The disease model of addiction – where did this concept come from and how does it help addicts to recover? In this article, we consider how the 20th century framing of addiction as a disease has contributed to advances in scientific research and patients’ access to treatment.
Yet, there’s also a case for moving beyond the definition of addiction as a chronic disease – including the potential to empower addicts to reclaim their health and well being.
The Emergence of the Disease Concept of Addiction
In the 20th century, the conceptualisation of addiction as a disease first came about in the United States – partly due to the expansion of the Narcotics Anonymous fellowship. The very first NA literature from 1956 defines addiction as ‘a disease, just like alcoholism, diabetes, tuberculosis, heart trouble or cancer.’ 
The idea of addiction as a disease gained further credibility with backing from organisations including the American Society for Addiction Medicine, the World Health Organisation and the National Institute for Mental Health. This helped to improve patients’ access to addiction treatment, opening up funding from medical insurers in the USA. This gave rise to the proliferation of residential and outpatient treatment services in the USA and beyond, as well as international growth of peer support groups for addiction.
It was the beginnings of a shift in how western society viewed addiction – rather than being seen as immoral, insane or criminal, addicts could be better supported as patients with a treatable disease. They were unwell but they could recover, particularly if they had access to specialist treatment and support.
Moving Beyond the Disease Model of Addiction
Jason Shiers, Psychotherapist at UK Addiction Treatment, says: ‘Without a doubt, the disease concept of addiction has helped countless people to access specialist addiction treatment worldwide. Insurers have terminology they can work with to fund treatment including drug and alcohol detox and rehab. Research into addiction and treatment methodologies has abounded, adding to the global knowledge and skills base. Today, clinicians can prescribe well-evidenced detoxification protocols and psychotherapists are schooled in techniques that unquestionably contribute to positive health and well being outcomes.’
Shiers also believes it can be helpful to view addiction from a very different perspective. ‘We need to be really clear about the main purpose of addiction treatment. Of course, it’s vital to support people to identify and cease their destructive habits. But what we’re really aiming for is to inspire lasting transformation – specifically, a state of mind that will render all addictive substances and processes less appealing or redundant. At the right stage, it can be beneficial to support people to look beyond the concept of disease, so they can understand themselves as innately healthy and able.’
For a deep dive into the history, psychology and interpretations of addiction, please visit the UK Addiction Treatment website.
If you’re concerned about addiction, please request an addiction assessment via you GP or an addiction treatment advisor.