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Grace Dominguez

Addiction: Choice or Disease?

Written by: Grace Dominguez

Edited by: Christy Qu



As humans, sometimes we engage in behavior that defies our better judgment. For example, someone with a Substance Use Disorder (SUD) may choose to continuously use a drug, despite the fact that they want to be clean from it. The National Center for Drug Abuse Statistics (NCDAS) states that approximately half the population in the United States, 12 years or older, have tried illegal substances or drugs at least once in their lives. In addition, the NCDAS also states that approximately 25% of individuals who have tried illegal substances or drugs have a “drug dependency or addiction” to these substances (Carberg, 2023). In cases of individuals with SUDs, are there internal mental factors that warrant the decision to continuously use drugs? 

On the one hand, it’s argued that everyone has free will. In other words everyone has the ability to recognize the consequences of their actions. As a result, individuals with SUDs are often viewed negatively for making conventionally unsound decisions. On the other hand, it is argued that SUDs are diseases because they are treatable, have a known pathology, and have a clear trajectory with identifiable causes and effects. Those who believe that developing SUDs are a choice focus more on the “social and environmental” aspects of SUDs (Lautieri, 2024). Oftentimes individuals with this perspective unknowingly perpetuate harmful stigmas and stereotypes through stigmatic language, name-calling, and blatant discrimination (John Hopkins Medicine, 2024). Simplification and invalidation of another individual’s life experiences and health conditions also contribute to the dissipation of harmful stigmas in society (John Hopkins Medicine, 2024). This is detrimental, as it can hinder individuals with SUDs from seeking or receiving treatment and cause unnecessary distress. Therefore it has become increasingly important to debunk these harmful stereotypes and stigmas about SUDs. 

Those who believe that SUDs are diseases, however, place greater emphasis on the scientific aspects of SUDs, like the biological and neurological underpinnings of the disease. In relation to behavior for example, individuals with SUDs can experience impairment in their thought and behavioral processes. Dr. Andrew Saxon, writing for the American Psychiatric Association (ASA), finds that brian imaging studies exemplify this impairment by displaying functioning differences in brain regions associated with “judgment, decision making, learning, memory, and behavioral control” (Saxon, 2024). These functioning differences, corroborated by Indiana University Health, affect individuals with SUDs by changing their behaviors and ways of thinking. For instance, an individual with an untreated  SUD is more susceptible to cravings and risk-taking behaviors than those without SUDs. Moreover, most diseases, just like SUDs, are preventable, treatable, have a viewable pathology, and can be influenced by genetics. Indiana University Health states that, if an individual has a family history of “drug addiction” or SUDs, they are at a greater risk of developing one themselves (Indiana University health, 2023).

In conclusion, there is substantial research and evidence that supports SUDs as a diagnosis. It is very important that we take time to educate ourselves about a disease or condition before we draw our conclusions about individuals, especially regarding SUDs. Ignoring crucial evidence can make it even more difficult for patients to seek help or treatment. In addition, harmful stigmas further validate stereotypes and discrimination, which is unethical. Overall, SUDs are definitely diagnosable diseases that can benefit from treatment, however it’s important to understand why this is the case so we can further help individuals with SUDs while also combating and exposing harmful stigmas along the way.


References:

Carberg, C. (2023, June 14). USA Addiction Statistics. AddictionHelp.com. Retrieved from https://www.addictionhelp.com/addiction/statistics/

Indiana University Health. (2023, July 13). Is Addiction Really a Disease?. Indiana University Health. Retrieved from https://iuhealth.org/thrive/is-addiction-really-a-disease 

Johns Hopkins Medicine. (2024). Reducing the Stigma of Addiction. Johns Hopkins Medicine. Retrieved from https://www.hopkinsmedicine.org/stigma-of-addiction/ 

Lautieri, A. (Ed.). (2024, February 7). Is Addiction a Disease or a Choice?. American Addiction Centers. Retrieved from https://americanaddictioncenters.org/rehab-guide/is-drug-addiction-a-disease 

Saxon, A. (2024). Addiction and Substance Use Disorders. American Psychiatric Association. Retrieved from https://www.psychiatry.org/patients-families/addiction-substance-use-disorders

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