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Speaker 4For decades, people have debated the question, is addiction, alcoholism a disease? Or is it a choice? What's going on here? Some people say addiction is a brain disease. Others say it is learned behavior. Some say it's trauma, coping, or even spiritual disconnection. Depending which model you believe, it completely changes how you think about recovery. So today, I'm going to break down the disease model of addiction, other major models used, and psychology, and treatment. And why understanding these perspectives actually matters in recovery. Disclaimer here, I'm not a doctor or a scientist. This is all personal experience in the 10 years, 11 years I've been in addiction recovery and education. So first, the disease model. Probably the most widely known. It became especially influential through Alcoholics Anonymous, medical research, and addiction treatment programs. The basic idea is, simple, addiction is a chronic brain disease. Just like diabetes or asthma. And it affects how the body functions. So, in something like Alcoholics Anonymous and 12-step programs, they believe that addiction is a disease of the mind and body. So it's an allergy of the body, an obsession of the mind. When I take that first drink, I can't stop. I need another one to satisfy the urge, the craving. Men and women essentially drink because they like the effect produced by alcohol and drugs. And they'll chase it into the depths of hell. They will go through any lengths to get that next drink or drug because it provides some sort of relief, ease and comfort for them. That once I start, I can't stop. And when I'm stopped, I can't stay stopped. I'm constantly obsessing over the next drink or drug. So, the disease model focuses on brain changes. Substances alter brain systems involved in reward. So it feels good when I get that dopamine hit. Motivation. Memory. Decision making and impulse control. These are all factors that contribute to the fact that I have no choice in the matter. Repeated use changes the brain's wiring so that the substance becomes prioritized over everything else. Nothing else matters except for that first drink, that next drug. I will do whatever it takes to get money to achieve that. I will lie, cheat, manipulate and steal so that I can get that ease and comfort with a few drinks. This is why addiction often involves craving compulsive behavior and relapse when someone wants to stop. So, we see people on the streets, for example, that don't have a choice in the matter. They're not enjoying themselves out there, a lot of them. I know for myself, I wasn't enjoying the depths towards the end of my addiction. It was fun in the beginning and then it becomes about chasing relief. It becomes about just survival, really. My medicine. One important idea in the disease model is this loss of control. People with addiction, addiction may sincerely want to stop but the brain's reward system has been altered. That's why addiction is described as chronic and relapsing. So, it's progressive. You'll hear people say it's a progressive disease. It's getting worse, not better over time. That was evidenced in my life when I relapsed after seven and a half years. I picked up way worse than I left off. I really couldn't control it. I had no say in the matter and I felt like I needed to drink. So, some strengths of the disease model. And again, there's no one way to look at this. This is a multi-layered, solution to a multi-layered problem. There is a lot of different beliefs out there. There's not just one way. So, whichever one you agree with, you confide in, you resonate with, go with that one. So, the strength of the disease model is there's big benefits to understanding addiction. First, it reduces stigma. Instead of seeing addiction as moral failure or weakness, it frames it as a medical condition. So, it doesn't, the way I like to look at it, it doesn't shift blame. It reduces shame, right? We're not shifting blame and saying, "Oh, it's not up to me. So, I'm gonna just do whatever I want. There's no point in all of this." No, it's not about that. It's about reducing shame so that I know that I am not just fucking up and I'm not just a failure in life. There's more to it than that. It's bigger than me. It's bigger than you. Second, it encourages people to seek treatment so that there is a treatment to it. There's not a, there is a solution, but there's not a cure. And in my experience, it's a daily reprieve contingent on the maintenance of my spiritual condition. That's me. And third, it emphasizes long-term management rather than quick fixes. So, this is something that I'm going to be battling with, dealing with, and it can lay dormant. It is not going to run my life, not gonna drive the bus, but I do have to work on it every single day. It doesn't just go away. It doesn't just disappear when I stop taking substances. Just like other chronic conditions, recovery may involve ongoing support. So, it's looking at people, as being sick rather than being flawed or broken or beyond repair. They're just stupid. They're just having fun. They're just selfish. They're just making decisions and choices to do that. Some criticisms of the disease model, 'cause there are criticisms for sure. There's a lot of scientists and neurologists that believe differently. And it's important to understand all the perspectives here. That's what I'm trying to do in this episode. So, at the same time, the disease model isn't perfect. Some critics say it makes people feel powerless. If addiction is purely a disease, some people interpret that as I have no control over this. Others argue that addiction is more complicated than just brain chemistry. It's multifaceted. Because addiction is also deeply connected to environment, trauma, social conditions, learning, and behavior. There's more going on beneath the surface. I talk about that at length in the last episode. So the disease model explains parts of the