Addiction has always been a complicated issue, but has become ever more prevalent in our daily lives due to the current opioid epidemic affecting our nation. Before that though, we had the crack cocaine epidemic of the ‘80s and even before that we had the rise of LSD use in the ‘60s and ‘70s.

Addiction is not a new phenomenon. One conception about these societal problems that is always thrown around is that addiction is a choice, and that people struggling with drug use chose this life for themselves. According to the National Institute on Drug Abuse (NIDA), addiction is defined as “a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.”

The idea that addiction is not a disease creates a stigma around people who use substances and ultimately guilts and pushes people into the fringes of society. It can cause people who use drugs to feel ostracized by their own communities and to not reach out for help. As we all know, you cannot choose a disease for yourself, so punishing and demoralizing people who use substances is the wrong way to go about handling this, or any, disease.

I mentioned earlier about how many people say that the substance user chose to take drugs, so it is therefore a choice and not a disease.  Addiction is very similar to other diseases like Type 2 diabetes or heart disease. Both of these diseases can be caused by choices in eating habits, exercise routines and other choices but they are still considered diseases. They both affect an organ, have harmful consequences, and are also treatable and preventable.  In that same sense, addiction is no different. A person may choose to not to exercise or to eat unhealthy food but that does not mean that they chose to get Type 2 diabetes or cardiovascular disease. We do not publicly shame and demoralize them. We encourage them to seek help and when viewed through this lens, addiction as a disease seems more realistic.

Addiction changes the pathways in a substance user’s brain. How that works is that drugs mimic chemicals that naturally occur in the brain, but they don’t work the same way that the natural chemicals work. They activate the neurons in our brain differently and more intensely, which then causes abnormal messages to be communicated. This interferes with the normal function of how neurons process, send, and receive information.

When the substances over stimulate a person’s neuron system, our brain looks at that as a great reward, like the euphoria you get when you ace a test or reach a goal you’ve been working hard it.  Our brains are wired so that we repeat activities that make our brain feel rewarded, and if our brain gets that rewarded feeling from substances, it will want us to keep using to get that reward.  Brain imaging has shown changes in areas of the brain that deal with decision making, judgment and behavior control, as well as memory and learning as a cause of regular substance use.

Addiction can happen to anyone. Whether a person is rich or poor, had “good” life experiences or “bad” ones, whether they graduated from college with a PhD or dropped out of high school. Scientists believe that addiction is between 40% to 60% genetically caused. There are no single factors that determine how someone may become addicted to substances, and that’s why understanding how addiction works and why it is not a choice is so important. Addiction is a treatable disease but may not ever be able to be cured. Like many other chronic illnesses though, it can be effectively managed. That is why it is so vitally important to not stigmatize drug use, as the people affected by this disease need support and care, not to be shamed and demoralized.



©2019 Do No Harm Foundation

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