Is Addiction a Choice or a Disease?

is addiction a choice

First the man takes a drink, then the drink takes the man.

~ Japanese proverb

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Jeremy’s Story

is addiction a choiceI took my first drink when I was 19. I could have said ‘no thanks’ when my roommate offered it to me. But I didn’t. I chose to put that liquor in my body. And I chose it again the next weekend, and the next.

Before I knew it, I was 26, and alcohol was my constant companion.

Was I still choosing to drink? No one was forcing me, so…yes. But I didn’t want to drink anymore. I wanted to make different choices, but I continued to do what I didn’t want to do. And what I wanted to do; I didn’t do.

I heard stories of people who sobered up. But I didn’t think I could. Drinking had become part of me. I felt like I was sick; like this would be with me forever.

The definition of disease is: “A condition…that impairs normal functioning and is typically manifested by distinguishing signs and symptoms.”

That sounds about right. My functioning was impaired, and I had the signs and symptoms I had always heard associated with alcoholism.

But some diseases are curable. Maybe if I chose my way into this disease, I could choose my way out.

Kara’s Story

I just wanted to feel better. I was sick of the anxiety. The sadness. I couldn’t take it. So, I drank—a lot. It eased the pain for a while. So, I kept drinking.

But after a couple of weeks, the alcohol wasn’t doing the trick anymore. I had to drink double the amount I used to drink just to keep my thoughts at bay. And in another two weeks, I doubled that amount again. I smelled like a whiskey factory 24/7.

My sister said I was becoming an alcoholic. She warned me I needed to stop drinking. “You need to make better choices, Kara. You don’t have to go down this path,” she said.

But do I? Do I really have a choice?

The definition of choice is: “The act of making a selection.”

But I’m no longer making a selection. There are no options. I have to have alcohol, otherwise I shake and sweat. I can’t concentrate; I can’t sleep.

I thought there was nothing better for me, that I had made choices I couldn’t take back.

My mom agrees that I can make better choices, but she also says that feeling unable to control my drinking is a sign of disease—a mental health disorder. She says my body and mind are sick. She says that my choices now determine how the disease progresses.

I think she’s probably right.

The Choice Argument

For those who struggle with alcohol addiction, they may feel immense pressure to make specific choices and feel like they can’t.

Do they have a disease, or is it a choice? Aren’t “diseases” specific conditions that you can’t control? Cancer. Alzheimer’s. Shingles. How can addiction be a disease if people choice the first drink… and every other drink?

But what about diabetes? Heart disease? STDs? A person’s choices can increase or decrease their risk of developing these illnesses. They are still diseases that are managed with the help of medical professionals.

Whether or not alcohol is an addiction is a long-standing debate. In these stories, Jeremy and Kara admit they willingly chose their drug of choice.

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The Disease Model

is addiction a choiceWhile Jeremy and Kara chose to take their first drink and their “drug of choice,” their ability to choose was influenced by physical processes that changed how they reacted to alcohol over time.

They developed a tolerance, they became dependent on alcohol to function normally, and they experienced withdrawal symptoms when they stopped drinking. Which, as Jeremy pointed out, seems to fit the definition of disease.

Mental health professionals currently call the behaviors and symptoms associated with “alcoholism” alcohol use disorder.

The definition of alcohol use disorder is: A mental health diagnosis describing a mild, moderate, or severe problematic pattern of significant impairment or distress, as manifested by certain symptoms manifesting within the last year.

However, addiction involves body, mind, and soul. The most accurate answer might be that addiction is a disease made up of a cycle of bad choices.

Alcohol addiction is considered a mental health condition, but this does not take away your ability to choose. One of the most empowering choices you can make for yourself is to seek alcohol addiction treatment.

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