When psychiatrist Tim Holden published his 2012 letter in the Canadian Medical Association Journal (CMAJ) boldly titled “Addiction is not a disease,” he did more than provoke debate. He inadvertently illustrated the heart of the problem: our assumptions about addiction (already a contentious term) often hinge on the even more slippery term, “disease” – a word that carries cultural, clinical, and moral weight, but remains surprisingly difficult to define.
Holden argued that addiction is not a disease because it lacks measurable pathology, is self-inflicted, and can be “cured” simply by removing access to the substance. But each of these points reveals a misunderstanding of both the nature of addiction and of the term “disease” itself. In this rebuttal, I aim to unpack Holden’s claims, examine their logical flaws, and offer a more nuanced, evidence-based framework – one that doesn’t reduce addiction to moral failure or dismiss the realities of treatment science.
Click HERE or click the image below to access the PDF. As always, comments and feedback are welcomed and appreciated!
