Choice vs Disease: Which One Should Addiction Fall Under?

tyranny of addiction

Would anyone in their right mind make the choice to become addicted to drugs or alcohol? Well, it kind of depends on who you ask.

This question is charged with so much political, moral, scientific, and financial controversy that it’s become an explosive topic. Even in a room with barely more than two people, you’ll likely find differing opinions on the issue.

Evaluating Both Sides of the Argument

Answers to this question encompass a full range of facts and opinions. With that in mind, we’ll go over the most common arguments for each side. Once all the information’s laid out, you can decide where you want to set up camp.

No – It’s Not a Choice.

“It’s a disease.”

the disease of drug addictionMany scientists label addiction as a disease. They argue that those struggling with substance abuse have literally lost control. The disease has taken over their bodies and they no longer have a choice.

The National Institute on Drug Abuse defines drug addiction as a “disease that will waste your brain.” Researchers who studied chemical dependency in rats and monkeys came to the conclusion that it’s a brain disease. They say the disease is characterized by a loss of control.

Also, it has been examined that drug addiction shares a lot of parallels with chronic diseases such as asthma and cancer. And while some factors of a person’s lifestyle may make them more susceptible to acquiring one of these illnesses, most people would agree that having cancer, asthma, or a related disease is not something a person chooses for themselves. 

For example, a patient will go into remission, but may have several relapses before beating the disease entirely. This is exactly how addiction works. Often times the road to recovery is winding and full of obstacles and setbacks, but like other diseases, recovery is entirely possible.

“It’s genetic.”

Some researchers have also looked into genetic predisposition for substance abuse. Their studies of genetically altered fish have led them to conclude that genes predispose some people to addiction and loss of self-control. They report that the altered fish “lost their free will.”

Yes – It’s a Choice.

“It’s free will.”

Many don’t accept the genetically altered fish experiment as proof that substance abuse involves a loss of free will. They argue if free will is no longer present, how do so many people quit? Some psychologists state that people “have more control over their behavior than they think,” pointing out that “addiction is a behavior, and all behaviors are choices.”

James Frey, author of A Million Little Pieces,says, “People need to get rid of the idea that addiction is caused by anything other than themselves.” And many doctors agree with Frey, noting that a person can still choose not to take drugs, even if they’ve caused changes in the brain.

“It’s a matter of choice.”

Researchers point to other experiments involving rats and monkeys as evidence that substance abuse is a choice. Rats given a choice between morphine and water made their choices based on their living environments.

Monkeys bullied by other monkeys chose to use cocaine, while the dominant monkeys did not. Researchers note this is “just like the human world.” Individuals who feel a lack of control in other areas of their lives are more likely to abuse substances, as are those who have been physically abused. These comparisons suggest chemical dependency isn’t a disease that removes free will, but a choice (often chosen by those who are hurting).

“It’s harmful to deny choice.”

Some experts argue labeling substance abuse as a “brain disease” is harmful to those struggling with it. They say it sends the message that there’s nothing you can do about it.

They also argue stigmatizing substance abuse shouldn’t be something we fear. It’s an unhealthy road for people to take, so it’s okay to say it’s a bad choice. Addiction expert Sally Satel asks, “Why would you want to take the stigma away? I can’t think of anything more worthwhile to stigmatize.”

Can It Be Both?

You may have read all of the above arguments and thought, well, why can’t it be both a choice and a disease? Addiction is a highly complex disorder, and therefore the answer may not be as black and white as some make it out to be. Lung cancer due to smoking is considered to be a disease, but one could also argue it is a choice because the person’s persistent use of tobacco led them to develop it in the first place. Should addiction be considered in the same way?

Where Do You Stand?

What do you think? Are those struggling with substance abuse at the mercy of a disease that has taken away their free will? Do you believe they’ve chosen to embody a disease? Or is chemical dependency simply a behavior made up of free-will choices?