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The Disease Model

MartinJon Garcia
MartinJon GarciaPublished on July 20, 2022

The disease model of addiction, although extremely outdated, is still the standard in the industry. We need to know this if we are looking to get help or if we are looking to help our loved ones. It is a billion-dollar industry but for all it's momey it is also failing spectacularly.

There are some wonderful centers around the country that are moving the needle away from the disease model but this takes time. And if they are not getting adequalytly funded they don't have time. All of that being said, I will do my best to address the disease model here so you know more about it and why it is so important as well as why it needs to go.

The disease model, in its simplest form, points to the idea that when you introduce a substance to the body, the brain/body cannot regulate itself. This is most often spoken about similarly to diabetes. In diabetes you cannot regulate sugars so you are medicated. The primary way this, and all diseases, are addressed is through clinical support of varying types and degrees. In addiction this support can be seen most commonly through outpatient programs (12-step model) and medical assistance.

It may sound cynical but the only reason we need a model(s) at all is to have the ability to measure success. In a consumer society if we cannot measure success then we cannot justify funding research or aid. The disease model was created in order to get help to people in need of help. That worked, however, when people believe it is a disease they struggle for decades measuring their degree of "illness," often in fear. They try to maintain their sobriety without stepping wholely into their own recovery. This is known as drinking the KoolAid, or I like to refer to it as Living Under the Influence.

There are many things we are surrounded by that we know don't work, like grading in schools, but because we don't have a better solution (on paper), we accept it as part of the way to do things. When better solutions come they will be met with resistance until such a time that it gains enough traction to attract increasing numbers of supporters (Think about the legalization of marijuana).

The shift to the disease model from the moral model, which took place many decades ago, has benefited millions. Rather than being seen as a moral failing we can look at the people who are suffering in active addiction as "sick." This is great when it comes to an approach to gain funding but would you ever want to be identified as sick?

But if we never started seeing it as a disease, no one would have backed spending money to help those struggling with addiction. The disease model does reduce stigma, but only so far as it can. If it were to actually eliminate the stigma around addiction completely then people would recognize their addictions to food, the internet, phones, gambling, shopping, social media, and all the other garbage that we get addicted to.

We still must shift away from the disease model if we are going to get rid of some stigma. Having said that, it was still necessary to shift to the current model so that we could get services to those in need.

I am a harm reductionist at heart and in order to reduce harm we had to move away from the moral model. Under that model those who do not struggle with the addictions we don't like (drugs and alcohol) look down on those that do.

As it relates to science, we now understand that addiction is the sign of a healthy brain. We all have addictions in our lives, maybe it is work, drugs, exercise, or food. No matter what our addiction is, it helps us do something very specific, and that is, be more comfortable with the separations we experience. If we did not recognize places where we feel comfortable, or at ease, we would have never survived as a species. We need to know where sugar, fat, and other feel good things can be found, and our brains make it a point to remember where we can find it because it feels good.

This is at the core of why we get addicted. If we need to pay lip service to the disease model to get funding, so be it. But the real work is in getting those people who are so uncomfortable in their skin to recognize they don't have to escape or be anything else for anyone else, that they are connected and have a purpose, even if they don't know what that is at the moment.

I want my clients to feel connected and I tell them that sobriety is just a beverage choice, their recovery is what matters most. Not what they are recovering from, that doesn't matter, but what they are recovering to is what matters to me, and the world. And what they are recovering to is themSelves. And that is what I want for you.

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