Doctors and scientists who study addiction classify it as a disease using what’s called the brain disease model of addiction (sometimes shortened to the disease model of addiction). Because addiction is a complex and often misunderstood disease, we regularly come across people—even people suffering from addiction themselves—who don’t believe it’s a disease.

In fact, there is even some controversy over whether the model is 100% accurate, but it’s important to note that the consensus in the scientific community is that it’s generally correct. Arguments against it are mostly on the fringes of the discussion and are not taken seriously by most experts.

This lack of understanding is usually just a lack of education. The idea that addiction is a disease goes back hundreds of years and is not new. However, it’s only in the last 90 years that this has been the basis for treatment methods, including the 12 Steps of Alcoholics Anonymous.

The difference between a disease and something else—a moral failing, a lack of willpower, weakness—is that a disease can be treated through the healthcare system. These other issues can’t be.

Additionally, if addiction is not a disease, anyone can claim to have a “method” of overcoming these issues, can charge money for it, and won’t have any oversight for how well that “method” actually works. Insurance also can’t get involved, which means whatever huge fee this “method” has must be paid entirely out of pocket.
To put it simply, it opens the door to predatory practices that were once far too common in the world of addiction—most addicts already experience plenty of that as it is.

In this article, you’ll learn what the disease model of addiction is and why it’s important for addiction and alcoholism treatment.

The (Brain) Disease Model of Addiction

The brain disease model of addiction suggests that addiction is a chronic medical condition. By “chronic,” we just mean a disease that has constant, recurring symptoms that require long-term treatment, just like diabetes, which requires daily medication and care.

While it’s possible for chronic diseases to be cured, there is currently no known cure for addiction. This is why many treatment methods, including the 12 Steps of AA, focus on complete abstinence.

A “cured” individual would presumably be able to use their drug of choice without any issues and not become addicted to it. This is not possible for most addicts, no matter how long their disease has been in remission.

This is yet another reason it’s so important to understand addiction as a disease—doctors and scientists can get grants and investments that allow them to study a disease and attempt to cure it.

Many diseases are eventually cured—a moral failing or personal weakness can never be cured, and it definitely won’t have billions of dollars of research money being spent on it (as addiction research has today).

That research has already paid dividends, helping us to better understand how addiction works in the brain. Here are the key features of the brain disease model of addiction as it’s understood today.

Chronic Nature

Addiction involves cycles of relapse and remission that, with successful treatment, can be managed over time. This understanding helps individuals and healthcare providers focus on long-term strategies rather than quick fixes.

Genetic Predisposition

Research shows that genetics can play a significant role in an individual’s likelihood of developing an addiction. Studies indicate that people whose biological parents had an addiction problem may be anywhere from 100% to 800% more likely to develop addiction themselves.

Brain Changes

Addiction alters brain function, particularly in areas related to reward, motivation, and memory. These changes can make it challenging to resist cravings and maintain sobriety without intervention.

Environmental Influences

Stress, trauma, and exposure to substances can significantly impact the development of addiction. Environmental factors often interact with genetic predispositions, increasing vulnerability.

Brain Chemistry and Addiction: How Addiction Alters the Brain

Addiction fundamentally changes the brain’s chemistry. Substances like alcohol and drugs affect the brain’s reward system, releasing very high levels of dopamine, a neurotransmitter associated with pleasure and reward. The amounts released can be 10 times larger than normal, which causes a host of issues.

Reward System and Tolerance

Addictive substances overstimulate this system, leading to feelings of euphoria. Over time, the brain adjusts by reducing its sensitivity to dopamine, which is a part of the phenomenon known as tolerance—more dopamine (and therefore higher amounts of a user’s drug of choice) are needed to achieve the same feeling.

On top of this, the amount of dopamine produced by normal pleasurable activities, like exercise, eating, or sex, diminishes. This cycle reinforces substance use as individuals seek to recreate feelings that can no longer be found in normal life activities.

Dependence

Dependence occurs when the brain relies on the substance to function normally, causing withdrawal symptoms when not used. Adding to the confusion, some substances will not cause dependence, and it’s possible for an individual to still have substance use disorder even if they’re not physically addicted to their drug of choice.

Decision-Making and Impulse Control

Addiction affects the prefrontal cortex, impairing judgment and self-control, making it harder to resist cravings. This alteration can lead to risky behaviors and difficulty in stopping substance use. This also increases the risk of relapse, even after long periods of abstinence.

Sobriety and Brain Retraining

Achieving sobriety allows the brain to begin healing. Although challenging, this process is crucial for recovery.

Neuroplasticity

The brain has the ability to reorganize and form new neural connections—this is known as brain plasticity or neuroplasticity. Through sobriety, therapy, and healthy habits, individuals can retrain their brains to function without substances. This adaptability is key to overcoming addiction.

Regaining Pleasure

Over time, the brain can start to produce dopamine at normal levels again while also becoming more sensitive to it, allowing individuals to find joy in everyday activities. Engaging in hobbies, exercise, and social interactions can support this process.

Improved Decision-Making

As the brain heals, individuals often find improvements in their ability to make decisions and control impulses. Therapy and support groups like Alcoholics Anonymous can enhance these gains.

The Brain Disease Model of Addiction Helps More People Achieve and Maintain Sobriety

The disease model of addiction provides a framework for understanding and treating addiction as a chronic condition. By recognizing the role of brain chemistry, genetics, and environmental factors, we can approach treatment with empathy and evidence-based strategies.

If you or a loved one are struggling with addiction, we can help. Learn more about all our programs here, including intensive outpatient treatment and residential treatment (sober living).