Addiction: Disease or Choice?
This is a touchy subject, whether or not addiction is a disease or a choice, but after engaging in a heated debate on Facebook I decided it is necessary for me to express my views on the topic. And, for the record, all of my views are supported by facts, science, experience, and the most recent research available.
Addiction is not a choice, nor is it a typical disease. It is more akin to a disorder, a learning disorder, to be specific. It effects the brain in much the same way as autism or attention deficit disorders would. There is something different about the addict brain in comparison to other brains. We are wired differently from birth, but our choices determine whether or not we become hindered by that disparity, what types of addictions we develop, and how severe the affliction becomes as it progresses. That is not the same as saying addiction is a choice because it is surely not. What I'm saying is that an element of choice is involved. But just in case there are a few narrow-minded idiots out there who want to misinterpret my words to validate/support their "addiction is a choice" argument, allow me to make a few comparisons: people who are at risk of developing diabetes still eat sugar. People still have sex even though they could get HIV, herpes, HPV, etc. People still eat and use all kinds of products that could be harmful (prescriptions and OTC drugs included) even though they could have an allergic reaction or get cancer from it later. But if any of those things occurred, would we say "they CHOSE to get diabetes" or "they CHOSE to get HIV" or "they CHOSE to go into anaphylactic shock"? Of course not, because that would be ridiculous and insensitive. What I'm trying to get through people's heads is that it is just as ridiculous and insensitive to say that someone chose to be an addict. People choose to engage in risky and potentially addictive behaviors every day. Sex, gambling, shopping, eating, working, exercising, drinking alcohol, using drugs...all of these things can become addictive and result in terrible consequences, but we wouldn't expect a person to never eat or have sex because they MIGHT get addicted. That would be silly. And yet we expect people to never try drugs. Which is also silly, and unrealistic.
Historically, humans have been finding ways to alter their consciousness since the dawn of time. In many cultures the use of mind-altering substances was considered a right of passage, and in others drugs were even used in religious practices. In modern society, experimenting with drugs and alcohol is actually the norm from a developmental standpoint. Over half of the American population has used marijuana, but very few of them ever developed a marijuana habit.
These facts are often overlooked because drug use is so stigmatized, and since it is also criminal, many people just won't openly discuss their own experiences. Drug use, however prevalent, has always been frowned upon and considered taboo by our society, which is why lawmakers saw fit many decades ago to create laws prohibiting their use and sale. But that was before we knew much about the nature of addiction itself. Over the years we have seen efforts like the War on Drugs and the D.A.R.E. program fail miserably, and it is clear at this juncture that we need to change our policies from punitive to rehabilitative and preventive if we want to slow addiction rates and save lives. We can't do that if we continue to incorrectly label addiction as a moral failing and not as a grave disorder.
For those of you who are having trouble understanding this, allow me to give you a little science lesson. Addiction is a disorder that effects two parts of the brain- the prefrontal cortex and the mid-brain. Let's start with the mid-brain. The mid-brain is the part of your brain that controls your involuntary and instinctual actions, like breathing or eating. When an addict reaches a certain point in their addictive behavior the mid-brain begins to equate that behavior with survival, much as it would with eating or breathing. However, there is no magic formula to determine when that shift occurs. Everyone is different...biology and chemical make up differs from one person to the next, as do genetic predispositions, environmental factors, etc. So while it might take one person years of recreational drug use to become addicted, it could take only one use of a substance for another individual. There is no way to know when that line will be crossed. Additionally, drug use effects the part of the brain that governs impulse control, judgment, and the regulation of emotions. So the longer an addict remains in active use, the less capable they become of making sound choices. It may seem simple to people with "normal" brains to "just quit" as soon as a negative consequence occurs, but it is not simple at all. Have you ever eaten something delicious that is totally bad for you and told yourself "just one more bite" over and over until it's gone, then felt guilty about it? It's the same way with drug addiction. Food and drugs both release "feel good" chemicals in the brain that tell you it's okay to indulge even if it's not. I'm pretty sure everyone can relate to that, right?
I have been battling addiction issues for the past fifteen years. I have been to inpatient rehab four times. I have gone to AA, NA, church, prison...I have received all kinds of therapy and most of it didn't work. Jail and prison don't work because, since addiction is a learning disorder, one of its primary features is that it is resistant to punishment, just like other learning disorders. Punishing a kid with ADHD or autism doesn't help them or fix them, and usually it makes them worse. Same with addiction. I've heard people ask so many times "why can't they learn from their mistakes?" My answer is how can they when THE WAY THEY LEARN IS COMPROMISED? It's not about learning...it's about UN-learning, which is far more complicated. This is why most rehabilitation programs don't work,because they haven't embraced the truth about addiction and because very few programs out there use evidence-based treatment methods. In addition, currently there is not a set standard of care or an accreditation process for these programs to follow like there is for other healthcare programs. So they are basically allowed to do whatever the hell they want, use outdated and often counterproductive methods, and produce atrociously low success rates, all while making millions off of desperate addicts and their families. And so far change is slow in coming.
I won't go into detail about what has kept me off of heroin, because what works for me may not work for everyone. There is no one-size-fits-all approach to recovery, and it took a lot of trial and error for me to get to where I am now. My best insight to those still struggling is to keep trying new things and never stop fighting, because a better life is possible.
