One of the most common discussions – between experts and researchers, as well as the general public – surrounding addiction is whether addiction is a disease or a choice. Based on my knowledge and personal beliefs, I believe addiction is a disease. In this paper, I will discuss the causes of addiction, the fact that anyone can become addicted, and the life-altering effects and consequences of addiction.
In 2012, Statistics Canada reported that “approximately 21.6% of Canadians (about 6 million people) met the criteria for a substance use disorder during their lifetime” (Pearson, Janz & Ali, 2013). Substance use disorder is the diagnostic term for addiction in the DSM-5. The DSM-5 defines it as “a problematic pattern of using alcohol or another substance that results in impairment in daily life or noticeable distress” (American Psychiatric Association, 2013). The fact that substance abuse disorder is a diagnostic term is one indication that addiction is a disease.
Addiction can be caused by both genetic, unhealthy coping skills, and environmental factors. American Psychological Association (2008) reported that “At least half of a person’s susceptibility to drug addiction can be linked to genetic factors.” This means that at least half of the people with addiction also has a biological relative who has addiction as well. Sometimes it can even be passed down multiple generations. This makes it beyond the person’s control if they develop addiction.
The other half of a person’s susceptibility comes from environmental factors and unhealthy coping skills. People that have unhealthy coping skills sometimes use drugs as “a way of coping with painful feelings, such as anxiety, depression and loneliness” (Mayo Clinic Staff, 2017) and as this becomes a habit, they could develop dependence on the substance of their choice (Cause of Addiction: Nature vs. Nurture, n.d.). But just because someone chooses to cope this way doesn’t mean they’re choosing addiction. This article compares this to engaging in other unhealthy lifestyle choices ultimately causing heart disease diabetes and cancer. “Consider heart disease. It’s partly due to genes and partly due to poor life style choices such as bad diet, lack of exercise, and smoking. The same is true for other common diseases like adult-onset diabetes. Many forms of cancers are due to a combination of genes and life style. But if your doctor said that you had diabetes or heart disease, you wouldn’t think you were bad person. You would think, ‘What can I do to overcome this disease?’ That is how you should approach addiction. Addiction is like most major diseases.”
Environmental factors that can affect the likelihood of becoming addicted include where we live, who we hang out with, how we were raised, as well as our general exposure to drugs and alcohol. While the things I’m about to discuss may not suggest addiction, it exposes them to drugs and alcohol. Depending how frequently their environment encourages them to drink or use, they may eventually become addicted.
People who are around people who drink and do drugs will most likely do the same. A study done by Columbia University found that teens who are around friends who drink are six times more likely to drink as well (Barker, 2011). Youth are more susceptible to peer pressure because their brains are still developing. “Growing brain cells make it hard for teens to measure current pleasure against future pain. When peers pressure teens to make a decision, they cave in” (Cause of Addiction: Nature vs. Nurture, n.d.).
As previously mentioned, parents can genetically cause their children to become addicted, however, they can also expose their children to drugs and alcohol, although most likely unintentionally. “Parents who drink in front of their children could be nurturing an addiction in those children even if they never intended to do so. The organization Drinkaware says that there is a strong link between early-onset drinking and a child’s exposure to drinking in the home. It could be that teens see their parents drinking often and become convinced that the activity is harmless and fun, or it could be that teens with drinking parents have easy access to alcohol” (Cause of Addiction: Nature vs. Nurture, n.d.).
Parenting style can also influence the way youth approach the decision to use drugs and alcohol. Looking at the authoritarian style, which involves “strict and harsh parenting that punishes children’s failure and ignores their successes” and the authoritative style, which involves praising children for accomplishments, while providing guidelines and encouragement to improve on successes”, of parenting, children who were raised to the authoritative style approach to parenting tend to be more successful and make better decisions as their peers in multiple areas of their life including their usage of drugs and alcohol (Understanding Addiction: The Nature vs. Nurture Debate, 2018).
Someone’s decision to use drugs and alcohol, even if they do so frequently, does not mean their choosing addiction either. Some people will use responsibly throughout their lives and some will become addicted. When people use drugs, it’s mostly to cope with a temporary problem or just for fun. A lot of times, people don’t realize they’re becoming addicted. “Addiction is never a choice, in that no one ever thinks or believes that their first drink or drug will lead to addiction. Every addict or alcoholic thought ‘it won’t happen to me – I’ll be careful, I’ll be smart about it, I’ll stop before that happens.’ Addiction is never a choice, a lifestyle, a decision or an ‘option’” (Escobar, 2013).
Addiction doesn’t discriminate. Everyone is vulnerable, regardless of sex, age, class, race, ability, etc. “Drugs and alcohol addiction is more than capable of getting a hold of anyone no matter how in order they seem to have their life” (Addiction Doesn’t Discriminate, 2011). This means addiction can affect those who are happy, successful and have everything they need in life. For these people, I don’t think they would willingly choose to give up everything they have. It wouldn’t be a choice they would make if given the option.
