Don't people choose to drink or do drugs? How can addiction be a disease?
Addiction is much more than a few bad choices. It disrupts the areas of the brain that are involved in reward, motivation, learning, judgement, and memory. Not only can it damage brain and body functions, but it can also damage relationships, families, and workplaces. As defined by both the American Medical Association and the American Society of Addiction Medicine, addiction is absolutely a chronic brain disease.
So what causes addiction?
Once though to be a moral failing, it's now understood that addiction is caused by a mixture of behavioral, environmental, and biological factors. It isn't an indication of weak willpower. Biological risk factors alone can account for almost half of the likelihood that a person will become an addict.
Anyone who knows someone struggling with addiction, or anyone who has struggled with addiction themselves, understands that it drastically changes you as a person. This is because it's a complex disease involving functional changes of the brain and body which result in the compulsive use of substances despite any consequences. If left untreated, addiction can lead to physical/mental disorders becoming even more severe and life threatening over time. As with other serious diseases, the ultimate consequence of addiction can be death.
How does addiction change the brain?
Addictive substances cause high secretion levels of the chemicals used in different reward pathways. When a person feels pleasure, the feelings are caused through the secretion of certain chemicals in the brain. Most addictive substances are used to mimic these feelings so they help to release higher levels of those chemicals.
As the new release of the chemicals occurs continuously over time, an individual may need the substance in order to feel normal. This could cause intense experiences of cravings or desires for the substance and even an overall loss of interest in normal life activities or healthy pleasures. These changes in the brain can remain with a person throughout the course of their life, long after a person stops using the substance. Those recovering from addiction can be more vulnerable to physical and environmental cues they associate with the substance, known as triggers, that can lead to a greater risk of relapse. Those in recovery can learn their triggers, and this awareness can prevent relapse.
Addiction is a chronic disease.
We now understand that addiction is a chronic disease. A chronic disease is a long-lasting ailment that can not be cured, so it's controlled or maintained. We wish there was a magic pill or a simple solution to fix addiction, but there isn't. The good news? Only around 20-25% of individuals who suffer from substance use have a severe, chronic disorder. These individuals are more prone to relapse and require intensive treatments, continuous aftercare, and peer support. In spite of this, even the most severe case of the chronic form of addiction can be reversed with long term treatment and support. Recovery is possible.
So why can some people recover so easily?
But recovery itself can cause confusion. Because some individuals can recover without treatment, many people find it hard to understand that addiction is a disease. Why do some people seem to give up problem drinking or drug use on their own without issue, while others can't? Individuals who struggle with a mild substance use disorder do have the ability to recover by themselves. However, most individuals with severe addiction require intensive treatment and continuous support. The need for treatment is based off the severity of the addiction and an individual’s own determination to recover.
There's also that element of choice. "Why can't you just choose to stop drinking or doing drugs?" People ask. Choosing to do something can't undermine the validity of the disease. Other diseases involve some level of personal choice. Personal choices like diet and exercise can lead to diseases such as diabetes and heart problems, but these diseases are never questioned.
Addiction is a disease that causes change in the brain. It causes changes in neural networks that can lead to an individual’s inability to make good decisions. The difficulty to act normally when suffering from addiction explains why addicts can't be entirely blamed for their actions.
With treatment, people can and do recover.
Regardless of the intensity of addiction, people can and do recover. Depending on the amount of treatment they need and with the right conditions, the recovery process is possible. Most effective programs include a focus on the underlying issues that caused the addictive behavior. Programs will also usually include mental health assessments and trauma treatment to help individuals who are suffering from addiction rooted in these issues. Some recovered addicts have also found help through spirituality and a focus on their mind/body. Workit Health offers an online treatment program to help you recover from addiction, anywhere, anytime.
To sum it up? Addiction is a disease, not a choice or a moral failing. It's a disease that causes changes in the brain. The good news, is that it's possible to recover from the disease of addiction. We need to shift our mindset, shed stigma, and focus on treatment options for those still struggling.
Workit Health helps you meet your recovery goals.
Manesy Ceja-Cevallos is an undergraduate student at the University of California, Berkeley studying Integrative Biology with a minor in English. She is excited to write using her English background for the Workit Health team. For Manesy, it is important that all individuals understand and have access to healthcare resources, and she is eager to help spread information that can ultimately help others.