Is Addiction a Disease or Choice. Both Sides, Debatable?
The old-age debate has asked this question for decades. Both sides have each been visited with sound pros and cons listed in numerous published articles. According to Scientific American’s website, the consensus today points to addiction being a disease. The National Institute on Drug Abuse (NIDA) agrees with this based on its medical model of mental disorders, which claims “that addiction is a chronic and relapsing brain disease in which drug use becomes involuntary despite its negative consequences.”
“The idea here is, roughly, that addiction is a disease because drug use changes the brain and, as a result of these changes, drug use becomes compulsive, beyond the voluntary control of the user. In other words, the addict has no choice and his behavior is resistant to long term change,” says scientificamerican.com, explaining the NIDA model.
The National Institute of Drug Abuse (NID) has a running list of Points that reinforce addiction is not a choice:
- *No single factor can predict whether a person will become addicted to drugs. A combination of genetic, environmental, and developmental factors influences risk for addiction. The more risk factors a person has, the greater the chance that taking drugs can lead to addiction.
- *Drug addiction is a chronic disease characterized by drug seeking and use that is compulsive, or difficult to control, despite harmful consequences.
- *Brain changes that occur over time with drug use challenge an addicted person’s self-control and interfere with their ability to resist intense urges to take drugs. This is why drug addiction is also a relapsing disease.
- *Relapse is the return to drug use after an attempt to stop. Relapse indicates the need for more or different treatment.
- *Most drugs affect the brain’s reward circuit by flooding it with the chemical messenger dopamine. This overstimulation of the reward circuit causes the intensely pleasurable “high.”
As regular drug use continues, the brain adjusts to the excess dopamine (pleasure) and begins to make less and less of it naturally, which in turn decreases the high feeling that an individual initially felt when they first took the drug. This is called “tolerance”—when the high doesn’t feel so “high” anymore. When someone is addicted, they typically will take more drugs in efforts to achieve the same dopamine high they once felt. Adversity to this pattern is it can cause the person to get less pleasure from other things they once enjoyed, like food or social activities. Furthermore, long-term usage also affects changes in other brain chemical systems and circuits as well, affecting functions such as:
On the other side of the spectrum, there are many doctors in agreement, who believe that someone can still choose not to take drugs, even if it cause changes in their brain—that addiction is a choice one makes. Doctors who concede addiction as a choice and not a chronic disease seldom believe in lifelong treatment. They believe the majority of addicts can and have stopped on their own without formal treatment.
ABC News states in an article it published titled “Is Addiction Just a Matter of Choice?”, that there are conflicting viewpoints on addiction and treatment our nation faces today and quotes Stanton Peele, the author of “The Diseasing of America,” in their write-up, saying “the United States has elevated addiction to a national icon. It’s our symbol, it’s our excuse.”
Psychologist Jeff Schaler, author of “Addiction Is a Choice,” argues that people have more control over their behavior than they think and it’s moreso an impulse control issue. “Addiction is a behavior and all behaviors are choices. What’s next, are we going to blame fast-food restaurants for the foods that they sell based on the marketing, because the person got addicted to hamburgers and french fries?”
Although the two opposing viewpoints display ample evidence, it is safe to say that the seriousness of addiction and the suffering it causes both to the addicts themselves, and to the people around them, cannot yet be fully understood in terms of disease, brain changes and/or loss of control. This is discussion will undoubtedly undergo further scrutiny and research in the coming years.