You don’t need to have experienced drug addiction first-hand to know that it can lead a person to act in erratic, reckless, and often dangerous ways. These behaviors and impulses can resemble those of a person with psychiatric disturbances. While there are plenty of things that can be said about the destructive nature of drug addiction and how it can alter our behavior in strange ways, is that enough for compulsive substance abuse to be considered a true mental illness?

Why addiction can cause strange behavior

According to the American Psychiatric Association, mental illness is defined as “health conditions involving changes in emotion, thinking, or behavior” that “can be associated with problems functioning in social, work, or family life”. By all accounts, this certainly sounds like an addiction. 

Drug addiction causes a number of psychological and physiological changes in the body–most notably, it quite literally rewires the brain. Repeated exposure to drugs or addictive behaviors can alter the brain’s reward system, motivation, and decision-making processes. As a result, the usual self-preservation instincts go by the wayside. Afflicted individuals may eventually find themselves shirking work, shelter, and even family ties in their pursuit of chemical stimulation – at seemingly any cost

Financial hardship and self-inflicted social isolation aren’t the only hardships they face. Another defining characteristic of destructive drug use is the insistence on continuing the consumption of substances in the face of the dangers to one’s health, with death being a very real possibility. Malnutrition is a common malady in drug addicts because drug use becomes more valuable than food. 

Is addiction a mental illness? 

Yes, addiction is considered a mental illness. This is primarily determined by its inclusion in the  Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM is the definitive text on mental disorders, a widely recognized and extensively used classification system for mental health professionals, and provides a standardized framework for diagnosing and treating mental health conditions. 

What the DSM says, goes. Take, for instance, internet addiction, a growing concern to which millions of people, especially youths, are believed to be afflicted. It displays many classic behavioral side effects of addiction, but because it is not included in the DSM, it is not recognized as a legitimate addiction (though this is hotly contested). Gambling addiction, on the other hand, is the only non-substance-related disorder included as an ‘addiction’ and because of this may have different methods of treatment or more options available. Therefore, since the DSM includes drug addiction in its pages, drug use disorders are officially established as a type of mental disorder. 

Addiction can be classified another way too

However, addiction can also be classified as a brain disease as well. The National Institute on Drug Abuse (NIDA), a federal scientific research institute and the world’s largest funder of biomedical research on drug use and addiction, likens the condition to that of other chronic disorders such as asthma, diabetes, and cancer. 

Like those, drug addiction often follows a relapsing pattern, with periods of abstinence followed by a recurrence of drug use or addictive behaviors. This relapse vulnerability is attributed to the long-lasting brain changes associated with addiction, which can trigger a return to drug seeking and use even after periods of recovery.

Why addiction’s classification matters

Inclusion in the DSM can have significant implications for insurance coverage and access to mental health services impacting insurance coverage and reimbursement for treatment. Insurance companies and healthcare systems often rely on the DSM to determine eligibility for coverage, treatment reimbursement, and how resources are allocated. Therefore, having a condition listed in the DSM may facilitate easier access to treatment and support services.

Standardized diagnostic criteria also ensure fairness, equity, and consistent access to necessary treatments and support services. This is important for ensuring proper diagnosis and consistent care. 

NIDA’s stance helps to reduce stigma, promote understanding, and foster support for individuals who are affected by addiction. This perspective encourages a public health approach to addiction rather than it being a criminal justice or moral issue, focusing on prevention, early intervention, and treatment rather than punitive measures. 

It also highlights the need for a public health approach to address the societal impact of addiction and the importance of early intervention and access to treatment services with a compassionate and supportive approach. If you or a loved one is struggling with drug addiction, there is no shame in reaching out for help. Talk to a mental health professional today.