If Addiction is a spiritual problem, how is it also a disease? Part 3: Questions about Addiction and Treatment Raised by Unbroken Brain

Okay this seems to have turned into a series of articles on the questions raised by the book Unbroken Brain by Maia Szalavitz.  Today's question is: if addiction is a spiritual problem with a spiritual solution, how is it also a disease?

This is tricky: as we explored in the last article, Alcoholics Anonymous was founded by desperate men who had no other viable treatment options in their time.  Somehow, addicts, by admitting that we are powerless over our addictions and by cleaning up the wreckage of our past are able to draw on a higher power that restores us to sanity.  Millions of addicts have found this to be true.  

For every person that finds recovery in the spiritual solution offered by the 12 steps, there are people who leave 12-step recovery claiming that the reason is that can't deal with the spiritual solution.  Much of the early work of Alcoholics Anonymous was about how to help drunks find a higher power that worked for them that wasn't the punishing God of their childhood or perhaps even a God at all.  Some alcoholics simply make the other people in the group their Higher Power--they speak of G.O.D. ("Group of Drunks")-- the point is something other than yourself.  (For people who have a hard time with this, I always recommend Martha Cleveland's pithy The Alternative 12 Steps: A Secular Guide to Recovery)

So that's loosely how the spiritual part of it works--not in depth.  Which brings us back to the question, if addiction is a spiritual problem with a spiritual solution, how is it also a disease?

When I was the communications director for Physicians for a National Health Program, I used to joke "I'm not a doctor but I play one on TV" (later I made the same joke as I represented nurses in the legislature).  My degrees are in psychology, law and consciousness studies, so take this for what it is worth.  

As someone who works closely with addicts in recovery and as someone who has studied the nature of disease and spiritual recovery, this is what I can offer:

Addiction easily meets this dictionary definition of disease, a disorder of structure or function in a human, animal or plant, especially one that produces specific signs or symptoms or that affects a specific location and is not simply a direct result of physical injury.

Though the treatment and care for the disease may be partly spiritual, from a functional standpoint, it is very useful to treat addiction as a disease.  If my addiction is a disease, then I can release myself from shame and blame.  If my addiction is a disease, then I need treatment for that disease every day.  If I think of addiction as diabetes, then I can define my insulin.  Maybe my insulin is going to 12 step meetings, praying and meditating every day, being of service, caring about others.  If that keeps my disease in remission then that's something I do every day.  Not just on week days.  Not just when I'm in town.  Every day.  A diabetic who takes a break from insulin injections does so at their mortal peril.  It is the same for the addict to take a break from their spiritual insulin. 

That's enough for today, stay tuned for me to think about these questions as well:

• Since doctors and medicine virtually provided no hope for treatment of addiction prior to 12 step, why should we trust them now?
• Follow-up to that question, how has medicine evolved in its treatment of addiction?
• If psychological components of addiction treatment, such as Cognitive Behavioral Therapy (CBT), use thought examination techniques popularized by 12-step groups, why should anyone pay a therapist when they can get it for free?
• How is it ethical for residential treatment centers to charge you or insurance companies a whole lot of money just to send you to free 12 step groups?
• Does it make sense for a medical model to refer you to a "spiritual solution" for what appears to be a disease?
• If addiction IS a disease AND has a spiritual solution, then why is there not a spiritual solution for other diseases?
• Follow up to that questions, and why aren't medical centers referring you to spiritual solutions for those?
• Are there some personality types that respond better to the radical responsibility model of 12 steps than others?
• How can it be that it is "not my fault" that I'm an addict and "only I can solve it" by doing "my work"?

Unbroken Brain Part 1: if you're addicted, is it your fault or? 
Unbroken Brain Part 2: Does shame and blame work in treatment and recovery from addiction?