Drug addiction is an epidemic in the United States. As of 2022, an estimated 48.7 million Americans struggled with a substance use disorder, also known as addiction. With 17.3% of the population qualifying as being “an addict”, it becomes more important than ever that we treat addiction, learn to recover, and figure out a way forward for everyone. Most of us have heard the “nature vs nurture” arguments, with some arguing that drug addiction is a “disease”. Traditionalists view substance use disorder as a choice, a moral failing, and something that people do because they are weak. That’s why many people still rely on “tough love” policies and allowing people to hit rock bottom before they recover.
Today, we know that drug addiction is much more complex than a personal choice. People facing addictions are often completely out of control of their own behavior. They struggle with pathological compulsions to acquire and use drugs, and often cannot help prioritizing those compulsions above every other thing in their life. That can make drug addicts seem cold, manipulative, uncaring, and like they’re deliberately using the people around them – which in turn makes it harder to feel empathy and to see drug addiction for what it is, a severe mental health problem that deserves and requires treatment.
In short, everything we know about drug addiction today shows that it is a “disease” or rather “a disorder”, and it is one that can be treated and one that can be recovered from. The longer answer is elaborated on in the rest of the article.
Is Choice a Part of Addiction?
Addiction is not something that happens to everyone. Instead, it is very much influenced by multiple factors including your genetics, your upbringing, your lifestyle, your socioeconomic standing, and your mental health.
At the same time, it’s also true that the greatest common denominator to addiction is exposure. People who are not exposed to drugs do not become addicted to them. So, the first step is that choosing to use drugs to begin with increases your risk of addiction. The more you choose to use, the greater that risk of addiction becomes.
Sometimes, drug use isn’t much of a choice. For example, if you are given a prescription for managing pain or panic disorder. Sometimes it can feel like much less of a choice. For example, if you’re struggling with mental health problems or significant stress and the people in your environment hand you drugs as an outlet.
No One Chooses Addiction
In every case, it’s important to keep in mind that it doesn’t matter that choosing to use drugs increases your risk of addiction, no one chooses addiction. Instead, people become addicted by making choices that increase risks. No one chooses to become dependent on a drug, just like no one chooses to be in situations where they feel like they need substances to escape or to make life livable.
No one chooses to become tolerant and then dependent, no one chooses to become behaviorally addicted to a substance. No one chooses addiction. That means that no matter how much someone chooses to use a substance, they are choosing escapism or feeling good in the moment – not addiction. Addiction is an unwanted side-effect, and it is not something that person chose for themselves.
Multiple Factors to Addiction
It’s important to keep in mind that addiction is normally pushed by risk factors and exposure. This means that the base of exposure makes addiction possible. You use a substance, so you have the potential of addiction. Still, some people will use substances and will never become addicted. Others will. What’s the difference? Risk factors include a diverse range of influencers such as epigenetics, genetics, upbringing, environment, socioeconomic status, stress, mental health, and physical health. There are likely other risk factors as well.
The Three-Factor model is an addiction model that shows three base contributors to addiction. They include:
Exposure – The more often someone is exposed to a drug, the more likely they are to be dependent on that substance. Repeat exposure means that you use a drug more often. Almost no one will develop addiction on their first time using the substance, although the “hook” of feeling good and becoming dependent on the drug can start right away. Seeking behavior can start right away. That means you use the drug and it makes you feel good, so you chase the second hit and then the third and then you end up with addiction.
Environment – Your environment, including upbringing, exposure to social events, and trauma greatly influence your likelihood of addiction. These introduce risk factors by changing brain development, changing how you respond to substances, and increasing your need for escapism and release. That’s especially true with childhood trauma but can apply at any time.
Genetics and Epigenetics – Your genetics can greatly influence your risk of addiction when using a substance. For example, some studies show that your genes can influence addiction by 40-60%. Often, that’s because of how your body responds to the chemical influence of a substance.
This three-point model means that you become addicted through one thing that is inside of your control most of the time and two things that are outside of your control. Essentially, modern medicine treats addiction as something that is mostly outside of your control. It’s a disorder or a “disease” and not a choice, although choice is something that does influence addiction.
Is Drug Addiction a Disease?
Drug addiction is a mental health disorder that qualifies as a temporary disability under U.S. law. In fact, if you have an addiction and you are getting treatment, you qualify for temporary disability rights and can get assistance with getting treatment and help. Drug addiction is not a “disease” because a disease is a pathological infection. However, drug addiction is a disorder and one that requires medical treatment to recover from. For many people, treatment means getting counseling, behavioral therapy, and ongoing support to build life skills and improve quality of life. Often that means treating the underlying problem behind the disorder, including mental health problems, trauma, helping to build coping mechanisms, and building life skills to ensure you have quality of life to support recovery and feeling good and happy in your daily life. Those behavioral interventions can mean reworking things you learned through the rest of your life, undoing the harm of trauma, working to build healthy strategies to manage mental health, and getting help with figuring out how to best apply that to the rest of your life.
Getting Help
If you or your loved one is struggling with drug addiction, it’s important to talk to your doctor. From there, you can work towards finding and getting treatment, figuring out if you need inpatient or outpatient treatment, and finding a facility to get that treatment from. Part of that should be figuring out what you need in terms of treatment. For example, what kind of behavioral therapy, what kind of counseling, whether you’re going for medication-assisted treatment or social detox, etc. All of that should have input from your doctor and from a recovery specialist, which means you should reach out and ask for help before moving forward.
Eventually, addiction is a disorder and not “just’ a personal choice. It’s something people need significant and intensive therapy and treatment to recover from. And, the sooner you seek that out, the higher your chances of getting the treatment and help you need at a point that is meaningful.
