What is addiction? Part 3

In my first two posts we discussed how addiction is a chronic, primary disease. We are now going to discuss the progressive nature of addiction.

Simply put, if allowed to remain active, the effects of addiction will get more severe over time. This is true of most chronic diseases. Let’s look back at our example of type 1 diabetes. Without proper treatment, diabetes will damage the circulatory and nervous systems of the body, along with several vital organs. Typical results of untreated diabetes include amputations, blindness, renal failure, and eventually death.

What make the progressive effects of addiction unique are the various aspects of a patient’s life that are affected. For many people, active addiction affects relationships, professional and work life, legal status, socioeconomic status, along with the physical effects. These consequences are a main reason there is so much misunderstanding about the nature and cause of addiction. After all, how many other illnesses cause such extensive personal destruction? It’s understandable to look at someone whose disease has caused family breakups, financial hardships, loss of careers, arrests, or children being taken out of the home by child protection agencies, and believing that this person is just immoral, uncaring and extremely selfish. If that is true, why do most people in recovery retake their place in society as law-abiders, caring parents, and hardworking providers for their families? My experience working in this field has convinced me that my patients are not bad people trying to be good, but sick people trying to get better. It’s the active phase of their disease that results in these consequences[1]. Patients are not their disease, but are profoundly affected by active addiction.

Let’s look at a typical example of the progressive nature of one MER[2]: alcohol. Patients may try alcohol for the first time in their early teens, and quickly start drinking for effect. They will soon experience getting drunk on a regular basis, blacking out, and doing embarrassing things while drinking.

The patient may discover that it is becoming harder to control his or her drinking. Predetermined limits on how much to drink become very hard to abide by. I have had patients report to me, that at this point in the disease it is easier to not drink at all then to try and limit oneself to only three or four drinks in an evening. This is when the “cycle of compulsive use” starts to manifest itself. Family members and friends begin to notice that the patient’s drinking is becoming problematic and may urge the patient to “slow down.”

As the patient passes through this stage more consequences become apparent. Perhaps the patient is starting to drink on weekdays or during the day. Drinking may start to affect job performance, resulting in reprimands or firing. Legal issues may arise, such as public drunkenness, fighting or DUIs. Interpersonal relationships become strained: partners get angry and frustrated, and children get worried and become embarrassed and upset at the home situation. In many cases the family creates strategies and roles that allow everyone to accommodate the reality of a family member’s addiction.

Perhaps the patient is a functional alcoholic and holds a job and is able to maintain a sense of personal continuity. That level of functioning can last for many years. But in many instances maintaining any type of successful life performance is short lived. Either way, the person’s alcoholism is affecting the body in profound ways. These include: liver damage, jaundice, tremors, internal bleeding of the stomach and esophagus, high blood pressure, higher instances of some cancers, getting sicker more often and longer recuperation times, heart attacks and strokes. These are just some of the physical consequences of moderate to advanced alcoholism. In end stage alcoholism, we see cirrhosis of the liver and profound neurological damage.


Addiction to other substances, basically, takes the same course. Early use develops into regular use, develops into uncontrollable use, which then takes over the patient. As the disease progresses, the patient probably experiences wrecked relationships, legal problems, occupational or educational difficulties, and is at increased risk for a whole host of physical and psychological consequences.

Some addiction related causes of death include, cirrhosis, overdose and alcohol/drug poisoning. However, statistics related to the fatal nature of addiction can be misleading. Many times the recorded cause of death does not indicate addiction. For example, it may be a stroke, liver failure, a heart attack, a car accident, or suicide. In such cases, the family and close friends know the real cause of death.

I don’t want to end this blog on such a sad note. Yes, addiction is a chronic, progressive and fatal disease, but it is very effectively treated. Over 20 million Americans today are in long-term recovery. No one has to endure the pain of active addiction. If you or a loved one is suffering with addiction, please speak to a professional about treatment options. If you have tried before and have relapsed, try again. Most people in long-term recovery have had to recuperate from several relapses before entering long-term recovery.

In upcoming posts, I will discuss the latest trends in treatment and how to evaluate treatment options.


[1] I will cover the three phases of addiction in a later post.

[2] Most Effective Reward, a more accurate term for what used to be called Drug of Choice. I will discuss why the language we use, when discussing addiction and recovery, is so important in a later post.

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