Is Addiction actually a disease?

I've been listening quite a bit to Peter Hitchens lately and he seems to believe quite sincerely that there is no such thing as addiction and that it is in almost every case a matter of will power. Since I consider myself somewhat of a fan of his I took his view seriously, despite that previous convictions would normally make me dismiss it offhand. Before you go crazy citing all the studies hear me out. I'm by no means decided on the issue but I have felt a clear difference in my own motivation once I stop seeing myself as an "addict". Addict implies a measure of non-control; a sense that were a slave to our genes or brain. Personally I've never found this label very helpful, and it mostly led me to self-pity. If anyone can offer an alternative way to view the word please share.

What we know of the brain is relatively unclear at this point. I've never been very impressed by so-called brain scans. Yes, we see similarities among all addicts, but ultimately if we are able to control our behavior, then addiction as a "disease" is a misnomer.

Consider that even the people who are addicted to the heaviest drugs can overcome their addiction by the exercise of will, friendship and accountability. Shouldn't this tell us something? I've been beating myself upside the head for forever trying to figure out why I have such a hard time quitting the Animal, as some people call it. Finally I had a moment of epiphany where I realized that I didn't really want to quit, that every time I relapsed it was because I "gave in", not because I couldn't handle it or that "my brain" was the culprit. I understand how viewing the process as chemical can be helpful for a start, but after a while I begin to question how far it can be stretched. Am I really supposed to believe that someone who relapses after a year or two does so because their brain is the villain? And how much "power" lies within our will as opposed to our brain chemistry?

I'm hoping this can generate some discussion. I don't want to belittle people who actually feel they have an addiction. If you are someone who genuinely believes that they're addicted I won't be the one to say you're wrong. This post is merely meant to stimulate more thought around the concept of addiction itself.

AlexthenotsoGreat said:

Consider that even the people who are addicted to the heaviest drugs can overcome their addiction by the exercise of will, friendship and accountability. Shouldn't this tell us something?

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Are you familiar with the rat park experiments? Here is a good video about addiction which mentions it.

AlexthenotsoGreat said:

he seems to believe quite sincerely that there is no such thing as addiction and that it is in almost every case a matter of will power.

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He's wrong.

Addict implies a measure of non-control; a sense that were a slave to our genes or brain.

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Thats because addiction causes pathological learning in our brain that dramatically increases the odds we will repeat the behavior. Self-control, as we think of it, does not exist.


People who quit solely through willpower are very likely to relapse in the future. It's not a viable long term solution, its "pressing on" without any other planning or strategy. Willpower plays a role of course but its just one of many factors. I would agree calling addictions a "disease" is wrong - its more accurate to think of them as pathological learning because thats what it is at the level of the brain.

Watch this video to see the changes porn does to the brain.

https://www.youtube.com/watch?v=ZLtSoWrEplM

AlexthenotsoGreat said:

I've been listening quite a bit to Peter Hitchens lately and he seems to believe quite sincerely that there is no such thing as addiction and that it is in almost every case a matter of will power.

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Heavy drug addicts may die of the withdrawl symptoms if not treated correctly. The symptoms are not solely psycolocial, they can be physical as well. That beeing said, I absolutely disagree with the thesis, that addiction does not exist.

He's wrong.

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But why though?

Thats because addiction causes pathological learning in our brain that dramatically increases the odds we will repeat the behavior. Self-control, as we think of it, does not exist.

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Completely disagree that self-control does not exist. However, I do agree that not finding sufficient reasons to quit, or lacking a vision for the future will increase the chances of relapse. On that I think most of us agree.

People who quit solely through willpower are very likely to relapse in the future. It's not a viable long term solution, its "pressing on" without any other planning or strategy. Willpower plays a role of course but its just one of many factors. I would agree calling addictions a "disease" is wrong - its more accurate to think of them as pathological learning because thats what it is at the level of the brain.

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That is sort of where I've landed. Addiction is essentially a reinforced habit. I think Hitchens makes some fair points, notably that it is not a disease. It seems likely that we're setting up young kids for failure if we try to convince them they're slaves to amorphous symptoms that vary so much from person to person that the term almost loses meaning. Calling it a disease has become increasingly common though, and I think this is a problem because it removes accountability from the equation.

