Sober living

Is Drug Addiction a Choice or Disease?

Options include withdrawal and detox, ongoing treatments such as medications and therapy, and intensive outpatient programs. The present paper is a response to the increasing number of criticisms of the view that addiction is a chronic relapsing brain disease. In many cases, we show that those criticisms target tenets that are neither needed nor held by a contemporary version of this view. With regard to disease course, we propose that viewing addiction as a chronic relapsing disease is appropriate for some populations, and much less so for others, simply necessitating better ways of delineating the populations being discussed. We argue that when considering addiction as a disease, the lens of neurobiology is valuable to use.

  • In the addiction field, compulsive drug use typically refers to inflexible, drug-centered behavior in which substance use is insensitive to adverse consequences [100].
  • Alcohol or drug addiction, also known as substance use disorder, is a chronic disease of the brain that can happen to anyone.
  • Once whole genome sequencing is readily available, it is likely that it will be possible to identify most of that DNA variation.
  • This means consciously training ourselves to think about and behave toward the patients with addiction we encounter on our wards, in our offices and in front of our hospitals in the same way we think about and behave toward other patients.

Read on to find out more about the true nature of addiction and whether it is a choice or disease. The first view (addiction as a choice) is the most common, resulting in stigmatization of individuals who have developed a drug addiction, preventing them from seeking professional help. While different types of substances can cause various signs and symptoms, being addicted to any type of substance results in the same action on the addiction center in the brain. For example, if you think that substance abuse is a disease, it may lessen your sense of guilt, or if you think it is a choice this may deepen your guilt. On a larger scale, it can impact and change interventions as well as drug policies. However, some people argue that addiction is not a disease but a choice.

Biological Risk Factors for Addiction

To achieve this goal, we first discuss the nature of the disease concept itself, and why we believe it is important for the science and treatment of addiction. This is followed by a discussion of the main points raised when the notion of addiction as a brain disease has come under criticism. In the process of discussing these issues, we also address the common criticism that viewing addiction as a brain disease is a fully deterministic theory of addiction. Much of the critique targeted at the conceptualization of addiction as a brain disease focuses on its original assertion that addiction is a chronic and relapsing condition. Epidemiological data are cited in support of the notion that large proportions of individuals achieve remission [27], frequently without any formal treatment [28, 29] and in some cases resuming low risk substance use [30]. These spontaneous remission rates are argued to invalidate the concept of a chronic, relapsing disease [4].

is addiction a disease or choice debate

If you moved to such a country, you’d have to change your habit, which isn’t easy. It would require deliberate action (the decision to change) and ongoing practice (diligence). Only then could the brain rewire itself and create a new automatic response—and even that would take time. In the meantime, you’d be stuck with a habit that is dangerous to your survival but difficult to override.

An addicted brain impacts behavior

Experts state that if you have family members who have been chemically dependent, then you are more likely to suffer from addiction. There are things that you can do to lessen those chances, such as not drinking or using drugs at all. Some experts think that if it is a disease, then you can be treated for it, just as any other illness. Most people who have been to a treatment center are familiar with the disease model of addiction.

  • These prejudices lead us to view the behaviours of smokers, alcoholics and other substance users as moral and lifestyle choices,3 rather than to see them through the lens of disease biology.
  • However, on the other side of the spectrum, many drug addiction treatment experts claim that managing addiction like a conventional brain disease doesn’t work.
  • The choice model also considers environmental factors such as poverty, which can substantially increase a person’s vulnerability to use drugs.
  • In contrast, today, descriptions of “brain disease” imply that people have no capacity for choice or self-control.
  • Research and input from top addiction authorities, addiction medicine doctors, neuroscientists and experts from the National Institute on Drug Abuse agree in classifying addiction as a disease.
  • Once I was a few years into my recovery, I began studying addiction medicine, in no small part to make sense of what had gone wrong with me and my family — both of my parents were alcoholics.

It does this by reducing how well the cells in the brain’s reward center respond to the drug. As a result, the brain needs more of the drug to achieve the same effects it felt the first time a user took the substance. Everyone makes a choice about using drugs or taking a drink for the first time. Willpower and shaming won’t undo the changes in the brain and cure addiction. There is no cure, but treatment helps you manage and successfully live with the disease.

Causes & Risk Factors of Addiction

Not only is there no evidence that they cannot moderate their drinking, there is clear evidence that they do so, rationally responding to incentives devised by hospital researchers. Again, the evidence supporting this assertion has been known in the scientific community for years (Table 2). While there is an element of choice in substance use, the neural actions of dopamine tilt the brain to be so interested in the immediate reward that it can’t even contemplate longer-term goals or exert control. That is why those who are addicted repeatedly act against their own best interests, frustrating everyone around them—and themselves. Once seen as a moral failure, addiction has more recently been viewed strictly as a medical problem.

A plurality of disciplines brings important and trenchant insights to bear on this condition; it is the exclusive remit of no single perspective or field. Addiction inherently and necessarily requires multidisciplinary examination. Moreover, those who suffer from addiction will benefit most from the application of the full armamentarium of scientific perspectives. Some say medications for opioid use disorder (MOUD) are merely substituting one drug for another.

Addiction causes the brain to ask for more

That does not in any way reflect a superordinate assumption that neuroscience will achieve global causality. On the contrary, since we realize that addiction involves interactions between biology, environment and society, ultimate (complete) prediction of behavior based on an understanding of neural processes alone is neither expected, nor a goal. However, a heritability of addiction of ~50% indicates that DNA sequence variation accounts for 50% of the risk for this condition. Once whole genome sequencing is readily available, it is likely that it will be possible to identify most of that DNA variation.

However, with a strong support system, professional therapy, and careful monitoring, addiction recovery can be managed long-term. This is consistent with the fact that moderate-to-severe SUD has the closest correspondence with the more severe diagnosis in ICD [117–119]. However, many scientists now know that this does not happen, which is where this argument quickly falls apart. Instead of returning to normal and no long being a problem, addiction is a process of ongoing recovery. Even years after being sober, a person who was once an addict will be at a higher risk for drug abuse than their peers who were never addicted.

Eventually this leads to the development of dependence, which means that their body has been altered so much that it loses the ability to function normally without their chosen substance. If use stops, they will experience a series of painful side effects known as withdrawal, until either their body returns to its normal state without drugs or when they use again. The first Sober Sayings and Sober Quotes option may take several days or weeks to accomplish, so many people opt for the latter as it is less painful. By choosing this option, the user becomes locked in a progressive cycle of addiction. So, does a person become addicted to a particular substance because of their personal choice, or is it a disease that warps their brain, taking choice out of the equation?

is addiction a disease or choice debate