I’m with you, y.
There may or may not be a genetic predisposition to alcohol or drug abuse; there is also a physical addiction which develops over long abuse.
But it is not a ‘disease’ in that you are physically able to prevent yourself from picking up the bottle and drinking it.
People with MS have a disease. They can’t control their movements. People with leukemia can’t get their immune system to work. People with asthma can’t control their breathing. These are REAL diseases.
When I hear alcohol/drug abuse classified as just a disease, I feel resentment on behalf of those with true diseases.
People with alcoholism can’t control their drinking.
I think that addiction can be viewed in some ways as a psychiatric disease, with some physical components. And this can get interesting.
To start with, it has been discovered that gamblers get a “brain storm” stimulation, literally, when they *lose*, but only mild stimulation when they win. This sets up a weird mental state called “operant conditioning”, made even stronger by randomness. That is, when random results reinforce actions, the effect is far stronger than when you get the same results every time.
The result is that a more primitive, far less self-aware and thoughtful part of the brain is trained with a stimulus-response action.
And this is where brain maturity comes into play. If a person gets to adulthood without developing this strong operant conditioning, that actually modifies the brain like exercising a muscle, when they are an adult, their brain is far more fixed in its purpose, and thus it is much harder to set up such “voluntary programming”.
They will never get as much stimulation from losing, either.
This is a good model to work with for chemical addictions as well. Today, most addictions are divided into physical and psychological addictions. The common statement is that “physical addiction only lasts three days” before recovery, so after that point it is all psychological.
But this does not take into account actual brain damage.
In the 1980s, the US Army decided to study alcoholism as it relates to leadership. They discovered that by the time a person becomes an alcoholic, they have damaged their forebrain, specifically their “judgment center”, so significantly that they cannot be relied on to have good judgment.
They suggested that after stopping alcohol consumption, it would typically take six months before the average soldier’s judgment was again good. As such, nobody diagnosed with alcoholism should be permitted in a leadership position. Of course they instantly recognized that if they removed all alcoholic leaders, the Army would be decapitated.
So instead, they settled on a long term policy to decrease and discourage alcohol use in the Army.
Bottom line, addiction is a psychiatric disease, with physical components, and physical damage all contributing to it.