Heavy drug addicts may die of the withdrawl symptoms if not treated correctly. The symptoms are not solely psycolocial, they can be physical as well. That beeing said, I absolutely disagree with the thesis, that addiction does not exist.

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Yes, this is where I think Hitchens misses the ball as concerns addiction as a general concept. That being said, if we turn to our own drug of choice, namely porn, I think the line between addiction and choice is considerably more blurred. And that I guess is the real question: is Porn Addiction a disease or a choice?

Are you familiar with the rat park experiments? Here is a good video about addiction which mentions it.

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Not yet. I've only heard about it briefly. Will check it out, thanks!

Pete McVries said:

AlexthenotsoGreat said:

Consider that even the people who are addicted to the heaviest drugs can overcome their addiction by the exercise of will, friendship and accountability. Shouldn't this tell us something?

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Are you familiar with the rat park experiments? Here is a good video about addiction which mentions it.

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There are a lot of problems Johan's claims regarding rat park and addiction, discussed here:

https://www.yourbrainonporn.com/relevant-research-and-articles-about-the-studies/critiques-of-questionable-debunking-propaganda-pieces/commentary-on-everything-we-think-we-know-about-addiction-is-wrong-in-a-nutshell/

Thanks for the link, Gabe.

It seems to me that if you don't define "addiction" or "disease" properly, you can make whatever conclusion you want.

I like the short definition of addiction, the same Gary Wilson has used in interviews: continued use despite negative consequences.  Then yes, addiction is real.  To say it is just will power is to say that an addict has a clear minded choice when they say "I am going to partake in this activity or not, and here is my rational decision", but anyone who has ever been addicted to anything knows this to be otherwise. 

There are a lot of problems Johan's claims regarding rat park and addiction...

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Thanks for the link Gabe, it was very helpful. Here are some thoughts on it.

"We see lots of users struggling with internet porn?s effects who have had happy upbringings and plenty of social activity. We see happily married men struggling with it."

I think the link between repeated porn use and depression is largely overlooked in studies. In 12-step it is not uncommon to hear from married men whose porn-use is directly linked to a lack of communication and active sex-life. But this is just an anecdotal observation. It will be fascinating to see the upcoming research on addiction and if underlying causes can worsen the issue.

"Eons of evolution have tailored mammalian brains to light up for food, sex, bonding, achievement, play and novelty. While Hari informs us that connection is the true reward we are seeking, he ignores these other natural rewards."

I don't see how these are exclusive from connection. Nearly all of them, when you think about it, involve interaction with others in one form or other. Especially the social component of sex has been divorced from our minds, largely through porn, but I would also argue through the cheapening of sex displayed on Tv and social media. These habits of thought aren't necessarily overcome even when we quit porn successfully. A perfect example would be the life of William G. Wilson, the founder of twelve step. Once he kicked alcohol-addiction, he instead turned to womanizing. From what I've heard, it is not at all uncommon to exchange one addiction for another.   

DoneAtLast said:

It seems to me that if you don't define "addiction" or "disease" properly, you can make whatever conclusion you want.

I like the short definition of addiction, the same Gary Wilson has used in interviews: continued use despite negative consequences.  Then yes, addiction is real.  To say it is just will power is to say that an addict has a clear minded choice when they say "I am going to partake in this activity or not, and here is my rational decision", but anyone who has ever been addicted to anything knows this to be otherwise.

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Good point. I agree that addiction is real. I would be lying to myself if I don't admit I suffer from it. But the more I think about it the more I realize that I have the power to change my own behavior as well, regardless of what some "expert" says.

I reject the idea that addiction doesn't exist since there's a mountain of neuroscience to the contrary. However, I have also always completely rejected the idea that addiction is a "disease". Cancer is a disease. It can happen to anyone at any time for almost any reason and it can't be cured by willing it away. Addiction is different. Addiction is a physical and psychological dependence on a substance or action brought about by an individual choosing to partake. We're all porn addicts here. We know that the symptoms and effects of our addiction feels like a disease. But we also know that our problem is brought about by ourselves and can only be fixed when we as individuals choose to fight it tooth and nail to be free of it.

Whether or not you consider excessive or problematical porn use as an ?addiction? or a compulsive behaviour, or a habit, it doesn?t matter. What matters is whether or not your behaviour is creating difficulties in your life or in your relationships, and whether or not you are able to create long term and lasting changes.

