Addiction Is a Complex Disease

In a WBUR CommonHealth article, “How I Was Seduced By Cigarettes, And What Set Me Free,” David C. Holzman bravely recalled his struggle with the addiction of nicotine. He was honest enough to describe the stressors in his life that made him vulnerable to the addiction and the changes of fortune that helped him to recover.

Holzman’s article can help dispel some common myths about addiction.

As the American Psychiatric Association says, “Addiction is a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequence.” That is correct, but many people define addiction incorrectly.

Misunderstandings About Addiction

Regrettably, some journalists and providers are so confused about the meaning of the word that they incorrectly label innocent babies as “addicts.” In those cases, the reporters generally confuse withdrawal symptoms with addiction, and they mistakenly refer to babies born with Neonatal Abstinence Syndrome (NAS) as drug addicted. This label can stigmatize babies for the rest of their lives.

Many providers similarly misunderstand addiction. If people request a particular pain medication or if they experience withdrawal, they could be inappropriately labeled addicted.

Others believe that addiction is a moral failing rather than a chronic disease. Former U.S. Surgeon General Vivek Murthy is among those who want this mistake remedied.

As CNN correctly points out, addiction is “the result of genetic heritability combined with environmental factors.” Sam Quinones talks about how poverty can invite the disease of addiction into an impoverished community in his book, Dreamland: The True Tale of America’s Opiate Epidemic. Quinones is correct in saying that economic factors can drive people to use drugs, and he includes another important point which is that social issues can also add to the problem.

Disproving the Addiction Myth

Holzman’s first-person account of his battle with nicotine helps disprove the myth that addiction only happens to people with poor track records, little hope, and few prospects.

A Journal Highlights editor for the American Society for Microbiology, and winner of a Plain Language/Clear Communication Award in 2011 from the National Institutes of Health, Holzman said it best in his article: “If anyone should have been immune to taking up smoking, it was me.” However, social factors, combined with a hereditary genetic predisposition, opened the door to addiction for Holzman.

Fortunately, his story points to another truth about the chronic disease that is addiction. Although there may be no cure, for many people, there is hope for recovery for some. Many people — even those with opioid addiction — can evolve beyond their disease depending on how environmental factors play out. Once Holzman successfully dealt with the relationship issues that had tempted him to self-medicate with nicotine, he was able to free himself of the need for nicotine.

Enduring difficult relationships or poor finances can trigger the disease of addiction. Forming loving, supportive relationships or bouncing back from financial stress can help one recover.

Holzman’s addiction did not end his career or his life. His article shatters the myth of addiction which is that one cannot ever escape its grip. The article is beautifully and honestly written, and I hope we can all learn from its messages.