Addiction as an Allergy

Sean Levine wrote this in Rehabilitation on Wednesday, July 16, 2014

The primary text of Alcoholics Anonymous, informally referred to as “The Big Book,” opens with a section called “The Doctor’s Opinion.” Written by William D. Silkworth, a doctor who had specialized in treating alcoholic addiction in New York for years, the Doctor’s Opinion claims

“…that the actionof alcohol on these chronic alcoholics is a manifestation of an allergy; that the phenomenon of craving is limited to this class and never occurs in the average temperate drinker. These allergic types can never safely use alcohol in any form at all…”

The allergy concept has become the basis for much substance abuse treatment, which of course includes drugs in addition to alcohol. Though most addicts are probably laymen, they don’t need years in medical school to appreciate the description of addiction as an “allergy.” It makes perfect sense to anyone who’s experienced addiction firsthand.

What exactly is an allergy? It means an adverse reaction, one that is experienced by only a fraction of society. Take peanut allergies, for example. Peanuts pose no danger to the majority of people in the world, yet they are deadly to the unlucky few who are allergic to them. Addiction may not require us to carry an epi pen, but it works exactly the same way. Drugs and alcohol work differently for addicts than they do for most people. Most people do not black out every single time they go to the bar. Most people don’t wake up with an overdrawn bank account and a pocket full of ATM receipts. These kinds of reactions are exclusive to addiction.

If, like peanuts, addiction is an allergy, then the Doctor’s warning to stay away from drugs and alcohol makes sense. The only way to prevent an allergic reaction is to avoid it at all costs. Unfortunately, things are not so easy with addiction. Unlike peanuts, our minds are constantly trying to convince us that we’re not allergic — despite all the evidence to the contrary. That’s why overcoming addiction requires so many resources. Alcoholics need alcohol detox and drug addicts need drug detox, then each of these is followed by some form of addiction treatment and/or addiction therapy.