Thursday, September 6, 2007

What's in a name?

I just heard about a bill in congress to recognize drug and alcohol abuse as an addiction. S.1011 and H.R.1348 both move to change the names of the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) to the National Institute on Disease of Addiction and the National Institute on Alcohol Disorders and Health respectively.

A Slate article by Sally Satel and Scott Lilienfeld brought this bill to my attention, and I agree with their position that viewing addiction as a disease is a bad idea. (Read the article here)

The text of the Senate bill reads in part, "Addiction is a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences."

Renaming the two institutes might be a fairly benign action that goes unoticed by many, but this establishes some bad principles. Calling something a disease removes personal responsibilty allowing someone to play a victim to his/her "disease" of addiction. And though the bill indicates that the term "abuse" is pejorative and can prevent someone from seeking treatment, I would think that calling something a disease might lead someone to think the cure was another's responsiblity and further hinder the chance of getting sober. I'm sure there is legitimate debate about these terms, but I wonder why Congress needs to take a stand?

I consider also that new addictions seem to be cropping up all over the place---I have heard of video game addictions, of TV addictions, even carb addictions---and of course addiction to pornography. Will we eventually be asked to consider all of these diseases? I wonder also how such a move might affect employment hiring and firing practices. If one's addiction is a disease, might the employer be obligated to provide sick leave or other benefits for behaviors that would otherwise lead to firing?

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