Scientists, psychologists, writers, and philosophers have been studying addiction for hundreds of years. Edgar Allen Poe spoke of his own personal demons, explaining, “I have absolutely no pleasure in the stimulants in which I sometimes so madly indulge. It has not been in the pursuit of pleasure that I have periled in life and reputation and reason. It has been the desperate attempt to escape from torturing memories, from a sense of insupportable loneliness and a dread of some strange impending doom.”
Poe seems to agree with the sentiments of Saul in the Bible, who is frustrated by his own inability to do that which he knows is against his conscience. He says in Romans 7:15, “I do not understand what I do. For what I want to do, I do not do, but what I hate, I do.” Both Poe and Saul would agree that their actions are outside of their control, and that they are trapped by their own demons. So is addiction a choice or are some just doomed to be slaves to their own bad habits and “addictive personality?” Are some of us just born with an inability to control our desire to indulge in drugs and alcohol, or has the environment we are apart of created a monster within us?
Though scientists have been studying whether addiction is caused by nature or nurture for decades, there is still not a complete consensus on the matter. Most doctors argue that it is a disease. According to the National Institute on Drug Abuse, “Addiction is a chronic, often relapsing brain disease that causes compulsive drug seeking and use, despite harmful consequences to the addicted individual and to those around him or her.”
In fact, the 12 step program itself is based somewhat on the disease model. The Big Book states that alcohol is an allergy, and that certain types of alcoholic drinkers become allergic to alcohol to the point that they can no longer control their urges. However, AA also calls for a “spiritual solution” to the problem, encompassed by the 12 steps, which infers that the problem is both medical and spiritual, both a physical allergy and a spiritual defect. The choice to get better is within us, if we seek a “spiritual solution.”
Not everyone is buying the disease explanation, however. One psychiatrist, who was highly criticized for his opinion that addiction was actually a choice, discusses his findings further in the Psychiatric Times. “Be that it may, chemical rewards have no ability to compel-although this notion that may be a cherished portion of clinicians’ folklore. I am rewarded every time I eat chocolate cake, but I often eschew this reward because I feel I ought to watch my weight.” He believes that there is no scientific explanation for addiction, and explains in detail why drugs or alcohol don’t magically compel us to act in a certain way.
Most experts agree, however, that just because addiction may be classified as a disease, it does not take the onus off of the addict to recover. In fact, if treated like a disease, it is the responsibility of the addict to do whatever is necessary to get better. If someone does not go to the doctor and eat properly after a diabetes diagnosis, then they cannot fully blame the diabetes on bad genetic luck, for example.
The most well known method of treatment for addiction are the Alcoholics Anonymous program, where meetings are held and sponsors work with sponsees through a rigorous 12 step program. It is important to note, again, that the solutions in the 12 steps are spiritual solutions to a medical or “allergy” problem. There are no medical treatments that are prescribed in Alcoholics Anonymous, except perhaps for those members in the program who advocate for a medically necessary drug detox, under certain circumstances.
The only way that treating addiction like a disease could prevent proper treatment is if the addict believes that because it is a disease, outside of their control, they have no responsibility to get better. Sometimes addicts justify their negative, destructive past behaviors by thinking it was “outside of their control,” or “just the way they are when they drank or did drugs.” Truthfully, though the addict may lose all choice after they pick up that first drink, they do bear all responsibility after picking up that first drink or drug. And in many ways, picking up that first drink is really the only choice that the addict has in their disease.
To avoid making the catastrophic decision of picking up the first drink or drug, the addict must take certain steps when they feel the urge beckoning. Alcoholics Anonymous and other 12 step programs advocate for calling a sponsor or going to a meeting. Deciding to isolate during a drug or alcohol craving is the number one factor that seems to trigger the addict or alcoholic to “choose” to pick up that first drink or drug.
Perhaps one day we will make more scientific discoveries about the nature of addiction, and we can decide, for sure, whether it is a defect in the brain or a choice that causes our brains to become defective. Regardless, treating addiction as a disease does not hurt the addict’s recovery process if the addict understands that the responsibility to get better and take ownership for their actions remains on them. It’s only if the addict refuses to take responsibility for their addiction by using the disease concept as an excuse that the disease concept can become detrimental to recovery.
Are you or someone you know struggling with an addiction to drugs or alcohol? Contact Linda Rose at 949-558-4723 and speak to one of our certified treatment counselors. Start planning your road map to recovery today.