picture. Many experts believe it doesn't explain the whole story. Next model. So the addiction being a behavioral and learning model. This is another major way of understanding addiction. It's called the learning model. Perspective says addiction develops through conditioning and reinforcement. So it happens over time. Reinforced behavior, repeated behavior, repeated patterns. We're conditioning the brain. In simple terms, your brain learning determines the substances produce relief or pleasure from whatever you're dealing with. For example, I get stressed at work. I drink alcohol. I feel relief. I can relate to this one as well. Because for a long time, alcohol and drugs quieted the noise in my head. I always say that it made me feel a part of, it made me feel connected. It made me feel like nothing else mattered in the world. And I could escape reality for a moment. That illusory freedom. I didn't have to be an adult. So over time, the brain records that pattern. Over time, stress appears. The brain says, use that thing that worked before. I know what'll work. Over time, this becomes a habit loop. Triggers start activating cravings automatically. So you're not even thinking about it subconscious. You're picking up the drink and you don't even realize you're picking up the drink. How did I get here? How did I get seven deep already? Your brain has learned a predictable reward pattern. Predictable and deadly. The next model we have is the trauma or self-medication model. This model focuses on emotional pain and trauma. You often hear Gabor Mate, the famous doctor on addiction. He goes on a lot of podcasts. He talks about trauma. Addiction is all about trauma and pain. So it's often called the self-medication model. According to this view, substances are used to regulate difficult emotional states like anxiety, depression, trauma, shame, loneliness. I am regulated when I am on substances. So people aren't necessarily seeking pleasure. They're trying to, to reduce pain. I'm in so much pain from whatever happened in the past or whatever. It's usually in the past that this is my solution to that pain. For example, someone with severe anxiety might discover alcohol quiets their nervous system. You hear that a lot. It calms me. Someone with trauma might use substances to numb intrusive memories. PTSD is another one. Over time, the brain learns substance equals emotional regulation. This is why emotional sobriety is so important and regulating your emotions naturally healthily, without substance, without mind-altering drug. This model helps explain why addiction is so common among people who have experienced childhood trauma, chronic stress, emotional neglect, abandonment issues. The next model is the biopsychosocial model. This one is probably one of the more popular ones in the science community, scientific community. It's called the biopsychosocial model. This approach combines multiple perspectives, perspectives. It recognizes that addiction is influenced by three major factors. Biological factors. So genetics and brain chemistry, which I talked about in the last episode. It can increase vulnerability. Some people are more biologically susceptible to addiction. I talk about this at length in why do some people get addicted and others don't in that episode. Check it out. Two, we have psychological factors. So things like trauma, mental health conditions, personality traits, coping skills. All influence how someone responds to substances. So you are predisposed to these things. You have more likely a chance to get addicted. Three, social factors. So environment. Things like peer groups, family dynamic, the culture you grew up with, stress, access to substances. Is it around? Are you hanging out with people that are using more often? They all shape the risk of addiction. The biopsychosocial, I said that wrong in the beginning. Biopsychosocial model basically says, Addiction isn't caused by one thing. It's the interaction of many factors. Why these models matter in recovery. So why should we care? These models aren't just theoretical. They influence how treatment works. So how do we treat the illness, the problem at hand? For example, if you follow the disease model, treatment might emphasize abstinence. So completely going off substances. All mind and mood altering substances. Because just because I liked alcohol doesn't mean that I can safely use marijuana. Because I'm always. The pattern below it is deeper. I'm escaping something instead of coping with it in a healthy way. So the disease model might emphasize abstinence, ongoing recovery programs like 12 step model or smart recovery. I need to constantly work at this daily, like I said, off the top and then medical support. If you focus on the learning model, treatments may focus breaking habit loops, identifying triggers, right? These more practical approaches, building new coping strategies. I'm actually writing out what my triggers are and how to combat them. CBT and DBTs, cognitive behavioral therapy and dialectical behavioral therapy. These are methods that are used to treat this sort of breaking these negative thought loops. If you focus on trauma model, treatment may involve therapy, trauma processing and emotional regulation. So digging up that stuff and dealing with it, not just ignoring it. In reality, effective recovery often. It involves elements of all three. So it's a multilayered approach. Addiction is one of the most complex human conditions. A lot of people don't really understand it fully. And that's why it's such a personal recovery, such a personal journey. It's not one single model explains everything. I used to think that abstinence was the only way to recovery. But I once heard somebody in harm reduction the other day. We were getting naloxone training at school. They talked about recovery being just progress. Just wins, small wins, incremental. So if I was drinking six beers a day, now drinking three, that is recovery. That is a win. Some people believe