The perception of addiction as a disease or a choice is a viewpoint with far-ranging consequences. For years, mainstream thinking posited that it was a choice, a “moral failing” that affects weak individuals. Fortunately, our knowledge and understanding of addiction have evolved, and we have seen that it affects all kinds of people, from all types of families and socioeconomic backgrounds, from all over the world.
Today, the National Institute of Drug Abuse defines addiction as a “chronic, relapsing brain disease characterized by compulsive drug seeking and use, despite harmful consequences.” Addiction actually changes the way the brain functions, and these changes can last for years — even after the individual stops using drugs or alcohol.
Roles Played in Addiction
Like other diseases such as heart disease, some types of cancer, and diabetes, addiction is also impacted by a number of hereditary and environmental factors. Heredity is believed to play a strong role, credited with 40 to 60 percent of an individual’s predisposition to addiction. Environmental factors also significantly impact whether someone who tries drugs or alcohol becomes addicted. An unsupportive family environment, friends who also abuse substances, personal trauma, underdeveloped coping skills, and the presence of mental health conditions such as ADHD, depression, and anxiety all weigh heavily on determining someone’s likelihood to become hooked after using drugs and alcohol.
Why We May Become Addicted
Many addictive substances cause the brain to release “pleasure chemicals” that naturally occurs when people feel pleasure during exercise, eating, and sex. However, the pleasure chemicals released with the use of drugs and alcohol tend to have more intense effects, leading the person to want to repeat the behavior, even when they know that doing so negatively impacts other areas of their life such as their relationships, careers, physical health, and more.
Over time, the person needs more and more of the substance — no longer for the euphoric feelings they may have initially experienced but just to feel “normal.” Physiological cravings lead the individual to use more and more of the substance, often leading them to feel as if they’ve lost control of their life and that their days and nights are driven by the need to find and use the substance.
And while the term “disease” underscores the seriousness of addiction, there is good news for those who struggle with substance abuse. As a chronic disease, addiction is a long-term condition, one that may entail relapses, but also one that can be managed through ongoing treatments, continuing aftercare, and family and peer support.
Our modern understanding of the science of addiction is integral in helping to remove the stigmas associated with mental health disorders and substance abuse to facilitate the treatment process for those in need of help. So is addiction a disease or a choice? Like many diseases, it’s a physiological health condition impacted by both, the genes we inherit as well as the choices we make along the way.