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Is Addiction a Choice, or a Disease?

addiction is a choice

When a loved one becomes addicted to drugs or alcohol, it’s incredibly devastating. You may experience feelings of disappointment, disbelief, and anger. You may blame your loved one for their behaviors, or fault them simply for hanging out with the “wrong crowd.” If you’re a parent, you may blame yourself for your son or daughter’s substance use. At the same time, you may be shocked that your son or daughter chose to use drugs, despite their good upbringing, in the first place. You may be asking, “Where did I go wrong?” and “Why did they choose this path—and choose to keep using drugs?”

Too often, we refer to drug addiction as a choice. We assume that addicts choose the life they are living, and choose to continue using drugs despite the consequences. We blame or shame them for these choices, seeing their drug habits as a wrongdoing rather than a real issue that needs medical help.

If you are asking, “Is addiction a choice?” and searching the web, you will find articles supporting both sides of the debate. However, there is a clear-cut answer to this question and science underlines its proof. Substance addiction, clinically referred to as a substance use disorder, is not a choice. Substance addiction is a disease—and it’s time we start viewing it as so.

Breaking the Myth: Addiction is a Choice

When someone says that drug addiction is a choice, it implies that a person can choose to stop using drugs if and when they want to. If addiction was a choice, in fact, addicted people could stop and drop their habits whenever they were ready—whether that be drugs, alcohol, gambling, sex, or cigarettes. Unfortunately, addiction does not work that way. Addiction is a much deeper-seated issue that makes physical changes and leaves lasting effects on a person’s brain. Choosing top stop using drugs is not always an option for those struggling.

Now, it is true that a person chooses to use drugs in the beginning. The initiation of drugs is completely voluntary and undoubtedly a choice that many, many people make. Perhaps you, as a parent, once made similar choices at one time in your life. Substance use is often seen as a phase or rite of passage for teenagers, whose brains are not fully developed and who often do not think about the consequences that might occur from actions like smoking marijuana. Some teenagers and college students will keep using drugs or drinking alcohol for fun, to be a part of a social circle, or to alleviate stress, without any concern of the long-term possibility of addiction. The problem is that young people are most at risk.  

Everyone reacts to drugs differently. Some people will not get addicted to their drug of choice. Some will use drugs a handful of times and develop a dependence. Some will use drugs repeatedly for a long period and eventually develop an addictive disorder. According to the National Institute on Drug Abuse, “There’s no rule about how soon someone becomes addicted.” 

While not everyone develops a substance addiction, it is still a real risk in drug-using individuals—particularly those at a young age or who are battling any struggles with mental health. However, addiction does not discriminate. It can happen to anyone, of any age, and of any background or upbringing. And when an addiction develops, it is diagnosed as a chronic disease or disorder.

Understanding the Facts: Addiction is a Disease

Evidence shows that drugs and alcohol change how the brain works. When a person uses drugs, the substances tap into the brain’s communication system, tamper with its nerve cells, and trigger certain chemicals to release (such as dopamine), overstimulating the brain’s reward circuit. These changes are lasting with repeated drug use. Due to the reward or pleasure experienced from drugs, the brain wants to repeat those activities. It learns and remembers that drugs provide euphoric-like effects, and sends out signals for a user to find and use the drugs again. The changes in the brain cause a user to desire to use drugs in order to feel good and, eventually, feel better. Soon, the brain needs the drugs to function.

When a person is struggling with addiction, it is not easy to stop and quit. Typically, quitting drugs cannot be done overnight, for a couple of reasons. First is the withdrawal symptoms that come from stopping drug use. When an addicted person stops using drugs for a period of time, their brain and body demand the drug to function. Withdrawal from the drug can cause painful side effects like nausea, fatigue, body aches, vomiting, flu-like symptoms, and more. Withdrawal is extremely uncomfortable, so to alleviate symptoms, many people turn back to using drugs again. This is not a choice—this is their body demanding and requiring more of the drug to function properly.

The second reason people cannot choose to stop using is because it is dangerous. Due to the chemical changes that have taken place in the brain, and the dependence established with a substance addiction, stopping drug use suddenly can cause dangerous and sometimes life-threatening symptoms. Benzodiazepine drugs, such as Xanax and Klonopin, can cause some of the most dangerous withdrawal symptoms, such as seizures and coma. These drugs should be detoxed in a professional, medically-managed setting.

Because substance addiction is associated with lasting, physiological changes in the brain, it is considered a disease. According to the National Institute on Drug Abuse (NIDA):

“Addiction is defined as a chronic, relapsing disorder characterized by compulsive drug seeking, continued use despite harmful consequences, and long-lasting changes in the brain. It is considered both a complex brain disorder and a mental illness. Addiction is the most severe form of a full spectrum of substance use disorders, and is a medical illness caused by repeated misuse of a substance or substances.”

The NIDA often compares substance addiction to other, chronic, and relapsing disorders like diabetes and hypertension. The commonality of the disorders is that they require ongoing and active management. They are treatable disorders, but they are also a chronic condition with a risk of relapse. In fact, addiction has relapse rates similar to other chronic illnesses.

So, Is Addiction a Choice or a Disease?

At the end of the day, substance addiction is a disease. While the initial act of using drugs is voluntary, no one chooses to become addicted to drugs. It happens as a result of chemical changes in the brain—unavoidable and unpredictable for many individuals.

The NIDA explains it perfectly, stating: “The first time a person uses drugs, it’s usually a free choice. However, repeated drug use can change the brain, driving a person to seek out and use drugs over and over, despite negative effects such as stealing, losing friends, family problems, or other physical or mental problems brought on by drug use. This is addiction.”

When addiction is viewed as a choice, it implies that users do not want to get help. It implies that they have failed morally, that they don’t care about their loved ones or their life. Seeing addiction as a choice implies that users are continuing to use drugs and make “bad choices” that put their health, their loved ones, and their life in disarray. This couldn’t be farther from the truth.

As you know, substance addiction does not just affect an individual – it affects their family, job, finances, reputation, legal background, mental health, and more. No one wants to keep using in the wake of these negative consequences. Therefore, it is not a choice that they continue using. Even when they recognize the harm drugs have caused on their lives, their brain still demands that they put the drugs first.

It is important that we, as a whole, view substance addiction as a disease. When seeing it in this light, we are better able to help people into treatment. Like other chronic illnesses, drug addiction requires and deserves professional, clinical intervention as well as long-term care. However, many people are scared to seek help. Out of fear of what others might think, or worry of disappointing loved ones, many people struggle with addiction silently. This poses great risk to their health.

Substance addiction is a treatable disease. With proper treatment, a person can go on to live a healthy, productive, meaningful life without drugs or alcohol. However, only one in every ten Americans get the treatment they require. Currently, more than eight million people in the U.S. have a drug use disorder. Even more are struggling with alcohol addiction. Millions have not received treatment.

If your loved one is showing signs of substance addiction, know that you can help. Rather than blaming them for their “choices,” you can start guiding them towards the treatment they deserve. Professional substance addiction treatment can lead to a long-lasting recovery. And with ongoing management and care, your loved one can find health, happiness, and purpose in their life again.

To learn about Turnbridge’s addiction treatment programs for young men and young women, please call 877-581-1793. We are here for you.