in a broad sense. This isn't so rare, for a famous example, think of what makes a "game" a game: it's neither a subjective free-for-all nor a deterministic question. The bodies this answer cites are as good as you are going to get. – user44544 Sep 14 at 11:58
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    @Dannie "it's not possible to develop a machine which by physical tests determines diseaseyness". That had me laughing out loud. :D – MichaelK Sep 14 at 11:59
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    @Dannie I kind of think of a disease as a change to an organ that requires some kind of medical treatment. Thus I'm skeptical of addiction being a disease since I am five years drug free with no interest in using, without any medical treatment. I asked the question because I assume that I am biased and cannot reasonably reason whether it is a disease or not for myself. But if it comes down to a simple definition, then I guess it makes no difference to me in the end. – Jerome Viveiros Sep 14 at 13:23
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    I'm going to accept this answer. I think the question can't be answered as I wanted because the definition of addiction is vague, and what constitutes a disease is also ambiguous in this sense. – Jerome Viveiros Sep 14 at 13:26
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    @JeromeViveiros Well even without resorting to woo-woo, snake oil or charlantry... not all medicinal treatments is about chemistry. There are plenty of medical conditions that are treated with non-medicinal treatments; not every medical condition needs to be — or even can be — treated with a pill, tincture, injection, or surgical procedure. Drug addiction is treated both medicinally, to deal with the drug and the changes they have caused to your physique, and non-medicinally, to deal with the psychological causes of and the ditto effects of the addiction. – MichaelK Sep 14 at 13:42

Let's sidestep the primary question of whether addiction is a disease, and ask whether addiction may be cured by medicine.

Can addiction be cured by medicine?

The University of Penn Health system says:

Can Addiction Be Cured?

Can diabetes be cured? No. It can be managed successfully with proper treatment. But treatment is lifelong. It's chronic, it's progressive, it's characterized by relapses…and if untreated or mistreated, it can and will result in death.

Yet, addiction, a similar disease, is supposed to be CURED in 7 days…or 28 days of treatment. It doesn't make sense. There is no cure for any of these chronic, progressive diseases. They all require lifelong treatment. Addiction is no different.

http://www.uphs.upenn.edu/addiction/berman/treatment/

The National Institute on Drug Abuse (USA) says this:

Can addiction be treated successfully?

Yes, addiction is a treatable disorder. Research on the science of addiction and the treatment of substance use disorders has led to the development of research-based methods that help people to stop using drugs and resume productive lives, also known as being in recovery.

Can addiction be cured?

Like other chronic diseases such as heart disease or asthma, treatment for drug addiction usually isn't a cure. But addiction can be managed successfully. Treatment enables people to counteract addiction's disruptive effects on their brain and behavior and regain control of their lives.

https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery

In an interview with Sally Satel, Scientific American reported:

Is it possible to cure yourself of addiction without professional help? How often does that happen?

Of course it's possible. Most people recover and most people do it on their own. That's in no way saying that everyone should be expected to quit on their own and in no way denies that quitting is a hard thing to do. This is just an empirical fact. It is even possible that those who quit on their own could have quit earlier if they sought professional help. The implicit message isn't that treatment isn't important for many—in fact it should probably be made more accessible—but it is simply a fact that most people cure themselves.

https://www.scientificamerican.com/article/can-you-cure-yourself-of-addiction/

  • Actaully you can cure type 1 diabetes with a pancreas transplant, I did not read farther in your answer – James Jenkins Sep 18 at 12:10
  • They don't say "cure", they say that "successful transplantation has shown to be efficacious in significantly improving quality of life..." with the caveat that the transplant also requires lifelong immunosuppression, which has its own side effects that must be managed... and that's why they need do "restrict [transplants] to patients who have serious progressive complications of diabetes or whose quality of life is unacceptable." – elliot svensson Sep 18 at 14:34
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    There are diseases which are curable and diseases which are uncurable. How does this matter for the question whether or not addiction is a disease? Also, there are claims that some forms of addiction aren't actually curable. For example, a mainstream view among people dealing with addiction is that there is no such thing as a cured alcoholic, only a dry alcoholic. – Philipp Sep 19 at 12:40
  • I'm five years clean without treatment, and have no interest whatsoever in using my former drug of choice (meth). The purpose of my question was to find if anyone could produce evidence on whether or not it is a disease. I would hesitate to even call it a chronic condition. Further, I don't know of any symptoms of addiction's effects on the brain that can't be explained as expected symptoms of a brain on narcotics. (The last bit was mentioned in the question originally but edited out.) – Jerome Viveiros Sep 19 at 13:49
  • Neither answer gives me enough to assert that evidence supports addiction being a disease (or not). – Jerome Viveiros Sep 19 at 13:49

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