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What is addiction?

WORLD SERVICE BOARD OF TRUSTEES BULLETIN #17

What is addiction?

The World Service Board of Trustees developed the "What is Addiction" essay during the 1988-1989 conference year.  It was revised during the 1995-96 conference year. 

The task of defining addiction has challenged physicians, judges, clergy, addicts, their families, and the general public throughout history.  There are as many potential definitions as there are groups with an interest in defining addiction.  These definitions emphasize such things as physiological dependence, psychological dependence, family dynamics, behavioral problems, and morality.  This list could be expanded at length, and NA could come up with its own definition and add it to the list.  Fortunately, Tradition Ten steers us away from such public debates.  Clearly, debating such issues is not NA's task.  Our task is to carry the message of recovery to the addict who still suffers.

Still, defining addiction for ourselves is certainly important to the process of recovery.  After all, in our First Step we admit powerlessness over it.  That admission is the foundation upon which our recovery is built.  So the question, "What is addiction?" is relevant indeed; the fellowship has a responsibility to consider it carefully.

This discussion will not include a restatement of our fellowship's broadest understanding of what addiction is.  That may be found in the Basic Text, especially in the chapter "Who is an Addict?"  Instead, we will focus on a few difficult issues that the World Service Board of Trustees has been asked to consider.

Is Addiction a Disease?

This is one of those questions about addiction that is difficult to answer.  There is much public debate over the question of whether addiction is a disease, and we do not choose to become involved in this debate.  However, it is our fellowship's collective experience and understanding that addiction is, in fact, a disease.  We have no reason to challenge that perception now.  It has served us well.

Our experience with addiction is that when we accept that it is a disease over which we are powerless, such surrender provides a basis for recovery through the Twelve Steps. The number of NA members living in freedom from active addiction show that this philosophy has worked for us.  So even though we as a fellowship are not in a position to argue what is or is not a disease in the strictest medical sense, we are fully confident that our use of the word "disease" in describing our condition is appropriate.

This is the key point:  professional people in fields like medicine, religion, psychiatry, law, and law enforcement define addiction in terms that are appropriate to their areas of concern.  So do we.  Narcotics Anonymous defines addiction for the purpose of providing recovery from it. We treat addiction as a disease because that makes sense to us and it works.  We have no need to press the issue any farther than that.

Does "Addiction" Mean Only Drug Addiction? 

What about other kinds of addiction?  By the word "addiction" we do, in  fact, mean "drug addiction."  Our Third Tradition says, "The only requirement for membership is a desire to stop using."  Clearly, we mean "... a desire to stop using drugs."

As a fellowship, we place much importance on the fact that we have shifted the focus of our steps off any specific drug and onto the addiction itself. We have done that by wording Step One "powerless over our addiction" rather than "powerless over drugs" or "powerless over narcotics."  Any wording of Step One which named specific drugs, or drugs at all, would have stated the principle with much less power than our current wording does.

If we were to broaden our focus beyond drug addiction to include other types of addiction, we believe we would seriously damage the atmosphere of identification in our meetings. The balance we strive for is a delicate one.  On the one hand, we must understand our First Step well enough to keep our sharing at meetings focused on the disease of addiction, not on specific drugs.  That way our focus is broad enough to include all drug addicts.  On the other hand, we must keep our focus specific enough to provide clear identification for our new members. 

Why is Our Fellowship Named After a Specific Category of Drugs, Then?

Since it is true that we attempt not to focus on any particular drugs in our meetings, many members have questioned why we are called Narcotics Anonymous. Wouldn't Addicts Anonymous or Drug Addicts Anonymous have been a more appropriate title?

The name of our program does seem incongruous with our philosophy and with the varied nature of our membership. In fact, when our fellowship first formed, we called ourselves "Addicts Anonymous."  Two separate fellowships, both calling themselves "AA" was not such a clean break, though.  So our founders chose the name Narcotics Anonymous.  At the time, "narcotics" referred to all drug categories, and so "Narcotics Anonymous" was a reasonable choice as the name of our fellowship.  The original title, then, did reflect our philosophy of not being focused on a specific drug or drugs.  Unfortunately, the word narcotics later became associated with a particular drug category.

As our message is translated into other languages, a dilemma occurs.  Sometimes "Narcotics Anonymous" is being translated into "Addicts Anonymous" or "Drug Addicts Anonymous" because the local translating committees understand the philosophy of our program.  Other times, a new word is created in a language to preserve a stricter translation of our name.  And sometimes "Narcotics Anonymous" is translated literally.  What has seemed important to us is that the spirit of the NA message be maintained in these translations and that the program, by message and by name, be recognizable regardless of the language used.

Afterward

The essay is intended to stimulate members' thinking discussion about the nature of addiction. As members awaken spiritually and share with one another, the answers get woven into the fabric of the fellowship's conventional wisdom.  Then, just when our thinking begins to harden into dogma, another generation comes along to challenge us and keep our perspective fresh.

We urge NA members to remain open-minded and flexible. It is important to look to our literature and our experienced members for guidance, but ultimately each member has the right to understand and apply this program in the way that works best for her or him.

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