Addiction: Is It a Disease or a Choice?
Many people don’t actually understand addiction and why it occurs. Some believe it is an issue of willpower, that people who become addicted simply aren’t strong enough to fight the problem. Others may see it as a choice addicts make to keep using, even though their substance abuse has caused them problems over and over again. The truth is actually much more complicated. Is addiction a disease?
Addiction is a disease that causes serious physical and psychological issues for the addict. Once people are able to grasp this concept more readily, more can be done to help these individuals and to ensure that they are able to recover from this disorder as safely and effectively as possible.
According to the National Institute on Drug Abuse, addiction is defined as a chronic disease. This disease is characterized by drug-seeking behavior that is very difficult to control. The behavior is also compulsive, which means the individual will continue to behave this way even though their substance abuse is causing serious problems in their life. They may realize this or not, but either way, it will be difficult—sometimes even impossible—for them to stop on their own.
This is the exact nature of addiction, which is not simply an issue of willpower. People don’t decide to become addicts, and they certainly don’t experience this problem because they are weaker willed than other individuals. The process of addiction occurs when a person abuses drugs and then changes happen in the brain that cause the individual to start thinking and behaving differently.
How Substance Abuse Affects the Brain
When a person starts to abuse drugs, it has a short-term effect on the brain that wears off when the drug does. But, in the case of most substances, there are also long-term changes that begin to work their way into the brain during the very first time use.
- When most drugs are abused, they flood the brain with dopamine (NIDA). This feels pleasurable, but it will also begin to alter the way the brain works.
- When the brain experiences this rush of pleasure, it begins to crave it again and again. This is because our brains are wired to repeat activities that make us feel good.
- When substance abuse is repeated frequently, dependence sets in. An individual who misuses addictive substances often will stop producing the necessary chemicals in their brain to experience pleasure or deal with sadness, pain, etc., instead relying on the drug for these functions.
- Over time, the individual will need the drug to deal with day-to-day life. They will start doing and saying things with only one goal in mind: getting more of the drug. This is compulsive use, which is the hallmark of addiction.
Now you understand the chemical reasons why drug abuse becomes compulsive. But why do some people become addicted when they use substances like alcohol, opioids, and even illicit drugs while others do not?
The Risk Factors of Addiction
Addiction, like many other diseases, has risk factors that can help determine whether or not an individual will become a victim of this disorder. For example, some individuals are more prone to other chronic diseases—like hypertension, asthma, and diabetes—because of their genetic makeup, their jobs, or for other reasons. Addiction is no different.
The risk factors associated with addiction are not completely understood, as the disorder itself is unpredictable and no one can say for certain who will become an addict and who will not. However, doctors and scientists have managed to study this problem at length to determine a few serious risk factors many people with this disease have.
One’s biological makeup can actually affect whether or not they are likely to become addicted if they do use drugs. People whose family members have struggled with this disease are more likely to suffer from it as well, as are those of certain genders, ethnicities, etc.
Mental illness is also a strong precursor. In fact, the NIDA states that people who suffer from a substance use disorder are twice as likely as the general population to suffer from a mental illness with the reverse also being true.
People who are living or did live in an environment that was more conducive to substance abuse are going to be more likely to participate in this behavior and then become addicted. Those who live in poorer neighborhoods have a higher chance of addiction, as do those who have stressful home lives or jobs and those who experience peer pressure to use.
Children whose parents use drugs or who do not have a lot of guidance and supervision are more likely to use because of their environments.
People who have been physically or sexually abused also have an increased risk of substance abuse and addiction. In a recent study by the Journal of Substance Abuse Treatment, 72% of the patients entering detox had histories of interpersonal trauma.
The point in a person’s life when they start using drugs can dramatically increase their likelihood of becoming addicted. When a teen uses drugs, they are more likely to experience this disorder than when an adult starts using. This is because a teenager’s mind is still developing and changing, and the use of drugs can deeply affect this development. According to Innovations in Clinical Neuroscience, family conflict, poor communication, and broken homes are a few family risk factors for teen drug abuse and addiction.
Making sure to avoid substance abuse is always a great way to evade any issues that could possibly occur with addiction. However, those who suffer from multiple risk factors should consider the fact that these issues could be extremely detrimental to them if they were to ever use drugs. Some people stay abstinent from all addictive substances—even alcohol—when their risk factors are very high.
Can Addiction Ever Be Reversed?
Addicted individuals can’t exactly change overnight, and even with treatment, they may be dealing with this issue for the rest of their lives. Like other chronic diseases, addiction can flare up at times and often requires long-term care in order to avoid serious problems. Still, it can be treated effectively in a professional recovery center.
- Detox is often the first stage of addiction treatment. It allows the individual to go through withdrawal in a safe, professional environment, surrounded by medical staff who can treat the symptoms of the disorder. Afterwards, the individual will no longer be dependent on the drug, but they will still be addicted. Detox is only the first stage of addiction treatment. Without rehab, most people are unable to safely recover and will be likely to relapse (NIDA).
- Rehab is another type of treatment program that usually comes after detox. It allows the individual to learn coping skills for the future and ways to avoid relapse. In many cases, both medications and behavioral therapies are used in rehab.
Even after one goes through rehab, there is still a chance for relapse and other serious problems. This is because addiction is a chronic disease that cannot be treated and fixed overnight. Many times, people need multiple treatment stints in order to safely recover and to stay strong in their commitment to abstinence.
Why Do Some People Not Want Treatment?
Sometimes, addiction really can seem like a choice. Many people will lie, deflect, or use a million other tactics to avoid going into treatment and to keep using drugs and alcohol. You may even start to wonder why your loved one has become so selfish or so unaware of the consequences of their own actions. When this occurs, you must remember that addiction is, in fact, a disease and that it has taken ahold of your friend, family member, or spouse.
When a person becomes addicted, the chemical changes made to their brain will cause them to put substance abuse ahead of everything else, including the feelings of their loved ones, their responsibilities, and other things that used to matter to them. Helping them realize this can be hard, but it is part of the process of recovery.
According to the National Institutes of Health, addiction is not a weakness, and it does not mean someone is a bad person. It is simply a disease like diabetes or asthma, causing chronic problems that are difficult to treat. However, it is more akin in some ways to depression, anxiety, and other types of mental disorders because it affects the way a person thinks and behaves. No matter how you view it, it is important to remember that addiction is not the fault of the addict. While drug abuse itself is a choice, addiction is a disease that sets in and takes away all of one’s ability to make choices.
How Do I Find Treatment for My Loved One?
We want to help you locate the best detox program for your loved one so they can begin their journey of recovery as soon as possible. Call 866-351-3840(Who Answers?) now to speak with a treatment advisor and to be matched with safe, effective detox programs near you.
- National Institute on Drug Abuse. (2018). Understanding Drug Use and Addiction.
- National Institute on Drug Abuse. (2018). Drugs, Brains, and Behavior: The Science of Addiction- Drugs and the Brain.
- National Institute on Drug Abuse. (2018). Comorbidity: Substance Use Disorders and Other Mental Illnesses.
- Journal of Substance Abuse Treatment. (2002). The Relationship Between Sexual and Physical Abuse and Substance Abuse Consequences.
- Innovations in Clinical Neuroscience. (2011). Early Detection of Illicit Drug Use in Teenagers.
- National Institute on Drug Abuse. (2016). Understanding Drug Use and Addiction: What Science Says- 8: Medical Detoxification.
- National Institutes of Health. (n.d.). What is An Addiction?