Is Substance Use Disorder a Choice or a Disease?

Is Substance Use Disorder a Choice or a Disease?

People have questioned whether addiction is a disease or a choice for many years. Unfortunately, the “addiction as a choice” narrative has perpetuated stigma and discrimination against people with substance use disorder (SUD). If you support a loved one through addiction recovery, it is important to understand addiction as a disease and why that fact matters.

Why Is Addiction Not a Choice?

When people initially interact with substances, such as drugs or alcohol, they most often do so by choice. However, even then, their choice is often influenced by risk factors beyond their control. For example, someone who uses prescription drugs for an illness or injury may become addicted. Alternatively, someone who drinks alcohol to deal with grief may develop a dependence on it.

When substance use becomes an addiction, drinking or using is no longer a choice. If it were, it would be easy to quit. For most people struggling with SUD, their ability to choose a sober life is taken away by the powerful effects of these substances. To state in absolute terms that addiction is a personal choice is to blame the individual. This can do more harm than good.

Why Is the Choice Narrative Harmful?

SUD is not a choice because almost no one, if anyone, initially engages with addictive substances intending to become addicted. Informed or not, most people think they will be able to control their use. The choice narrative is harmful because it simplifies the struggles that occur during SUD and generates more guilt. When addictive patterns become solidified, quitting is no longer a matter of willpower.

Another harm perpetuated by the choice narrative is a lack of compassion. Without understanding the root causes of substance use, one can easily point judgmental fingers. This attitude may create barriers that prevent people with SUD from seeking treatment.

Why Should Addiction Be Understood as a Disease?

A range of risk factors, including genetics, family history, and life circumstances, determines substance addiction. Some people are in high-risk groups impacted by factors like parental substance use, trauma, or mental health problems. These people may be genetically, environmentally, or socially predisposed to use substances.

Once habits of substance use form into a compulsion, it becomes a chronic brain disease. Research shows that, like other common forms of chronic brain diseases, substance addiction changes brain structures and requires specialized treatment before fully healing.

Why Is Addiction a Disease of the Brain?

Scientific consensus has concluded that SUD is a chronic but treatable brain disorder. It involves changes to neurological structures and pathways in the brain’s reward, stress, emotional regulation, and self-control systems. Therefore, treating addiction requires brain science-based approaches.

The disease perspective helps people stop viewing addiction as a moral failing. However, this does not mean social and environmental factors lose their effect. In fact, because of the brain’s neuroplasticity, addiction recovery experts rely on modifying environmental factors to help the brain return to its normal, sober state.

How Does This Change of Perspective Help?

Acknowledging addiction as a disease can help people become more informed about treatment processes. This does not mean that people are not responsible for their actions. Most addiction treatment programs emphasize recognizing and righting wrongs and taking back control of a healthy lifestyle.

Knowing that addiction is a treatable disease can motivate people with SUD to seek treatment. While one does not have a choice about developing an addiction to substances, one can choose to begin treatment, knowing that willpower and shame cannot undo the damage in the brain.

Viewing addiction as a chronic disease can help recovering individuals adopt a proactive approach to wellness. It can also help them avoid complacency because addiction recovery requires long-term maintenance, like healing from most chronic diseases.

How Can You Remain Hopeful in Addiction Recovery?

If substance addiction is such a powerful and stubborn brain disease and the relapse rate is very high, where is the hope? Long-term sobriety is hard to maintain; such is the nature of living with a chronic disease. Take people with diabetes or chronic heart disease, for example. They must constantly work on maintaining their health or risk serious health consequences.

Hope comes from continuous action. By committing to managing stress and adopting healthy behaviors, recovering individuals can gradually move into a healthy maintenance mode. There is no quick fix to addiction. Instead, individuals must work hard and gather support from family and friends. The good news is many people have succeeded in recovery with the help of science-based treatment methods.

Overcoming guilt, shame, and lack of knowledge is a key step toward recovery. Knowledge about addiction recovery can also give hope and assurance. Recovering individuals need unconditional and nonjudgmental support. These are the best gifts loved ones of those struggling with SUD can give.

Do you know how to support your loved one best as they go through treatment? Have you learned about addiction being a chronic disease, not a choice or moral failing? A change of perspective may help you understand your loved one’s struggle and better support them. At Laguna Shores Recovery Center, our staff educates families who support their loved one through addiction. We design science-based methods for the most effective treatment. Our programs include various treatment programs, including cognitive-behavioral therapy (CBT), 12-Step programs, experiential therapy, and more substance-specific interventions. Do not give in to shame and guilt. Recovery can begin here and now. Call us today at (866) 774-1532 to learn more.