Addiction as a Disease Is More Complicated, Researchers Find

Research finds that people with substance-use problems who read a message describing addiction as a disease are less likely to report wanting to engage in effective therapies, compared to those who read a message that addiction behaviors are subject to change. The finding could inform future public and interpersonal communication efforts regarding addiction.

"When we began talking about addiction as a disease, the goal was to decrease stigma and encourage treatment," says Sarah Desmarais, coauthor of a paper on the work and an associate professor of psychology at North Carolina State University. "That worked, to an extent, but an unforeseen byproduct was that some people experiencing addiction felt like they had less agency; people with diseases have no control over them."

"We wanted to see if an alternative message aimed at changing that mindset could affect how people with substance-use problems viewed themselves with regard to addiction," says Jeni Burnette, first author of the paper and an associate professor of psychology at NC State. "Specifically, we focused on using a growth mindset message. The growth mindset message stresses that human attributes are malleable, and we know from previous work that it encourages better self-regulatory strategies such as seeking helping from others."

Growth Mindset Message

For this study, the researchers enrolled 214 men and women who screened as positive for substance-use problems. One hundred and twenty-four of the study participants received the growth mindset message, whereas 90 participants received the message that addiction is a disease. The growth mindset article described various factors that can contribute to substance abuse, and stressed that there are multiple ways for people to address their addiction. The disease article described the changes in the brain that take place during addiction.

After reading their respective articles, participants in both groups completed a survey that asked them about how much they felt they could change their substance abuse; how confident they were in their ability to address the problem; how much they blamed themselves for their substance abuse; and the extent to which they planned to seek several types of treatment for addiction.

The researchers found that study participants who received the growth mindset message reported stronger growth mindsets and more confidence in their ability to handle their addiction, relative to the study participants who received the disease message. Importantly, there was no difference between the two groups regarding the extent to which they blamed themselves for their addiction.

Confident They Can Change

"These findings are good news," Desmarais says. "We want people to feel empowered and confident to change their behavior, but not to feel guilty about it."

Additionally, participants in the growth mindset message group reported stronger intentions to seek counseling or cognitive-behavioral therapy, compared to the participants who got the disease message. There was no difference between groups when it came to seeking pharmacological treatment for addiction.

"It's promising to see the growth mindset group express a greater willingness to seek treatment via counseling or cognitive-behavioral therapy," Desmarais says. "And the lack of difference between groups on medication treatment is also good news, because it reflects the fact that both groups equally appreciate the medical aspects of addiction.

Potential Interventions

"Overall, our findings support moving away from messaging about addiction solely as a disease," Desmarais says. "It's more complicated than that. Instead, the finding suggests that it would be more helpful to talk about the many different reasons people become addicted."

"The findings also highlight the potential to use growth mindset interventions to help substance users engage in effective treatments," Burnette notes.

Source: Burnette JL, et al. "Mindsets of Addiction: Implications for Treatment Intentions." Journal of Social and Clinical Psychology, May 2019

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