Written by: Anthony Anders, ADC, LCDC-III - Chemical Dependency Counselor
I hate hearing people exclaim that “addicts are where they are due to their choices. Or, “It’s not a disease, it’s a moral failing.” I have as much trouble with hearing that now as much as I did when I sat at the edge of my own bed in treatment dealing with my own situation. Being told I had a disease did not sit well. I thought, “A disease is like cancer, or diabetes, addiction is something else.” “Addiction is bad people doing bad things.” It is not a bad person who needs to get “good, “ it is a “sick” person who needs to get healthy.
As I moved forward in working on myself, as well as getting my degrees in Mental Health, Addiction, and Psychology with a concentration in addiction, I became aware of the importance of dissecting some of these terms in helping both the addict and those on the periphery in coping with the complicated subject of addiction. I came to realize that people will often gaze upon addiction and alcoholism through the lens of their own personal experiences. For example, if someone were raised by an abusive alcoholic, then all alcoholics will seem like abusive a-holes. If one had a heroin addict in their life who was stealing to support their habit, then all opiate addicts are thieves. I realized I had some work to do.
I first started by looking at the definition of “disease.” Merriam-Webster’s Dictionary offered this:
“A condition of the living animal or plant body or of one of its parts that impairs normal functioning and is typically manifested by distinguishing signs and symptoms.” (Merriam-Webster Dictionary Online)
This put my mind at ease as I have come to realize the term “disease” itself is broad enough to encompass the broad array of that which it defines. Addiction does involve impaired functioning and does have its signs and symptoms. So, my recommendation is for people to not get so hung up on the diatribe of whether or not it is a “disease” (it is) and move on to either help someone else who suffers or to galvanize their own coping whether in dealing with it personally or socially.
People compare addiction claims to cancer or diabetes thinking that [addicts] unfairly juxtapose themselves to these groups of individuals, but let’s look a bit deeper. Certain behaviors can create disease. Take cancer for example. There are internal or genetic causes that may prompt the onset of these diseases. True. But there are other portals for disease to occur.
In the case of lung cancer, it can happen in a variety of ways, but let’s look at smoking for the sake of argument. Smoking is not the disease but the potential cause. Smoking introduces toxins that impair healthy cellular function which causes the fertile ground for cancer to develop (very short description to make a point). Smoking (the behavior) triggers pathological organ changes that result in the disease state of cancer.
Also, since people like to compare, if you are a smoker, put down your cigarettes right now. Just stop. Been there. It’s kind of hard isn’t it? Chemical dependency is chemical dependency. The level of withdrawal and other insidious behaviors are only indicative of the ingested drug, but if you want to quit and can’t, it is still addiction.
Similarly, since many bring up diabetes in their argument, poor diet and sedentary lifestyles (behaviors) can prompt the conditions that allow diabetes to develop (the disease). I use these examples to show how it is hard to sterilize this down into simple definitions, and yet one that will sit well with all people. Let’s just say, or be open to digesting that using drugs or alcohol (to the point of chemical dependency) is a behavior that creates changes in the body that becomes a disease. The word “disease” is not an excuse, just a definition that many do not quite understand. (Plus, diseases can go into remission, but that is another conversation.)
As I did use the word “behavior,” I must pause for a moment to show the dichotomy between the words “choices” and “behaviors.” In my years as a chemical dependency counselor, I have yet to find anyone who has sat on my couch saying that, “Ever since I was a young child, I wanted to find something that would harm my health, take my money, cost me jobs, ruin relationships, put me in jail, and possibly kill me.” If you are to ask most any young child, they are probably aware (in today’s age) that drugs are bad.
I firmly do not believe that people “choose” their current lot. Choices are often decisions we make with many facets that can determine how we come to conclusions. Our age, environment, health, upbringing, culture, etc. are just a few of the many influences. When one may, for the first time, “choose” to take a puff, a sip, a pill, or whatever, the choice at the time is influenced by many factors that may make this snapshot decision in time seem like a good idea (even if devastatingly bad in the future). “I just broke up with my girlfriend, so yes, I will take a drink”, “My foot is broken, and the doctor gave me these pills as medicine,” “I want them to think I am cool at this party so I will take a hit off the joint.” I use this example in both embarking into, and recovering from addiction, “If you are on a rowboat in a lake, a one inch nudge of your rudder can take you to a while different part of the lake over time.”
I think we have all made decisions at one point that may have gone south, cost us a job, a marriage, health and friends, even our freedom. At the time of the decision, whether it be for self-soothing, retaliation, immediate gratification, or immature ignorance, it “nudged our rudder.” The thing with drugs is we have then introduced something that can chemically alter our brain likened to giving the keys to your car to a hijacker that promises to get you home safe (Rarely is “home safe” what you get.)
Another comparison - if our regular computer gets a virus, the virus corrupts the operating system - bad data comes out, a system crash occurs, or it is rendered inoperable. Our brains are, in essence, a chemical computer. If we download a virus (drugs/alcohol), we spew bad thoughts and behavior, we crash or can be rendered inoperable with our operating system corrupted. We then, as do our home computers, need an “antivirus” (detox, medication, etc.) and then to put up a “firewall” (counseling, rehab, support groups, etc.) so it does not happen again or at least reduces risk. The same brain that tries to abstain from using is the same one screaming, “Feed me!” Brain chemistry trumps will power, morality, character, and sadly even love every time until the chemicals are eradicated and failsafes introduced.
So, yes we observe people using. We see a behavior. A chemically-driven, very complicated, convoluted, behavior that results from perhaps a combination of genetics, environment, exposure, trauma, and bio-pharmacology that can prompt a decision to use something that, over time, results in addiction/dependency to a substance that impairs the brain to a diseased state that distorts reality and succumbs the individual to a rapacious internal drive to feed on that which can eventually kill the host. (Whew!)
I emphatically do not believe active addiction is a “choice.” It is something that occurs from a variety of impacting forces that can cause people to make decisions to engage in behaviors that over time trigger dependency to where escalated and repeated use creates a diseased state in our brains that allow the brain to take over in a behavior that can cause self-destruction. (Whew, again!)
If nothing more, let’s bypass arguing over disease vs. non-disease (it is). Let’s separate observable “behaviors” from “choices” (they are different) and at least agree that there is a problem out there. Let’s agree to protect ourselves and those we love with good information and be proactive in protecting those we care about and our communities. Be open to being open. And if we can prevent a disease in some way, let’s do so by making the choice to engage in good behaviors by seeking help from those who can.