The effects of pornography are being studied and it is becoming clearer that porn consumption, as it exists today, is having a detrimental effect on male sexual function. Porn use within a relationship, where one partner uses porn to the detriment of the couple?s sexual relationship, is an increasingly documented problem too. There are various ways in which porn can have a negative effect on a relationship from deception and secrecy to female partners feeling coerced into sexual activities they don?t feel comfortable with. This is probably a bit beyond questions of ?addiction? but relationships can also be negatively impacted by porn use. I am a partner of a (recovered) porn addict and I witnessed a perfectly healthy sexual relationship becoming unhealthy and damaged by porn addiction and it?s an experience I have no intention of repeating.

Many behavioural problems respond well to self help, although the same ?diagnosis? may require professional help from mental health services. This can include addictions such as alcoholism and recreational drugs, behavioural addictions such as gambling, but also other conditions that have a behavioural component such as agoraphobia, panic attacks, depression where it affects daily functioning, anxiety where it affects daily functioning, OCD, and so on. The fact is that these conditions are not simple behaviours that someone can just choose or not choose to do, but are often a consequence of complex emotional, social, situational and behavioural components, and often require the individual to develop various strategies to manage their condition. Eating disorders are another complex bio-psychosocial group of disorders. For example, you can?t just tell an anorexic to eat and then expect an instant and permanent cure. Sometimes an individual needs to be hospitalised and often the family need to be involved in the recovery process. What I?m saying here is that sometimes people develop conditions with a behavioural component that become very difficult to control without some help. Sometimes professional help is necessary, sometimes peer support is helpful and sometimes people can manage their behaviours/conditions with self help strategies.

With porn addiction, some people can also have a complex set of issues that need to addressed, although some people don?t ? they have developed a habit through excessive or long term use. Personally, I believe that there are changes that occur in the brain through repeated use and I have witnessed these effects and I?ve witnessed a recovery of normal sexual functioning. The studies referred to on Your Brain On Porn make sense to me.

Willpower is only helpful up to a point. That goes for anything. Later on you need to have strategies in place that can bring more meaning and personal satisfaction, achievement or whatever, than what porn did for your life.

I don?t know what this Hitchens guy is about but a quick google shows me that he has opinions but certainly no specialist knowledge or expertise on these issues we?re discussing here. I know it?s kind of fashionable in the UK to diss ?experts? but if you were unwell would you rather see a doctor or would you ask some random person at the bus stop? If you don?t believe in experts? .... just saying. You can be a fan of whoever you like but you have to make your own judgements about what?s best for you. Only you can live your life. Nobody else can.

I don?t know what this Hitchens guy is about but a quick google shows me that he has opinions but certainly no specialist knowledge or expertise on these issues we?re discussing here. I know it?s kind of fashionable in the UK to diss ?experts? but if you were unwell would you rather see a doctor or would you ask some random person at the bus stop? If you don?t believe in experts? .... just saying. You can be a fan of whoever you like but you have to make your own judgements about what?s best for you. Only you can live your life. Nobody else can.

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First of all thank you for your thoughts. You made an excellent point about the anorexic. Perhaps it would be more accurate to describe addiction as essentially a mental disorder. The similarities are very striking.

The reason I referred to Hitchens is because he wrote a book on drugs called The War we Never Fought. I haven't read it so I can't speak for the book but I do know that Hitchens normally researches his answers carefully before giving them. The information I've heard him give has nearly always been an eye-opener, so for that reason I wanted to give him the benefit of the doubt.
I am fully aware that underlying issues can be a contributing factor, but at the same time I doubt whether the urges ever get so strong to the point that some argue "free will" is essentially gone. That is the clincher as I see it. Labelling ourselves "addicts" can become an excuse for some not to take control of their behavior. Not all, but probably more of us than we think. On the other hand, I would never go so far as to say that these adolescents who begin before sexual maturity are not addicted, but I am strongly against using the term as a label of disease. Obviously someone who has been a habitual user since ten years of age is going to have long-lasting changes in the brain that are not easy to counteract. But at the same time I see encouraging those with low self-esteem as a better tool than labelling them with a medical term. I suppose you could say it's not so much the idea I criticize as the language used.