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 www.diabetes.ca or www.diabetes.org 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
www.TorontoPsychotherapyCentre.com