Though in recent decades most doctors and scientists have come to accept the view of addiction as a disease, there are still those who argue that it is really a choice.

Critics say that addiction is mainly considered a disease because of the changes in brain structure and function, but this can be true of any number of changes in behavior. For instance, the brain of someone who reads frequently will be different from that of someone who never reads because then the more white matter will appear in the areas of the brain that have to do with language. The more someone reads, the more the brain structure changes and improves. In that case, people adhering strictly to the definition could refer to readers as having a disease.

Another argument is that, even if addiction is a disease, everyone has a choice to take that first step. Assuming no one has literally shoved a pill or poured a drink down your throat, it was your decision to start using. Also, skeptics say, people can make the choice to stop, even if it is difficult. If you have cancer or heart disease, you can’t simply will yourself to stop being sick.

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Finally, labeling addiction as a disease can lead to fatalism. If an addict views his addiction as some outside force that acted upon him, he might say, “I had no choice in the matter. I didn’t do anything wrong; this just happened to me. Nothing I can do will change the outcome.”

On the other hand, there is a great deal of evidence that there are genetic and biological factors involved in addiction. The American Psychiatric Association calls addiction a complex condition and “a brain disease that is manifested by compulsive substance use despite harmful consequence.” Similarly, the American Society of Addiction Medicine defines addiction as a chronic disease of the brain circuitry affecting reward, motivation, memory, and more. Dysfunction in these circuits leads to biological, psychological, social, and spiritual changes.

Researchers have identified genes that can predispose someone to addiction. There have been studies that looked at families, including identical twins and fraternal twins, that revealed that as much as half of a person’s risk of becoming addicted to nicotine, alcohol, or other drugs depends on his or her genetic makeup.

As for the decision to take that first drink or hit of drugs, people do not choose how their brain and body will respond. Alcohol is perfectly legal for those of age, and there’s nothing wrong with someone deciding to have a drink. The problem is that some people can stop within normal limits, and people with addiction will find it much harder to do so.

Finally, babies exposed to drugs in the womb may be born addicted to the mother’s substance of choice. No one on either side of this debate can argue that they chose to be born that way. In that instance, addiction is much more comparable to something like inheriting cancer genes than any kind of choice.

If you or a loved one need help to quit drugs or alcohol, consider Asana Recovery. We offer medical detox, along with both residential and outpatient programs, and you’ll be supervised by a highly trained staff of medical professionals, counselors, and therapists. Call us any time at (949) 438-4504.