Addiction has life-altering effects and consequences. Addicts face multiple types of consequences including, health, legal, financial, social. Health effects include organ damage, hormone imbalance, cancer (caused by nicotine or steroid use), prenatal and fertility issues, gastrointestinal disease, HIV/AIDS and neurological impairment. Legal consequences include large fines, extensive jail sentences, probation, arrest records that make it difficult to find a job driver’s license suspension and transportation difficulty, strict community service requirements and restrictions on living in certain communities. Social consequences include job loss, relationship changes between both friends and family members, aggression toward friends and family members, divorce, suspension or expulsion from organized activities (What Is The Worst-Case Scenario When Someone Is Addicted To Drugs Or Alcohol?, n.d.). Financial consequences include, debt due to cost of drugs, loss of productivity and income, health care costs, insurance costs, and legal fees (The Financial Toll of Addiction, n.d.)
Addiction also has life-threatening effects. In 2017, there was an estimate of more than 72,000 drug overdose deaths (National Institute of Drug Abuse, 2018a), which is most likely due to the opioid epidemic. “In 2016, synthetic opioids (primarily illegal fentanyl) passed prescription opioids as the most common drugs involved in overdose deaths in the United States” (National Institute of Drug Abuse, 2018b). However, many of these overdose deaths are accidental as drugs are being laced with fentanyl, which is much more deadly than other drugs, without the user’s knowledge.
Family members also face consequences because of their loved one’s actions. “Family members experience tremendous collateral damage from addiction—financial, emotional, social, sometimes-physical damage that can lead to strong feelings of anger, resentment, hurt, and betrayal (Escobar, 2013).
If addiction comes with all these negative consequences for the addicts and their family, it wouldn’t be a matter of choice because no one would choose to live like this. I think we would do everything in our power to avoid it. If addiction is a choice, I also believe recovery would be easier. For addicts who acknowledge they have a problem and want to get better, recovery isn’t easy and could last a lifetime.
Someone who has recently been in the news for her accidental overdose is Demi Lovato. In 2011, she revealed she struggled with addiction and other mental health issues. After six years of her sobriety, she relapsed. Soon after her relapse, she had an accidental overdose, with the drug being laced with fentanyl. She was one of the lucky ones who survived.
Lovato is otherwise a very successful, happy and healthy person. She has an amazing career as an artist and has millions of people who love her. She is also an advocate for mental health. She doesn’t seem like someone that society paints as having an addiction. Yet, she is still has it. She didn’t choose to risk everything to have an addiction. Her addiction was caused by genetic (her parents were addicts) and environmental factors (living in Hollywood, being around drugs and alcohol). Having been six months sober before, and working on her sobriety again, clearly says she wants to recover, and it wasn’t a lifestyle that she chose to have.
Based on my research and personal opinion, I believe addiction is a disease. No one would choose addiction therefore it isn’t a choice. While yes, many people choose to drink alcohol and use drugs, this doesn’t cause addiction. Many people can do so without becoming addicted. What can cause addiction is the genetics and multiple environmental factors that put a person at risk of developing addiction. Addiction can affect anyone no matter how good or bad their life is. Addiction also comes with life-altering and life-threatening consequences that not only affects the person that has the addiction but their loved ones as well. Even though addiction isn’t a choice, recovery can be if you work hard enough.
Addiction Doesn’t Discriminate. (2011). Lakeview Health. Retrieved from https://www.lakeviewhealth.com/resources/drug-addiction/addiction-doesnt-discriminate/
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Barker, J. (2011). Teens and Peer Pressure. WebMD. Retrieved from https://www.webmd.com/parenting/features/peer-pressure#1
Cause of Addiction: Nature vs. Nurture. (n.d.). Sunrise House. Retrieved from https://sunrisehouse.com/cause-effect/nature-nurture-addiction/
Escobar, A. (2013). No One Chooses to Become an Addict. DAT: Drug Addiction Treatment. Retrieved from https://www.drugaddictiontreatment.com/addiction-in-the-news/addiction-news/no-one-chooses-to-become-an-addict/
Mayo Clinic Staff. (2017). Drug addiction (substance use disorder). Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/drug-addiction/symptoms-causes/syc-20365112
National Institute of Drug Abuse. (2018a). Overdose Death Rates. Retrieved from https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates
National Institute of Drug Abuse. (2018b). Fentanyl and Other Synthetic Opioids Drug Overdose Deaths. Retrieved from https://www.drugabuse.gov/related-topics/trends-statistics/infographics/fentanyl-other-synthetic-opioids-drug-overdose-deaths
Pearson, C., Janz, T., & Ali, J. (2013). Mental and substance use disorders in Canada. Statistics Canada. Retrieved from https://www150.statcan.gc.ca/n1/pub/82-624-x/2013001/article/11855-eng.htm
The Financial Toll of Addiction. (n.d.). DrugAbuse.com. Retrieved from https://drugabuse.com/financial-toll-addiction/
Understanding Addiction: The Nature vs. Nurture Debate. (2018). The District Recovery Community. Retrieved from https://thedistrictrecovery.com/blog/understanding-addiction-the-nature-vs-nurture-debate/
What Is The Worst-Case Scenario When Someone Is Addicted To Drugs Or Alcohol? (n.d.). Serenity at Summit. Retrieved from https://www.serenityatsummit.com/resources/consequences-of-addiction/