For hundreds of years, addiction was treated as a moral failing. People who struggled with addiction were accused of lacking self-discipline and willpower. While some people still believe that drug or alcohol addiction is a choice, advances in scientific research have made it evident that addiction is actually a chronic, progressive and relapsing disease of the brain. In this article, we’ll take a closer look at whether addiction is a disease or a choice, examine the disease model of addiction and explain why it’s important to recognize addiction as a chronic condition.

Is Addiction a Disease or a Choice?

Addiction shares certain important characteristics with other chronic conditions, including diabetes, heart disease and asthma. In cases of these diseases, an affected person can go into remission with proper treatment; the risk of relapse is significant with these conditions as well. Addiction, along with many other chronic diseases, can be successfully managed and treated, resulting in remission. Another factor that points to addiction as a disease is the genetic component; esearch shows that about half the risk for drug or alcohol addiction can be liked to genes.1

Changes in the Brain

The disease model of addiction illustrates the fact that addiction causes changes in the brain.2 When a physical dependency forms, the affected person loses the ability to stop taking the substance without experiencing unpleasant withdrawal symptoms. Addiction also impacts a person’s ability to make decisions and exert self-control.

The reality of these changes in the brain counter an objection some people have to the disease model of addiction: how can addiction be considered a disease when a person chooses to begin using drugs or alcohol in the first place? It is true that people make a conscious choice to first try alcohol or drugs, but many people experiment with or casually use these substances without developing an addiction. For people with a genetic predisposition to addiction or who are exposed to other factors that increase the risk of addiction, the changes to the brain occur early on. It doesn’t take long for drug or alcohol use to develop into a full-blown addiction.

Key Implications

Why does it matter whether we consider addiction a disease or a choice? The answer is simple: the way we understand addiction has a large impact on the way we view and treat people who struggle with it. The idea that a person suffering from addiction made a conscious choice and “got what they deserved” is baseless and discouraging. Understanding that addiction is a disease that can be treated provides hope and reaffirms that it’s possible to overcome the condition and get a fresh start. The disease model of addiction also serves as a good reminder that relapse is common and not a sign of failure. A relapse simply means that the person may require further treatment or need more time to work on their recovery skills.

The scientific advances of the 20th century made it clear that addiction is a chronic and relapsing disease with a significant genetic component. Addiction has devastating consequences, ruining relationships, derailing careers and destroying good health.

With this in mind, a key question needs to be asked. If addiction is simply a choice, why would anyone choose it?