Why is Alcoholism is Considered a Disease While Drug Addiction is Often Viewed as a Crime?

By Nancy Wurtzel

Alcoholism was once considered a personal or moral failing.  However, after the American Medical Association (AMA) declared alcoholism a disease in 1956, viewpoints began to shift.  Today, alcoholism is universally recognized as a health issue rather than a character flaw.

The same cannot be said about drug addiction.  In 1989, the AMA identified all other drug addictions as diseases, but attitudes surrounding drug addiction have been slow to change.  A Pew Research Center survey showed that while 67 percent believed treatment should be emphasized for those who abuse drugs, 26 percent still think drug users are criminals who should be jailed.

Why is there still such a disparity between how society views these addictions?

One reason is misinformation.  Alcohol consumption is legal (at a certain age) and is largely considered a benign social activity.  Drug use, on the other hand, is widely viewed as an abhorrent, personal choice, and one that is vastly more destructive than alcohol. Individuals who use drugs are routinely described as junkies or crackheads.

There are myths associated with drug addiction:

• People who become addicted are weak and a drain on society
• Dependence on drugs is a choice
• Drug users could stop if they really wanted to
• 12-step programs work for everyone
• An addict can be scared straight
• Decriminalization is an endorsement of drug use

Health care professionals who specialize in addiction point out that alcohol and drugs are both addictive substances and can be equally destructive.

Dr. John Sharp, an addiction-focused psychiatrist, explains, “The only difference is that alcohol is more prevalent. It’s the most widely used drug in the world, and it’s a normal part of many cultures. But people who are vulnerable to addiction run into trouble with it in the same way they would run into trouble with substances that they might need to reach out for more, like illegal drugs which aren’t as widely available.”

It’s also important to note that not everyone who consumes alcohol or drugs will become addicted.

Biology plays a significant role as a person’s genes account for about half of their risk for addiction.  Other causes include the environment, peer pressure, mental illness, self-medication, curiosity, and even boredom.  Studies have shown the earlier the drug use begins, the higher the risk it will lead to addiction.

The legal system has also played a role in how alcohol and drug addiction are viewed in our society.

For decades, national and state laws were rooted in Richard Nixon’s 1971 “War on Drugs,” a failed public policy, which encouraged the criminalization and incarceration of the nonviolent user of drugs.  Critics say this approach was counterproductive.  Instead of helping addicts, the “War on Drugs” filled our jails, created a culture of shame and did little to solve the problem of addiction.

It’s now widely recognized that drug users often fall into a vicious cycle, leading to compulsive behavior and progressive drug use, even though the consequences are both physically and mentally harmful – and sometimes fatal.  Drug-induced overdose deaths now surpass homicides and car crash deaths in America.

But help and a renewed understanding of drug addiction may be coming.

Earlier this year, the White House unveiled its evidence-based Drug policy Plan for the 21^st Century, emphasizing prevention and treatment over incarceration.  The plan includes both alcoholism and drug addiction, but noted both are public health challenges with no distinction that one is worse than the other.

From the White House policy, “Today, about 22 million Americans need treatment for a substance use disorder, and yet only 2 million—about 1-in-10—actually receive the treatment they need. This is unacceptable. Research shows that addiction is a disease from which people can recover. In fact, success rates for treating addictive disorders are roughly on par with recovery rates for other chronic diseases such as diabetes, asthma, and hypertension.”

Also highlighted are the enormous economic costs of drug addiction.  A study conducted in 2007, revealed that illicit drug use cost the U.S. more than $193 billion in lost productivity, healthcare, and criminal justice costs.

Prevention is the key to turning around this dire situation of human and economic loss. According to the new White House drug policy, “Preventing drug use before it begins— particularly among young people— is the most cost-effective way to reduce drug use and its consequences. In fact, recent research has concluded that every dollar invested in school-based substance use prevention programs has the potential to save up to $18 in costs related to substance use disorders.”

Finally, the White House plan includes this: “Even now, discussion of substance use disorders is too often relegated to the shadows, steeped in stigma and misunderstanding.  Today, thanks to significant advances in neuroscience, our Nation’s responses to drug abuse have begun to change.”