It depends on why they are abstaining from the substance! I am copying my reply to your other comment as it is relevant here, too:

"Chemical dependence is a necessary but insufficient precondition for addiction. Addiction is a biopsychosocial disorder & one needs a particular constellation of biological, psychological, & sociological symptoms or risk factors to be diagnosed...
...Being chemically dependent on something doesn't necessarily mean you're addicted to it.
Take the example I wrote about elsewhere in this thread. I am chemically dependent on my antidepressants. Meaning, if I stopped taking them, I would experience deleterious physical symptoms. However, I am not "addicted" to these medications as such, because, for one, I am not abusing them [I take them as prescribed], & taking these medications does not impact my ability to live my life or meet social or familial obligations, &c.
So, chemical dependence needs to be present to diagnose a substance use disorder, but chemical dependence on its own is insufficient to meet the criteria of substance use disorder."

Chemical dependence is a necessary but insufficient precondition for addiction. Addiction is a biopsychosocial disorder & one needs a particular constellation of biological, psychological, & sociological symptoms or risk factors to be diagnosed.

Anyone who says that addiction is purely biological, or purely psychological is missing part of the puzzle.

Being chemically dependent on something doesn't necessarily mean you're addicted to it.

Take the example I wrote about elsewhere in this thread. I am chemically dependent on my antidepressants. Meaning, if I stopped taking them, I would experience deleterious physical symptoms. However, I am not "addicted" to these medications as such, because, for one, I am not abusing them [I take them as prescribed], & taking these medications does not impact my ability to live my life or meet social or familial obligations, &c.

So, chemical dependence needs to be present to diagnose a substance use disorder, but chemical dependence on its own is insufficient in terms of meeting the criteria of substance use disorder.

Addiction & substance use disorder are different, too. Eating disorders are process/behavioral addictions, but not substance use disorders as there is no, well, substance involved per se.

I would, except that is not what I said, nor was it the point of my comment. Your retrograde defensiveness over whose addiction is "real" clouded your ability to understand what I was trying to point out. Moreover, chemical dependence is not the only thing that drives addictive behavior, but I suspect you were not replying in good faith.

Except that there are neurological changes to the brain in people who are addicted to food that mirror those present when someone is addicted to a substance. The pathology creates neurological changes, not necessarily the substance itself. It is easier for us to accept chemical dependence as more legitimate only because of our social history with pharmaceuticals, but people with eating disorders, for example, display brain changes, too!

Thanks for explaining this! I will look into this more as my research only looks at genetics in terms of their role in predisposition rather than expression. Interesting!

There is also a lot of conflicting research on the efficacy of AA & NA. While these programs saved my life, some research suggests that their success rate is much lower than previously thought & rather, it is AA/NA's dominance, & the paucity of other available treatment options that leads to its perceived efficacy.

Something else about these programs is their tautological approach. If AA works for you, you're an alcoholic, if it doesn't, it is either because you didn't work the program or because you could actually "drink like a gentleman," aka you weren't an alcoholic in the first place.

What this does is taint the sample such that only those who find success in AA are counted, whereas those that don't are dismissed as not qualifying for the program. It makes it hard to get accurate statistics on how successful AA is compared to other treatment options.

Yes, there are a lot of effective pharmacological treatments for opioid use disorder, but these treatments only address the biological aspect of this particular addiction. Any treatment modality that does not address the full biopsychosocial spectrum of factors will not succeed on its own.

Correct. I am dependent on my antidepressants, & if I stopped taking them, I would experience unfun physiological symptoms, but I am not "addicted" to my antidepressants.

This difference between dependence & addiction led to some confusion during the first wave of the opioid crisis; many people were displaying the physiological symptoms of opioid dependence without the social or behavioral aspects that also need to be present to formally diagnose a substance use disorder. But this is a whole other can of worms, honestly!

Genetic predisposition is only one aspect of addiction. There are still psychological & sociological risk factors that need to be taken into account if we want to "cure" it, though I am not convinced that "curing" addiction is what the goal should be as the language of a cure belies the necessity to raise people's social circumstances, which isn't as sexy as, say, a genetic intervention that doesn't require us to question the allocation of resources & services under capitalism.

The idea that there are two types of addiction is not supported in the research or literature on addiction. It is true that there are both physiological & psychological aspects to some substance use disorders, but not all addictions come with withdrawal, for example.

The most current understanding of addiction is that it is a biopsychosocial disorder. Meaning there are biological, psychological, & sociological aspects to any addiction.

There is also a lot of conflicting research on the efficacy of AA & NA. While these programs saved my life, some research suggests that their success rate is much lower than previously thought & rather, it is AA/NA's dominance, & the paucity of other available treatment options that leads to its perceived efficacy.

I think looking for a "cure" is the incorrect approach, to be honest. It would make more sense to aim to mitigate the risk & predisposition of addiction while making biopsychosocial treatment modalities accessible & free.

source: 10 years of sobriety, working on Ph.D. in sociology & addiction studies

Addiction is a biopsychosocial disorder, meaning there are biological, psychological, & social factors that contribute to its predisposition & manifestation. Any treatment that does not address these three prongs will not succeed. For example, a purely pharmacological treatment that does not address the social condition of unaffordable housing is unlikely to lead to contiguous recovery.

This is why addiction, especially substance use disorder [SUD], is nefariously difficult to treat & prevent. It is inherently extremely complex & requires the cooperation of many often disarticulated fields [social work, psychiatry/psychology, medicine, &c.]. The U.S. does not have a robust system in place to adequately foster this type of multipronged treatment, but it should.

The best way to prevent addiction from manifesting would be to address the social conditions that often surround it: poverty, precarity, lack of social support, social isolation, &c. The best way to treat addiction would be to make treatment more accessible [read: free] & for treatment to include raising a person's social circumstances rather than simply isolating them in a treatment facility for 30-90 days & then dropping them back into the same conditions where the addiction developed in the first place.

source: I am working on my Ph.D. in sociology & addiction studies & have 10, hard fought, years of sobriety.