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Is Addiction a Choice?

Updated: Apr 25, 2023

Is Addiction A Choice, or Is It A Disorder?

A large portion of my childhood was spent sharing a home with a man who I believed chose his addictions over his family. My step-father’s addictions ran the gamut: sex, drugs, alcohol, infidelity. As I watched him burn bridge-after-bridge, I questioned why this all took precedence over the people who loved and cared for him. Could he really be choosing the things that were tearing us apart? Were the consequences of his actions not enough for him to make the choice to stop? Now, as an adult, I understand the issue is much more complex. Here’s why.

Why Some People Believe Addiction Is A Choice

Although science has proven that addiction is in fact a disorder, there remains a widely-spread belief that addiction is the result of weak character or moral failing. Because addiction begins with a choice to use, the misconception around addiction remains prevalent.

Those who insist that addiction is a choice, believe that the addict could stop using if they wanted to (3), but it just doesn’t work that way. It is argued that addiction is not a disease because:

  • Addiction is compulsive, meaning the addict drinks/uses/indulges with the intent to do it again(4).

  • The addict typically knows how much they can use to achieve the result they need.

  • The person chooses to begin using, so the addiction is self-acquired(5).

The weight of addiction creates an emotional response in those affected. This means that there will always be someone who is angry or hurt that their loved one has “chosen” addiction, so the belief of choice over disease will continue on in some capacity.

Somewhere between risky usage and dependence, the brain starts to change. The natural chemical conversation between serotonin and dopamine in the brain rewires and the addiction becomes a culture, a way of life, and then a necessity for survival.

When A Personal Choice Becomes An Addiction

While a behavior often begins with a personal choice, it can quickly slip into the disease of addiction. Consider for a moment how you spend your free time. Is it on your phone? Your career? Your kids? Your spouse? Exercise? Sugar? Carbs? Gaming? As humans, we are faced with choices every day, and without realizing it, those choices often lead to addiction in one form or another.

This process begins in the reward center of the brain. When something feels good - when we enjoy what we are doing - we are inclined to repeat the behavior.

But when does a behavior that feels good turn into addiction? When we are compelled to continue the behavior even though it is hurting our family, our job, our finances, and starts to have an impact on their general well-being.

Addiction occurs in seven critical stages:

  1. Initiation - the individual tries a substance for the first time.

  2. Experimentation - the individual uses in different contexts to see how it affects their life; e.g. at a party, after a long day of work, during sex.

  3. Regular Usage - the individual uses in a pattern; e.g. every weekend; times of stress, etc.

  4. Risky Usage - the individual begins experiencing a negative impact on their life in some capacity.

  5. Dependence - the user has formed a tolerance and relies on the substance to function.

  6. Addiction - the individual no longer has a conscious choice to use

  7. Crisis/Treatment - the breaking point of the individual’s life. They either get help or risk death(7).

Somewhere between risky usage and dependence, the brain starts to change. The natural chemical conversation between serotonin and dopamine in the brain rewires and the addiction becomes a culture, a way of life, and then a necessity for survival. The body eventually needs the substance just to get out of bed.

People are not addicted to behaviors and substances. They are addicted to a naturally-occurring substance that our brain produces called dopamine. When a person’s dopamine breaks down and the brain produces less, an individual - now known as an addict - will do anything in their power to get more as a basic human need to survive.

Why Is Addiction A Disorder?

The American Medical Association (AMA) classified alcoholism as a disease in 1956(1) and addiction as a disease in 1987(2). Alcohol or drug addiction, now more commonly referred to as Substance Use Disorder, is a chronic disease of the brain. And while others might be more prone to drug addiction or alcoholism because of their family history, it can truly happen to anyone. Here’s what we know today about the disease:

The Brain Chemistry Of An Addict

The change in classification from choice to disease was a result of determining how substances affect and change the brain. What begins as a conscious choice eventually forces the user to crave the substance, making it an unconscious act. The part of the brain responsible for making the decision to use moves from the front of the brain to the back, which is also where unconscious activities like breathing and blinking are happening. This is what proves that drug and alcohol usage or a displeasing behavior is no longer a choice, but an intrinsic part of the person’s brain(6).

What Happens In The Body

The user’s body will detect the substance and begin to adapt to having it in it’s system in an effort to maintain balance. This is what you and I know as tolerance. The result of tolerance? Using more and more to achieve an experience. The brain and body are now working together; rewiring themselves to desire more (6).

Recognized Risk Factors For Addiction

Addiction knows no bounds. It can take hold of anyone no matter their race, sex, social class, or career field. We’ve all heard the stories of well-educated doctors and nurses developing drug addictions and as a population, we are all too aware of the unfortunate results of opioids taking individuals from all corners of the country. There isn’t one single determining factor for who will develop a drug or alcohol addiction, but we do know there are a few key factors that can increase your risk:

  • Genetics - The National Institute on Drug Abuse states that at least 50% of an individual’s risk of addiction is based on their familial history (8).

  • Environment - Children who are immersed in traumatic situations involving mental health issues, domestic violence, verbal, sexual, or physical abuse, criminal behavior, or neglect are significantly more likely to become addicted later in life.

  • Development - The brain is still developing up until the age of 25. Substance abuse during such a crucial time in a person’s life can increase the risk of addiction and cause lasting damage (9).

Why Recovery Can Seem Difficult

The stigma around addiction has created a massive barrier for those who want recovery. The shame and guilt associated with addiction can leave a person feeling overwhelmed and defeated, resulting in a further decline into the cycle of addiction. While huge strides have been made in this area, the fear of being openly labeled an alcoholic or addict can feel debilitating.

The world doesn’t support sobriety. There are triggers everywhere, and an individual’s daily environment can feel like a comfort blanket, despite it being an obstacle for recovery.

Recovery is a lifelong choice. Once recovered, the individual doesn’t just stop thinking about their substance of choice. They have to make a conscious decision every single day to remain outside the cycle of addiction. The thought of practicing relapse prevention for a lifetime can feel overwhelming and even impossible. Recovery is difficult, but there are resources available to overcome addiction and stay in sobriety for life.

How To Overcome Addiction

Treatment for addiction must be comprehensive, meaning both medical and mental health services are crucial. A Band-Aid fix won’t do.

Recovery requires all hands on deck. This means you can’t do it alone. Seek the treatment you need, then seek the community you need to hold you accountable. Overcoming drug and alcohol addiction is a long process, and you need a community in your corner who will guide, and support you. You need multiple support people who will be there anytime day or night to make sure you won’t give in to your addiction.

The Treatment For Addiction Is A Choice

There is one common choice that all who suffer from addiction, and that is access to treatment. At Recovery for Life, we understand that recovery is just that - for life. Treatment is not a one-size-fits-all because addiction is not a one-size-fits-all.

Our goal is to connect the individual with the treatment needed to fully recover and stay in the practice of recovery. Anytime, day and night, for as long as you need support, we are always there, by your side, fighting with you daily to overcome addiction. We never stop fighting this fight alongside you. We can stay with you, every minute, every day, every month, every year, for life. You can stop engaging in addictive behavior, but the hard truth is, there is no cure for addiction, only recovery. Relapse is to addiction as heart attacks are to heart disease. You can't change your past, but you can choose to change your future.

Choose to seek help. Choose to break down walls. Choose to take back your life. Choose to treat your addiction. Choose to recover. Choose to stay in Recovery For Life.



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