The " Who decides what is a "disease"? In America the public does not vote on this. Elected politicians do not make their voices known in this regard. In fact, it is a very few number of people who are granted the power to decide what a disease is or is not. In the medical field that power might be the American Medical Association. In the psychological world and mental health department that might be the American Psychiatric Association or the authors of the DSM (Diagnostic and Statistical Manual of Mental Disorders).
We have seen how this enormous use of power to name something has come to have major consequences in our society. Naming an illness is not always because a new illness was discovered. Often there are political or economic reasons why a new disease has come to light. For instance, in the early 1980's we saw a new series of diseases pop up that we had not seen before. This new set of disease was called HIV and AIDS.
We have also seen pre-existing conditions like stress and anxiety to be renamed as Anxiety Disorder. This was a way to sell more "anxiety reducing" drugs now that something had an illness label attached to it. We have seen something as innocent as "impotence" be rebranded as ED (Erectile Dysfunction). Yes, we now have a drug for that male "disease". Before it was just an unfortunate condition. Now it is a disease.
We have seen this same rebranding in the addiction sphere. In the last few years the authorities who hold power over names have reclassified addiction as a disease. What was once a condition where some people made bad choices now became an evil biological mistake within the human body. Some people were reported to have this new disease and others were free of it. With this new classification comes new standards, perceptions and outcomes.
Like most higher level decisions, if you were to follow the money trail you would find why decisions have been made the way they have. In the case of shifting the world of addictions from a case of bad choices to one of a biological disease, you will find where the profit leads you.
First off, medical doctors can now have power over the addiction field. They can make determinations, help set up policies and review guidelines. They become the authority in the matter. They will also make lots of money with this new definition. You now have to be treated by a medical team if you are determined to be a heroin addict or an alcoholic because you are now labeled with a medical condition.
Because of the Affordable Care Act (Obamacare), most health insurance companies are now mandated to provide for addiction recovery. This could mean "in house" doctor's visits or monthly residential detox facilities. We have seen over the last few years this surge in residential detox facilities sprouting up in neighborhoods from the shores of Laguna Beach to the enclaves of Santa Barbara. If you are arrested for a crime where there are drugs involved, ( to pay for your drug habit), a judge might give you the choice to go to rehab or go to jail. Instead of sitting in a 10 x 15 foot jail cell for months on end you can now go to a beach resort detox facility and the insurance company will have to pay for it. Who wouldn't want that deal? You are told that you are sick and have a disease and jail is not the place for you. This just shifts the financial responsibility from the criminal justice system to the health insurance system where everyone with a health insurance policy is now paying for someone's bad choices.
Just as we have patholigized emotions we have also done this with addictions. We have made anger an evil emotion. The scientific community has made grief an illness. Addictions have found their way in the same course. We are now told that it is not your fault and that some people have a genetic illness that forces them to drink, smoke or snort. We are still told this even though these mysterious genes have never been identified.
Medical doctors have almost no business in the world of addictions because it is not a medical issue; it is an emotional issue. When we choose not to feel our emotions we find something to self-medicate ourselves with. The only time a medical doctor might be useful in the addiction field is when someone is detoxing from a physically dependent drug like heroin. A person could die from coming off these drugs "cold turkey" because their body has now become physically dependent on them. A doctor's help in drug therapy would be helpful in this case and this is one of the few times medical intervention is necessary.
When you medicalize something like addictions you can now shift blame away from yourself and on to something else. This shift is now blaming your supposed defective body. When we claim to have a physical or mental disease we feel released from any responsibility.
You can even eliminate a disease or create a new one just with a name change. For instance, polio was widely recognized as being cured by the intervention of the polio vaccine. What most people do not realize is that people still acquired polio after the polio vaccine was introduced (even those who had been vaccinated against it) but the medical community was instructed to stop calling it polio. Names like "infantile paralysis" began to appear to describe those who had polio.
Just the same, when you can rename addictions as being a biological defect you now have created a whole new class of diseases. You have opened up "Pandora's Box" to believing that your body is creating a horrible biology for you. In essence, the name change has now made you sick.
As we have medicalized alcoholism for instance, it is now very difficult to fire an employee who might come to work drunk or drink on the job. It is illegal in many states to fire someone because of an illness alone. Employers find it much more difficult to get rid of troubled employees now that alcoholism in many states is categorized as a disease rather than a choice.
Medicalizing something that is not a medical condition only brings profits to some and lack of responsibility to most. We have demonized our emotions as evil and have created diseases by a name change alone. The medicalization of our world has become hugely profitable for many but has solved nothing. The power to name something is the power to control its destiny. Maybe it is time for some new names.
May 14, 2013
Oct 8, 2007
by Thomas Szasz
Jun 12, 2015