Why Addiction Is and Isn’t a Choice
“I understand people that say it’s a disease, I don’t know if I believe it’s a disease. Some people will equate it like people that have cancer. And I say ‘It’s not.’ People don’t choose to have cancer. And the people with cancer aren’t stealing my air conditioners and aren’t stealing the copper out of people’s houses.” — Sheriff Richard Jones — Talking About Addiction
People argue that addiction isn’t a disease. They’re also the same people who haven’t experienced fighting against their bodies. The intensity of cravings building tension in each blood vessel. The experience of feeling every heartbeat pumping what seems like oxygen-deficient blood throughout the body. All while trying to avoid using another time.
WHEN ADDICTION WAS A CHOICE
If you hold your breath, you’ll start to understand what happens in a person’s body when they stop using drugs. Vision becomes blurry, your eyes bulge, swallowing becomes difficult, and your focus becomes singular. Your body trembles as your heart and lungs feel as if they’ve grown hands that are reaching out for any sort of breath.
You might think that this is a bad analogy for addiction. The body needs oxygen. It doesn’t need drugs. This is true before an addiction has started. Born into the world, your body only needs oxygen, food, and water. When someone uses a drug the first time, it’s a choice, not a necessity. Unlike oxygen, they can choose to not use and be fine. They don’t need the substance. And this is where people fixate. Addiction starts as a choice which means sobriety is also a choice, right?
Yet, I want you to ask why someone started using drugs? What circumstances led up to that first moment?
Rarely does addiction start without trauma or emotional pain leading the way. One recovering substance abuser said:
“When I started drinking, everything went blank in my mind as far as thinking, feeling emotions. So I…started getting used to it. I said ‘Well that numbed me the first time.’ I didn’t think of how I was abused or the sexual molestation so I just continued on every day and then I got used to alcohol.”
Another said:
“I remember the first time I got drunk. I felt normal for the first time in my life; I fit in, was like others — in control and satisfied.”
Addictions frequently form in the teenage and young-adult years. The time when someone’s brain isn’t fully developed. A time, when the person isn’t able to comprehend long-term consequences. To expect a teenager to fully understand that their life will be forever changed by addiction is like expecting a 5-year-old to understand why eating a whole sleeve of cookies is bad. The consequences of the stomach ache won’t be strong enough to stop the hunger. The first choice to use drugs was one seeking freedom from an uncontrollable pain. It wasn’t a search for addiction.
WHEN ADDICTION BECAME MORE THAN A CHOICE
Even though substance use begins as a choice, over time the choice becomes forced. The person addicted is trying to avoid withdrawal symptoms, not just emotional pain. With every use, their body grows dependent on the substance that originally helped them. The brain stops producing essential neurotransmitters as the chemicals from the drugs provide all it needs. To feel a sense of normalcy, the body now will need the drug.
“It got to the point where it wasn’t working anymore…I’d drink and I’d still be sad, and I’d drink more…it got to the point where I had to drink so much more to not feel anything…it was like I was drunk all day long.” — 17-year-old recovering alcoholic
Once someone has become addicted, their body treats a drug like its oxygen itself. Detoxing from alcohol, opiates, or benzodiazepines requires medical supervision because it can be lethal. Yes, lethal. Without supervision, a person can seize, have blackouts, or experience delirium. For those withdrawing from other drugs, their pain isn’t any less severe. One 23-year-old stated:
“Your muscles are like wrenching; your entire digestive tract is going crazy. Stomach cramps. Not just stomach cramps, diarrhea…everything that can go wrong with your intestinal tract happens. Your legs, you kick constantly at night…your legs will jerk and kick uncontrollably. You have insomnia. You vomit, sweat…and, oh yeah, the craziness and delirium.”
To ask someone to stop using is asking them to feel pain so intense that they want to die. And if that person can make it through withdrawals, then they face the internal turmoil of post-acute withdrawals. Their body has stopped producing Dopamine and Serotonin — the neurotransmitters responsible for helping people feel good. The body will have to redevelop this ability which can take not days, weeks, or months, but years. To stop using is to feel a physical pain worse than death and then feel years of depression and anxiety after. But again, sobriety is an easy choice to make right?
WHY THIS MATTERS
Those addicted are labeled as “addicts” so that we can ignore the stories they bring. The stories of neglectful parents, abusive spouses, or stories of rape and bullying. It’s easier to label addiction as a choice than it is to bear the burden of others’ suffering.
I’m not arguing that society should bend over backward to save those with addictions. There are plenty of people who will take advantage of a stranger’s kindness. What I’m asking is that we look at the stories of those who are suffering. To not ignore the pain of others but to keep it in perspective.
Those addicted aren’t without responsibility. Cognitively they know that their choices are killing them. They’ve shamed themselves after every use. The truth is plain that what they’re doing is hurting themselves and others.
One person stated:
“It was like I was two people. My inner self would try to communicate to me that, ‘this is not you’… My outer self would communicate to me, ‘this is who you have to be.’ So I was caught in between two entities…the entities of what is good to you or what is good for you.”
Lecturing addicts and hitting them over the head with shame only furthers their descent into substance abuse hell. It encourages people to ignore others; to spend time with the only thing in the world that allows them to feel something other than pain. Shame will only make their choice of sobriety harder.
We must find a way to communicate love, acceptance, and encouragement that doesn’t enable addiction. We need to provide those addicted with something other than shame. We can’t think that this is a simple choice. If we do, those addicted will only feel more shame when they fail at sobriety.
If we want people to become sober, we have to understand the choice we’re asking them to make. It’s not as simple as stopping. They have to prepare for sobriety and plan; we need to be available for when they fall over and relapse. They’ll need acceptance and help to hold onto hope. Maybe then the choice for sobriety will be a little easier to make.
Quotes from:
Darryl S. Inaba, William E. Cohen. Uppers, Downers, All Arounders: Physical and Mental Effects of Psychoactive Drugs. 7th Edition. Medford: CNS Productions INC, 2011
Sheriff Richard Jones Quote from: Last Week Tonight with John Oliver. Perf. John Oliver. 2020.