For those of you who are still of the opinion that addiction is a choice, I encourage you to do your research and adjust your views accordingly, because until you do that, YOU are a part of the problem. Ignorance stops progress, so please educate yourselves. Lives depend on it.
Addiction is not a choice, nor is it a typical disease. It is more akin to a disorder, a learning disorder, to be specific. It effects the brain in much the same way as autism or attention deficit disorders would. There is something different about the addict brain in comparison to other brains. We are wired differently from birth, but our choices determine whether or not we become hindered by that disparity, what types of addictions we develop, and how severe the affliction becomes as it progresses. That is not the same as saying addiction is a choice because it is surely not. What I'm saying is that an element of choice is involved. But just in case there are a few narrow-minded idiots out there who want to misinterpret my words to validate/support their "addiction is a choice" argument, allow me to make a few comparisons: people who are at risk of developing diabetes still eat sugar. People still have sex even though they could get HIV, herpes, HPV, etc. People still eat and use all kinds of products that could be harmful (prescriptions and OTC drugs included) even though they could have an allergic reaction or get cancer from it later. But if any of those things occurred, would we say "they CHOSE to get diabetes" or "they CHOSE to get HIV" or "they CHOSE to go into anaphylactic shock"? Of course not, because that would be ridiculous and insensitive. What I'm trying to get through people's heads is that it is just as ridiculous and insensitive to say that someone chose to be an addict. People choose to engage in risky and potentially addictive behaviors every day. Sex, gambling, shopping, eating, working, exercising, drinking alcohol, using drugs...all of these things can become addictive and result in terrible consequences, but we wouldn't expect a person to never eat or have sex because they MIGHT get addicted. That would be silly. And yet we expect people to never try drugs. Which is also silly, and unrealistic.
Historically, humans have been finding ways to alter their consciousness since the dawn of time. In many cultures the use of mind-altering substances was considered a right of passage, and in others drugs were even used in religious practices. In modern society, experimenting with drugs and alcohol is actually the norm from a developmental standpoint. Over half of the American population has used marijuana, but very few of them ever developed a marijuana habit.
These facts are often overlooked because drug use is so stigmatized, and since it is also criminal, many people just won't openly discuss their own experiences. Drug use, however prevalent, has always been frowned upon and considered taboo by our society, which is why lawmakers saw fit many decades ago to create laws prohibiting their use and sale. But that was before we knew much about the nature of addiction itself. Over the years we have seen efforts like the War on Drugs and the D.A.R.E. program fail miserably, and it is clear at this juncture that we need to change our policies from punitive to rehabilitative and preventive if we want to slow addiction rates and save lives. We can't do that if we continue to incorrectly label addiction as a moral failing and not as a grave disorder.
For those of you who are having trouble understanding this, allow me to give you a little science lesson. Addiction is a disorder that effects two parts of the brain- the prefrontal cortex and the mid-brain. Let's start with the mid-brain. The mid-brain is the part of your brain that controls your involuntary and instinctual actions, like breathing or eating. When an addict reaches a certain point in their addictive behavior the mid-brain begins to equate that behavior with survival, much as it would with eating or breathing. However, there is no magic formula to determine when that shift occurs. Everyone is different...biology and chemical make up differs from one person to the next, as do genetic predispositions, environmental factors, etc. So while it might take one person years of recreational drug use to become addicted, it could take only one use of a substance for another individual. There is no way to know when that line will be crossed. Additionally, drug use effects the part of the brain that governs impulse control, judgment, and the regulation of emotions. So the longer an addict remains in active use, the less capable they become of making sound choices. It may seem simple to people with "normal" brains to "just quit" as soon as a negative consequence occurs, but it is not simple at all. Have you ever eaten something delicious that is totally bad for you and told yourself "just one more bite" over and over until it's gone, then felt guilty about it? It's the same way with drug addiction. Food and drugs both release "feel good" chemicals in the brain that tell you it's okay to indulge even if it's not. I'm pretty sure everyone can relate to that, right?
I have been battling addiction issues for the past fifteen years. I have been to inpatient rehab four times. I have gone to AA, NA, church, prison...I have received all kinds of therapy and most of it didn't work. Jail and prison don't work because, since addiction is a learning disorder, one of its primary features is that it is resistant to punishment, just like other learning disorders. Punishing a kid with ADHD or autism doesn't help them or fix them, and usually it makes them worse. Same with addiction. I've heard people ask so many times "why can't they learn from their mistakes?" My answer is how can they when THE WAY THEY LEARN IS COMPROMISED? It's not about learning...it's about UN-learning, which is far more complicated. This is why most rehabilitation programs don't work,because they haven't embraced the truth about addiction and because very few programs out there use evidence-based treatment methods. In addition, currently there is not a set standard of care or an accreditation process for these programs to follow like there is for other healthcare programs. So they are basically allowed to do whatever the hell they want, use outdated and often counterproductive methods, and produce atrociously low success rates, all while making millions off of desperate addicts and their families. And so far change is slow in coming.
I won't go into detail about what has kept me off of heroin, because what works for me may not work for everyone. There is no one-size-fits-all approach to recovery, and it took a lot of trial and error for me to get to where I am now. My best insight to those still struggling is to keep trying new things and never stop fighting, because a better life is possible.
For those of you who are still of the opinion that addiction is a choice, I encourage you to do your research and adjust your views accordingly, because until you do that, YOU are a part of the problem. Ignorance stops progress, so please educate yourselves. Lives depend on it.
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