Is Addiction a Disease or a Choice?
Addiction is an epidemic. In the past month, 13% of people 12 years or older have used drugs. With the prevalent use of drugs and alcohol, there comes more information and misconceptions. One common myth is that addiction is a choice, not a disease. With its inclusion in the DSM (the Diagnostic and Statistical Manual of Mental Disorders) in 1952, addiction is being better researched and recognized as a disease.
Addiction is misunderstood and sometimes treated with a lack of compassion. We would never shame someone with cancer, so why the stigma around addiction? Addiction is a complex and nuanced disease that is difficult to explain in a “one-size-fits-all” manner. The reasons someone develops this disease are multifaceted, including genetics, underlying mental health disorders, and trauma.
We will review the arguments on addiction as a choice or disease, as well as give resources to help those suffering.
Read on to learn more.
Is Addiction a Disease or a Choice? Looking at Both Arguments
We will look at both sides of the argument to answer this question. This way, we can identify any inconsistencies which separate myth from fact.
Addiction as a Choice
First, we will review the argument that alcohol or drug addiction is a choice.
While the argument lacks concrete data, some professionals in the industry hold this opinion. For example, Psychiatric Times calls substance abuse “foolish” and “self-destructive,” and because of this, claims that “[substance abuse] is not necessarily a disease.”
You might wonder why psychiatric professionals still argue over this point when the literature (DSM) states that addiction is a disease. Those who believe addiction is a choice perceive it as more of a behavioral issue than a psychiatric illness. They think people use drugs and alcohol to relieve stress or increase pleasure. Some casual users indeed have that motivation, but it is a gross oversimplification of the changes the mind and body go through when someone is in the throes of addiction.
These same professionals may not limit addiction to just substance abuse. When viewed from a behavioral standpoint, addiction can include actions such as watching pornography and overeating. These activities also activate the pleasure centers of the mind, causing individuals to engage more frequently.
Over time, a drug or alcohol user will create a routine for substance abuse. Addiction leads to a habitual response; in short, the craving will increase as the mechanism becomes an intrinsic part of their life.
Experts debate the habitual response. Those who believe addiction is a choice will argue that the user creates a habitual response by taking the substance for pleasure, ignoring that many users are far past the “pleasure” stage and are fully dependent.
Addiction as a Disease
Although some professionals still view addiction as a choice, the evidence that addiction is a disease is overwhelming. Professionals have documented the changes that occur to the brain of an addicted individual, proving that for some, addiction is not a conscious choice. Chemical changes and brain alterations develop when someone goes from a “casual user” to an addict. We do not know when those physiological changes occur, but once they do, it is an extensive process to reverse. People in recovery are rewiring their brains to alleviate the dependency.
So how does addiction change the brain? Drugs and alcohol overwhelm the brain’s pleasure centers. When one comes down from a high, the dopamine receptors decrease in activity. The receptors are then less likely to respond to normal stimuli that those who are not addicted would typically get joy. Additionally, the user must take the drug in higher dosages over time to receive the same high.
If the user decides to quit taking substances, it will affect how their body operates. This process is commonly called withdrawal. These symptoms can take weeks or even months to conclude. The body cannot function properly without the substance until the withdrawal is over. Withdrawal is one example that proves people with addiction deal with more than a behavioral issue, and the choice to stop is fraught with mental and physical challenges.
While this argument touches on the physical effects of addiction, what about the choice to start using substances in the first place? When it comes to that initial use, genetics and epigenetics can play a role. Studies show that a person’s genetic makeup can affect the possibility of drug and alcohol experimentation. Geneticists have proven that an individual’s DNA can increase the likelihood of certain diseases, such as heart disease and diabetes. Addiction is far more complex than these diseases, often including more risk factors. For example, mental illness may be genetic. If someone inherits a mental disorder, this can contribute to substance abuse.
What about environmental concerns? Epigenetics is the study of genes and how they interact with our environment. The argument is that choices such as abusing substances can remodel the DNA at a cellular level. Epigenetic marks can impact a person’s health at all levels, making addiction a disease more than a choice.
Why Do People Misunderstand Addiction?