that and I am more open minded to that. I do not believe one way my recovery is my recovery. However, you practice your recovery is going to be different than the way I practice it. And that is fine. It is accepted. As long as we are moving towards a goal. What is the goal here? Do I want to get abstinent? Do I want to fix my life or do I want to just moderate? Do I want to control my drinking? In my experience, control is never an option. Regression was never an option. I could never just take one and take it as prescribed. I never had benefits with that. That is evidenced by my reaction to nicotine. I got back on these damn Zin pouches that I just I can't just moderate it. I'm always thinking about it. And it's not something I'm proud of. It's not something that I want to do for the rest of my life. But, you know, these are things that I just need to understand more about myself, that I can't have one of anything and that is OK. And there's ways to live around that and to cope with that and to live successfully and happily and whole and be happy, joyous and free, while also recognizing that there is work to be done. I'm always in progress. I am always moving toward this power greater than myself, this connection with what I choose to call God. So no single model explains everything, like I said. But most modern research will agree on this. That addiction involves changes in the brain, patterns of learning, emotional coping, and life circumstances. This it all involves it's all encompassing. And in order to recover, we need to focus on all of these areas. Understanding these models helps us move away from blame and toward compassion and effective recovery. So. The better we understand addiction, the better we can help people heal. And this is all about empathy to me. The next time you see someone struggling with addiction in your life or on the street or whatever scenario you might run into because addiction is everywhere. Let's place it. If you don't think you have an addiction, rethink how your relationship is with your phone, your social media, your coffee. That is addiction. It's just not the circumstances may not be harming you in the way they're harming other people. If we can understand and empathize with people instead of saying what's wrong with them, say what happened to them, what are they going through? Everybody is facing a battle that you know nothing about. Try to understand it from everything that is led up. What happened to that person? To make them need to escape it, to look for relief, to look for. Ease and comfort. What is driving that behavior? What is driving the need to seek pleasure or to whatever it is for that person? Understanding it can help us treat it can help us empathize with people more instead of sympathize and look down on people and realize that at the end of the day, this is not a choice, that that is the one thing that upsets me is when I hear people say, well, they're just choosing to do that. They're choosing to live this way. They're choosing to separate themselves from society and isolate. I have spent a lot of time around recovering addicts and new people and new guys and worked with them one on one. If it was a choice, a lot of us wouldn't need recovery. We would just choose to change our life. And for some people, they can just do that. They can just change small things in their life and work out more and read more books and go to retreats and see a psychologist and they're fine, go on a certain medication and they're OK. But at the end of the day, think of recovery like this. It is simply just improvements, progress, not perfection. We are moving toward a goal and any small win is a win. If I stop doing heroin and I'm smoking weed now, that is a win. That is recovery. If I am California sober, which a lot of people disagree with and I did for a long time, try to open your mind to that concept that maybe that person doesn't need abstinence, maybe they don't want it. Maybe they don't want it ever. And I know certainly I was practicing harm reduction when I was in my relapse. I was looking for ways to safely use drugs. And I just found that I could never come to a happy, useful incorporation of drugs in my life, even ADHD medication. There was no benefit to me. It was just providing relief, providing illusory freedom. I didn't want to be an adult. I wanted to escape the moment. I had such a hard time, still have such a hard time being in the now and just being in my skin, being here and now. So meditation helps with that. All these other things help with that. But at the end of the day, try to open your mind to more different concepts. And there's not one way to recover. There's not one way to get this thing. It is multilayered, multifaceted, have compassion towards those people. Because at the end of the day, I think we're all just trying to do better. And when I see the world that way, I have no problems. There are no issues in the world. There are no discrepancies. I'm seeing the world through a lens of acceptance, through compassion, tolerance, love and tolerance of others is our code, patience. I just need to accept that if I see somebody living in a way that I disagree with, I can simply say to myself, that person is simply not living in a way in which I would prefer. And when they see me, I am not living in a way in which they would prefer. And that's okay. We can all coexist. I can be of service to those people. So is addiction a disease? I don't know. I believe today that my brain is wired differently than other people. And that provides me with enough solace to work my recovery program that I know that I can never moderate anything, I can never just have one of anything, anything mood or mind altering, even gambling, shopping. These are all things that I use to escape the present moment, to escape myself. Thank you for listening today. Please like, subscribe, follow the podcast. Recovery is simple, not easy.
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