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


Address correspondence to Dr. Lawrence, Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, 1051 Riverside Drive, Box 90, New York, NY 10032. E-mail:


Background and Objectives

Society debates whether addiction is a disease, a response to psychological woundedness, or moral failing.


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.”


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. (Am J Addict 2013; 22:255–260)