Physicians' Beliefs about the Nature of Addiction: A Survey of Primary Care Physicians and Psychiatrists

BACKGROUND AND OBJECTIVES: Society debates whether addiction is a disease, a response to psychological woundedness, or moral failing. METHOD: We surveyed a national sample of 1427 US primary care physicians (PCPs) and 487 psychiatrists, asking "In your judgment, to what extent is alcoholism/drug addiction each of the following? A) a disease B) a response to psychological woundedness C) a result of moral failings." RESULTS: The response rate was 63% for PCPs and 64% for psychiatrists. More psychiatrists than PCPs consider addiction a disease (64% versus 56%). Some PCPs (31%) and psychiatrists (27%) attribute addiction to psychological woundedness. More psychiatrists than PCPs said addiction is "not at all" due to moral failings (55% versus 39%). CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: The disease model for addiction is prominent among physicians, but exists alongside beliefs that addiction is a response to psychological woundedness, or a result of moral failings.