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RE 147: Is Alcoholism a Disease, a Habit, or Voluntary?

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The 3 basic camps of addiction can be broken into the following categories: The prevailing wisdom today is that addiction is a disease. This is the main line of the medical model of mental disorders with which the National Institute on Drug Abuse (NIDA) is aligned: addiction is a chronic and relapsing brain disease in which alcohol use becomes involuntary despite its negative consequences. The idea here is, roughly, that addiction is a disease because alcohol use changes the brain and, as a result of these changes, alcohol use becomes compulsive, beyond the voluntary control of the user. In other words, drinker has no choice and his behavior is resistant to long term change. Marc Lewis’ “The Biology of Desire: Why Addiction is Not a Disease”, has stirred controversy among addicts, their families, addiction researchers, and treatment providers. Lewis claims that the scientific facts don’t support the disease model of addiction. Rather, addiction, like romantic love and other emotionally loaded habits, dev