While arguments support both sides, addiction as a disease has far more evidence. People typically think addiction is a choice based on biases and judgments about addicts. The stereotype is that an addict is broke, homeless, and uneducated. People assume they come from broken homes or poverty. Some people associate addiction with certain races, ethnicities, and cultures.
Even the medical community includes professionals who hold these stigmas against addicts. These stereotypes are both inaccurate and harmful. They are a gross oversimplification of who an addict is and how their life looks. There are plenty of “high-functioning” addicts and alcoholics that fly entirely under the radar. These opinions are not grounded in logic or research.
In reality, anyone can become addicted to substances. There is no correlation between race, ethnicity, or socioeconomic class. The diversity of addiction became painfully apparent during the opioid crisis; individuals as old as 54 were affected by prescription drug abuse, even if they had never tried substances in any other context.
More Facts About Addiction
Identifying if you or someone you love is addicted to drugs or alcohol can be difficult. Here are some key facts that will make the process easier.
Symptoms of Addiction
While everyone is different, most people show similar signs of addiction. These include:
- Unable to cut or stop substance use
- Taking a substance for long periods of time and/or in large quantities
- Experiencing cravings
- Constantly recovering from the negative effects of substance use
- Experiencing social, personal, career, educational, and economic problems
- Failing to fulfill obligations at work, school, and/or home
- Risky and dangerous behavior
- Giving up on passions and hobbies
- Continuing substance use when it’s causing physical and/or mental effects
- Experiencing withdrawal symptoms when substance use is suspended
If you or a loved one is experiencing any of these symptoms, it may be time to consider treatment.
While genetics make one more likely to develop an addiction, this isn’t the only cause. There is no single reason that universally represents why someone becomes addicted. However, someone will usually start to use substances for one of four reasons:
- To feel better
- To feel good
- To fit in
- To improve
Some of these reasons seem overly simple or similar. For example, “feeling better” and “feeling good” have different underlying emotions. Someone struggling with depression may start drinking to alleviate symptoms. Alternatively, another person may drink on weekends to have more fun. Both of these causes run the risk of addiction.
“To improve” is one of the more surprising and misunderstood causes. For example, an athlete may start abusing steroids to improve athletic performance, while a successful business owner may use cocaine to stay awake and get more work done. The intention “to improve” is about functionality, not leisure, but it is extremely risky.
Using substances to “fit in” mainly happens among young people who are more susceptible to peer pressure but it can also occur based on certain environments. For example, if someone works in an industry where partying is common, such as the music industry, they are more likely to abuse substances than those in other professional fields.
Other Risk Factors
While genetics are a risk factor, other triggers play a part in developing an addiction. They include:
- Age and development
All genders are susceptible to substance abuse, but research shows that men are more likely to develop a dependency than women. It has been shown that although men and women both can become addicted, the way that they respond to drugs can be different. Additionally, the struggles of recovery impact the genders differently. Research shows that women are more susceptible to cravings and relapse.
Age is a crucial factor in substance use disorder. Anyone of any age can develop an addiction, but the reasons are different. Teenagers often turn to drugs, alcohol, or nicotine to fit in with their peers. This experimentation can lead to addiction down the line. On the other side of the spectrum, adult and elderly populations are more likely to receive an opioid prescription, increasing the risk of addiction.
In racial and ethnic groups, illicit drug use is higher among those who identify with two or more races. The rates for drug use in indigenous communities are second. However, Caucasians were more likely to receive drug treatment. Those in the BIPOC community aren’t given the same socioeconomic opportunities as white people. This discrepancy impacts those who abuse substances compared to those who can seek treatment.
Do You or a Loved One Need Addiction Treatment?
Whether you believe addiction is a choice or a disease, receiving treatment for those afflicted is vital. Whether you or a loved one are struggling with mental health challenges or addiction, we are here to help.
Sunshine Care Centers has a suite of medical, therapeutic, and addiction professionals with over 30 years of experience in the field. We pride ourselves on a clean, compassionate, and secure environment that encourages recovery. We use evidence-based addiction treatment with flexible programs that cater to your needs.
Don’t wait to receive the help you deserve.