“Help Me, I’m SICK!”

l'addiction est-elle une maladie?

Opinion and testimony, by Pierre Bremond. "Drug addiction is a brain disease". Such bold statement is made by those who support the "disease model". According to it, addiction is characterized by altered brain structure and functioning.  These brain abnormalities cause persons with this disease to be predisposed toward addiction, moreover, in certain individuals, each incidence of substance abuse chemically alters the brain causing them to become more dependent upon the substance and progressively installing the disease. So, what solution do they have left? Well… None. Because drug and alcohol addiction is defined as a "unique, irreversible and progressive disease that cannot be cured."

I'm going a bit too far though. There are solutions, but they aren't much rosy. According to the disease model, the only way to keep addiction under control is to maintain complete abstinence from all addictive substances. And because abstinence is difficult to achieve and, more importantly, to maintain, the disease model emphasizes the importance of peer support in groups such as Alcoholics, Narcotics or Cocaine Anonymous (AA, NA, etc.).

You've heard of them I guess. Those are peer support groups, quite common in North America (much less on the old continent), whose participants start all their sentences with: "Hi, my name is John and I'm an alcoholic". Or a drug addict, a sex and love addict, a shopaholic, and so on. They will never, ever say they are ex-alcoholics or former drug addicts, even though they haven't touched a drink or drugs in thirty years and more. Because, don't you know, addiction is still there. The disease is only dormant, latent, but it is still present. Ready to jump on you at the slightest weakness[1].

I suppose you know now what I'm getting at. There's something I find deeply disturbing with the addiction model. It is a way or stripping substance abuser of their responsibilities. "Not their fault, they're sick!". Of course arguments to defend the disease model are no rare commodity. For example, calling addiction a disease is a good avenue for getting help for low-functioning drug users, especially in countries not renowned for the generosity of their social model. Fair enough. But that's politics not science.

To give you a bit of background about myself, during my misspent youth I think I drank enough to fill maybe not an Olympic size swimming pool, but close. Say, my neighborhood pool maybe. I've snorted and smoked enough dope to match a small country's quantity of drugs seized annually. To make it short, I was a true addict.  However, I don't feel I should have to walk on egg-shells for the rest of my life, lest the addiction "virus" wake up once again. I happen to drink a glass of wine, or two, maybe once or twice a week, and I sometimes feel like I could smoke weed again without any trouble, except I don't feel like it.

I have fought my addiction and won, I really won, and I'm proud of it. I did it with a little help from an organization and from the people who work in it. I also did it through my own sense of responsibility, an eye-opener, an urge to make something of my life.

In my opinion, should the disease model ever turn out to be valid, it would fundamentally change the way we understand, label and treat addiction. Calling addiction a disease is not only inaccurate, it is harmful. It's harmful because it's like replacing one stigma with another. People rarely boast about having a "progressive and irreversible" disease. There is nothing to be proud of. And a sense of responsibility doesn't do much to combat most real diseases. Although the "will to fight" is a highly prized value in our western culture, it has been proven that it only has little impact on the progression of some diseases like cancers. On the contrary, the will to fight and the sense of responsibility are crucial parts of the arsenal for combating addiction.

Among all the people I know and work with, many are former substance users, former drug addicts. They too have fought addiction and won. They work and most probably live with a great sense of responsibility. I am almost certain that none of them would ever consider introducing themselves, or seeing themselves, as alcoholics or heroin user, or cocaine user. They are recovered addicts just like me. And just like me they don't see themselves as cured, because they never were sick, nor as in remission, but as free. Just free.

Pierre Bremond

Certified Drug Counselor, Web Developer


(1) With all due respect to the Alcoholics or Narcotics Anonymous who in several decades have helped millions.  Their approach however cannot suit everyone.