Addiction, a Choice or Disease?

Addiction, is it a choice or a disease? This is a controversial question that has plagued the Internet as of late. Although this is not a new debate I am seeing more and more Memes, studies, comments and blogs about this topic. After much thought I decided to address the issue publicly, add my point of view and possibly ruffle some feathers.

Please let me start by saying both side have validity to them. I myself hold the opinion that addiction a disease. This opinion is based on research and life experience. I’m fairly certain that no one wakes up one day and decides to be an addict. From research and addiction studies I have read it states that once drugs or alcohol have been introduced into an addicts body it changes the already defective brain chemistry making it very difficult for an addict to stop using and causing them to crave drugs even when the consequences of using outweigh the happiness they receive from the high. A disease is defined as;

“A particular abnormal condition that negatively affects the structure or function of part or all of an organism, and that is not due to any physical injury. Diseases are often construed as medical conditions that are associated with specific symptoms and signs.”

Therefore since substance abuse causes abnormal function of the addicts brain and can only be minimized with intervention and treatment this would lead me to believe addiction falls under the definition of a disease. Another factor that leads me to this conclusion is that two individuals can use the same addictive substance for the same timeframe; One can become addicted and the other is able to stop using with no physical or mental symptoms.

Choice Theories Disputed

There are many theories and myths about addiction and what makes it a choice. I just wanted to take a few minutes to bring a fresh perspective and just plain dispute some of these statements.

1. If you stop using using drugs you will no longer be an addict. Wrong! Addiction is a life long struggle. Although you can regain quality of life with abstinence from drug and alcohol, addiction is a lifelong struggle. From personal experience I know once you have hit the point where you have become addicted to a substance, your brain will not go back to pre-using function, any amount of drug use can cause a full blown relapse and relapse can happen no matter how long you have been clean. Addiction can be controlled and maintained with treatment and/or medication but it cannot be cured by not using. Using is a symptom of the disease.
2. I read an article on Psychiatric Times that an alcoholic can monitor and control use. They were using this point as a reason to dispute addiction as a disease. This doesn’t make sense to me. I have never seen an alcoholic or addict that can monitor or control their use, if they could they would not be addicts. Once at the point addiction has taken over the desire to use surpasses anything including family, responsibilities and self preservation.
3. A person addicted to drugs or alcohol can just stop using and be free from addiction. In all of my years I have never seen someone successfully “just stop” using drugs and remain clean. In my opinion the only way to successfully abstain from drug use is to admit and accept that you have a problem then seek help for your problem. So this is where the addict has a choice. The problem is that for most this is not easy to do especially when their brain is no longer functioning at the same capacity as a healthy individual. Weather seeking a self help group, religion based program, inpatient, outpatient, medication assistance program or a combination of treatments some type of intervention is usually necessary for long term success in fighting this disease.
4. There is no science to prove addiction is a disease. In my opinion and after much research I find this is also incorrect. Scans have shown the effects of drugs on the brain receptors. Also, genetic testing has proven that there are approximately 40 different gene variations linked to addiction. The HTR1B gene is known to make someone more sensitive to the effects of alcohol and cocaine. On the opposite end of the spectrum, the YP2A6 gene makes a person intolerant of cigarette smoke which would make them less likely to become a smoker.

Just because there are scientific factors and addiction meets the definition of a disease does not mean that this would eliminate the addicts responsibility to make a change for a better quality of life and end the cycle of addiction. Just as it is the responsibility and choice of a cancer patients to follow the doctors advice, take medications as prescribed & keep appointment if they want to recover. I think this is where people get confused and thus the debate. A person with Type 2 diabetes makes lifestyle choices that will cause the disease of diabetes. Even though lifestyle choices caused their diabetes it does not make it any less of a disease. This is how I feel we should be looking at addiction. As with addiction, choices, lifestyle change, and medication will put the diabetes into remission. At anytime you make the decision to continue poor eating habits your diabetes will no longer be managed and will return. Just like consuming sugar causes a rush of “happy chemicals” to your brain that makes it difficult to change your diet, the same principle applies for that bottle of Vodka or pills. The part where this analogy ends is that Type 2 diabetes can go away. Unfortunately, once an addict always an addict. The predisposition to this disease and damage to your brain will never fully recover once triggered by substance abuse. Addicts have to be vigilant in recovery to remain in remission.

All walks of life can become addicts. There are so many stories and circumstances. From an only child born into a wealthy, well-to-do society family to a child born into a poverty stricken large family. There is so much more I can discuss about this topic and what factors can contribute to a person becoming an addict. Weather you believe that is is a disease or a choice, education, awareness and treatment are the only way to end this epidemic sweeping our Country. If shame, ridicule and consequences were enough to keep someone sober there would be more sober people than using. Unfortunately, embarrassment or love is not enough to fight the cravings caused by the diseased mind of an addict. I want my readers to understand that just because I believe addiction is a disease does not mean I believe that it is a free pass to be unaccountable. Fighting this illness does involves a choice but does not make it less of a disease. I hope this sheads a new light on this age old discussion.

I will be posting links below for addiction treatment & awareness and suicide prevention. The most important thing no matter what side of the debate you are on is if you or someone you know is suffering from addiction please seek help, support and awareness!

Nationwide drug abuse hotlines

You are not alone! Nationwide suicide prevention hotline

Nar Anon is a support group for families & friends of addicts. A good support system is one major key to your loved ones fight against addiction.

Information on methadone & medication assisted addiction therapies. For some recovering addicts methadone is a medication that saved their lives, get informed.