Joe Biden has had some ups and downs in life. As a young Senator, his wife and infant daughter were killed in a car wreck. During his 1988 bid for the presidency, it was revealed he cribbed sections of other politicians' speeches. He had a life-threatening aneurism.
Whatever problems he has had and overcome, however, Biden is an addiction nut. Thus, his remarkable effort to compel government agencies to call addiction a disease, titled the "Recognizing Addiction as a Disease Act of 2007," has been introduced for debate in the United States Senate this month.
Biden's nutty, mistaken bill will rewrite government language regarding addiction and recovery. Outside of China, most technologically advanced countries don't pass bills announcing scientific truths. Einstein had to muddle along seeking recognition and acceptance of his ideas from the scientific community, while Galileo labored under the Catholic Church's declaring that his finding that the sun was the center of the solar system - not the earth - was doctrinally unsound.
Biden is seeking to replace the word substance "abuse," which suggests that addicts intentionally abuse substances. Well, some do. What about all the people who abuse substances who don't achieve the level of addiction (or "dependence"). DSM-IV (for which I was an advisor) divides substance use disorders into "abuse" and "dependence" categories, which is already a complex oversimplification.
And nearly all addicts are aware at various points in their careers that their use is excessive, negative, and dangerous - as a result of which many quit. Some do not, at least right away. But you can't capture this complexity by replacing the term "drug abuse" with "brain disease."
In fact, Biden's bill, while oversimplifying, self-consciously recognizes it is oversimplified (see below) - note such formulations in section (1) as "it is considered a brain disease," "scientists have identified many of the biological and environmental factors that contribute to" (let's not go out on a limb and say something definitive here). As for personal shame and social stigma in part (2), what if an addict kills a child in their care. Should they be ashamed? What if people quit addictions like smoking because they can't take the stigma of huddling in the courtyard with other smokers, or if addicts or alcoholics quit drugging or drinking because they don't want their children to be ashamed of them?
Here is the bill:
S. 1011: Recognizing Addiction as a Disease Act of 2007
Sponsor: Sen. Joseph Biden [D-DE]
Introduced: March 28, 2007
Schduled for Debate: August 1, 2007
(1) Addiction is a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain's structure and manner in which it functions. These brain changes can be long lasting, and can lead to the harmful behaviors seen in people who abuse drugs. The disease of addiction affects both brain and behavior, and scientists have identified many of the biological and environmental factors that contribute to the development and progression of the disease.
(2) The pejorative term "abuse" used in connection with diseases of addiction [note that part (1) itself speaks of "people who abuse drugs"] has the adverse effect of increasing social stigma and personal shame, both of which are so often barriers to an individual's decision to seek treatment.
I like Biden because he is independent, brave, hard-headed, and says what he believes. But isn't this bill getting into totalitarian territory, declaring what researchers and clinicians may call and regard a problem? I have never, and will never call addiction a brain disease (although once HBO joined with the National Institute on Drug Abuse in declaring this God's truth it amounted to an official coronation).
When Jeff Schaler got me kicked off the St. John's server (including addiction groups on whose boards I served) after I disagreed with how he handled opponents to our anti-disease views on the Controlled Drinking/Drug Use Listserv, I thought I was as much in Siberia as I was likely to get. But now I suppose the government could declare my views on addiction illegal and confiscate my computer. However, even if they put me on the rack I won't say addiction is a brain disease -- you have to stand for something.