I was just asked, “How is drug addiction is similar to heart disease”, on a Foundations of Addiction’s homework assignment and was surprised at how similar they are.  Here are my thoughts:

Both drug addiction and heart disease start with behaviors that ultimately lead to the development of the condition. With drug addiction this is the use of drugs in an experimental or social pattern. With heart disease this is the unconscious eating of food, refraining from regular exercise, and other behaviors such as smoking cigarettes.

In neither case does the person believe that their actions could lead to a problem, and even if they have some forethought, there is a tendency for them to minimize the possible consequences in their mind.  A friend, who is studying the effect of time on decision making at Wharton School of Business, reminds me that the further off the possible consequence the less value the consequence has.  With drug use, most early users do not even entertain the possibility of becoming addicted, while with people making poor diet and lifestyle choices the consequences are so far in the future they also seem like an improbability.

Both diseases have a genetic component as well. Addiction and heart disease tend to run in families. This predisposition means that the same type and level of use in the future addict or cardiac patient may not result in the development of disease in others when they use at that level. This reality, coupled with the time delay in the progression of the illnesses, contributes to the ability of a person to deny that their behaviors are creating problems.

In addition, both diseases are multifaceted. Heart disease results from a combination of factors including behavioral, genetic, environmental, and social.  In addition, since food addiction and cigarette addiction are risk factors for heart disease, the same psychological issues that lead to any addiction can contribute to heart disease.

We also know now that some addictions lead to hard to reverse changes in how the brain works, much like the damage of a heart attack tends to be permanent. The organs affected may be different, but the seriousness of the illnesses are the same.  Although, I would be remiss not to mention that some addictions lead to cardiovascular issues such as heart failure and stroke.

Indeed, it appears that the two diseases in terms of fundamental etiology, are more similar than they are different.