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Addiction as a Disease: The Parallel with Type-2 Diabetes

January 23, 2011

I had planned on writing about the Social Model of addictions – how our socialization and learning contributes to the development of addictions. However, just this past week our newspapers here in Canada announced that Brian Mulroney (a former Canadian Prime Minister) had developed Type-2 diabetes. In reading about this story, I immediately began to think about how the onset of Type-2 diabetes exemplifies the disease (or biological) model of addiction. Also, given that people expressed interest on the biological model of addiction, I thought I would add a few more thoughts on the topic.

Diabetes: Type-1 vs. Type-2
Type-1 diabetes is caused by genetic or hereditary factors alone. It is not preventable and is not caused by what the individual eats. In fact, many people who develop Type-1 diabetes can be very healthy. It is purely a result of cells in the pancreas being unable to produce insulin (Visit or for more information). Type-2 diabetes, however, is caused by a combination of environmental influence and genetic factors. The individual must have some genetic predisposition to diabetes (a family history), while also being exposed either to a lifestyle or an environmental influence that complicates their body’s breakdown of natural sugars (e.g., lack of exercise, poor diet, obesity, illness). To summarize, the development of Type-1 diabetes is more likely to occur from genetics alone, whereas Type-2 diabetes results from an interaction between genetics and environment.

Mulroney suffered from a serious pancreatic illness in 2005 and then contracted hepatitis E over the summer. The contraction of these two illnesses speaks to the influence of environment in the development of disease. Unbeknown to him, something that entered his body from the outside (an influence from the environment) interacted with his physiology, or genetics. In much the same way, people who drink or use drugs (environment) and have a family history of addiction (heredity) are more likely to develop the disease than those who only drink but have no family history of addiction.

In summary, you can be born with the predisposition to contracting diabetes (or addiction), but you can lead a lifestyle that never allows it to develop. Unfortunately, while someone can make the choice of whether or not to use alcohol or drugs, they often cannot choose the environment, or family, they are born into.

Richard Amaral

  1. Thank you for that perspective Dr. Amaral. It is interesting to note both of these conditions have origins based on genetics and the environment. As a registered nurse, I have noticed similarities in the behavioral aspect of patients living with chronic disease, and those living with addictions. Both types of patients are at risk of long term complications related to their condition, however, changes in their behavior can often prevent or delay those complications. Whether it be changes in diet, activity level, or medication compliance, or abstinence from an addiction.

    • Hello, DR, and thanks for your comment. I appreciate your perspective on chronic disease management, particularly as it relates to the topic of addiction. I also wanted to echo the importance of changing behaviour as a way of preventing or delaying the onset of the disease. Great point.

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