Addiction, is it a disease or is it a choice? So much controversy on social media about whether it’s a mental disorder, behavior issue, lack of will power, or moral failing. I have my opinions as do many others all over the world; some ideas are based on experience, education or lack thereof better known as judgements. I see it everywhere, there’s people that have lived it or with it and then there’s people on the outside looking in. We are all entitled to our opinions, but they are just that. Some of us will care to look at the evidence, others will turn a cheek, but I did the research. How many will be open to the facts? The reality is that this has been an issue for many centuries and generations of us have suffered either as a direct or indirect result of Addiction. I will be doing blogs for the next few weeks around what Addiction is according to doctors and scientists along with the different approaches that evidence has backed up to assist those that suffer. Feel free to compare or relate these facts to your opinions, I’m open to any and all feedback throughout the next few weeks on the subjects I’ll be discussing! This week I am going to do a breakdown of the different views we use to describe addiction with in the evidenced based data I’ve accumulated, and the different diagnosis’ doctors and scientists have about the controversy of addiction.
So, we have the simple labeled controversy of disease or choice right, well how does the dictionary describe these words? English dictionary says a disease is an illness that affects a person, animal, or plant: a condition that prevents the body or mind from working normally. Another definition of disease is any harmful deviation from the normal structural or functional state of an organism, generally associated with certain signs and symptoms. Now the definition of choice is the act of picking or deciding between two or more possibilities; the right or ability to make, such a selection. Another definition for choice is a range of possibilities; the opportunity or power to pick between two or more possibilities. Well if it’s a disease by definition then clearly a person’s mind is not able to make a normal choice, but maybe it’s a choice because one has to choose between the possibility of living a disease free life or using a drink or a drug even just once! What choice did you make the first time you got drunk or high, were you aware of the possibilities? Does it even matter because people with addictions have gotten clean and then chose to use again fully aware of the possibilities and still made the choice. As far as the topic of definitions go, what does the dictionary say the word addiction means? Webster says addiction is compulsive, chronic, physiological or psychological need for a habit-forming substance, behavior, or activity having harmful physical, psychological, or social effects and typically causing well-defined symptoms upon withdrawal or abstinence such as anxiety, irritability, tremors, or nausea. Did you read that right? The symptoms occur after withdrawal or abstinence so one’s choices of possibilities may then simply be; feel better or continue feeling anxious, irritable, and uncomfortable physically. Another definition of addiction states a chronic dysfunction of the brain system that involves reward, motivation and memory; body’s craving of substance or behavior when caused by compulsive or obsessive pursuit of reward and lack of concern over consequences. Take notice that addiction was not just defined using drugs or alcohol, it also includes activities and behaviors. Perhaps this is where the ideas of mental disorders, and behavioral issues, or lack of will power and moral failings got thrown into the mix?
What do the professionals say about Addiction, is it a disease by facts or a choice by facts? Addiction falls under disease according to the American Medical Association. Like diabetes, cancer and heart disease, addiction is caused by a combination of behavioral, environmental and biological factors. Addiction involves changes in the functioning of the brain and body. These changes may be brought on by substance use or may pre-exist; genetic risk factors in the brain that has produced addiction in some individuals. If left untreated, addiction results in consequences of physical and mental health disorders and over time, addiction becomes more severe, disabling and life threatening, much like any disease! The reward system is what gives us pleasure when hunger, thirst, and sex are met it’s the part of the brain that help us survive. In most cases, these feelings of pleasure are caused by the release of certain chemicals in the brain. Addictive substances cause the brain to release high levels of the same chemicals that are associated with pleasure or reward.
Long term use will release these chemicals causing changes in the brain systems involved in reward, motivation and memory. As these changes occur, a person may need the substance to feel normal. The individual may also experience intense desires or cravings for the addictive substance and will continue use, despite the harmful consequences. The person will lose the ability to decide what is important, a person can stop caring about their own or other’s well-being or survival. This all sounds like our definitions previously identified in the second paragraphs. These changes in the brain can remain, even after the person stops using substances. It is believed that these changes may leave those with addiction vulnerable to physical and environmental triggers, which can increase their risk of relapse. Addiction then becomes a chronic disease; a long-lasting condition that can be controlled but not cured.
The initial and early decisions to use substances reflect a person’s free choice. However, once the brain has been changed by addiction, that choice or willpower becomes impaired. People do not get to choose how their brain and body will respond to drugs and alcohol, that’s why some people can control their use while others can’t. People with addiction can still stop using – it’s just much harder than it is for someone who has not become addicted. Some people think addiction isn’t a disease because it is caused by the individual’s choice to use drugs or alcohol. Choice does not determine whether something is a disease. Heart disease, diabetes and some forms of cancer involve personal choices like diet, exercise, sun exposure, so on and so forth. A disease is what happens in the body as a result of those choices. Most experts believe that the person loses control of their behavior once the brain has been changed by addiction. Some will argue that addiction is not a disease because some people with addiction get better without treatment. There are stages of addiction just as there are stages of cancer or diabetes. Some treatments help some stages other require more intense treatment.
In conclusion, doctors and scientist don’t see evidence in addiction being a choice rather addiction is a disease as well as a behavioral issue the evidence has been accumulated by studies done on animals brains and behaviors and the effectiveness of treatments practiced mind you these treatments have been improving the more time doctors and scientists have focused on the brain. Next week we will get into the different types of treatments. I am so grateful as a person who has suffered from addiction myself that there were those who took the time to learn and understand this thing so I could get better. People feel so strongly on the matter of whether we think it is a disease or a choice, I feel the most important matter is there are treatments regardless of what we think it addiction is.