Addiction: choice or disease?

There is an interesting discussion going on on facebook, i think that addiction stems from an underlying cause , like disbehaviour and that its not just a matter of choosing the easy option out of not feeling anything , what do you think ?

In my opinion, it's both a personal choice AND a disorder requiring medical intervention. Addiction is so complex that I don't think you can categorize it as one of the other. Plus, more often than not, it's co-morbid with other conditions - often mood/trauma/compulsive disorders.

It starts with a choice, but it becomes a disease. For example, I cannot develop alcoholism or get addicted to cigarettes if I choose to never drink alcohol or smoke a cigarette. But once I do those things stopping is not as simple as saying "no more for me thanks." I will have developed an actual chemical dependence. You can choose to quit, but it's rarely that easy once the choice is made. It's like choosing to cure yourself of a disease, you can choose to fight it through various means but you can't simply will yourself to not actually be sick right then and there.

Leah Starspectre wrote: In my opinion, it's both a personal choice AND a disorder requiring medical intervention. Addiction is so complex that I don't think you can categorize it as one of the other. Plus, more often than not, it's co-morbid with other conditions - often mood/trauma/compulsive disorders.

Its indeed complex , but to get it clear i pointed out just 2 possibilities so we can explore all within , and even outside these parameters , i think however that a completely "sane" person still can get addicted and go from not diseased to diseased , i see perfectly sane people smoking , i would not call them ill , could you explain why you think they need medical help ? Be aware that i dont disagree , i just want to know what your drive behind this is

Goken wrote: It starts with a choice, but it becomes a disease. For example, I cannot develop alcoholism or get addicted to cigarettes if I choose to never drink alcohol or smoke a cigarette. But once I do those things stopping is not as simple as saying "no more for me thanks." I will have developed an actual chemical dependence. You can choose to quit, but it's rarely that easy once the choice is made. It's like choosing to cure yourself of a disease, you can choose to fight it through various means but you can't simply will yourself to not actually be sick right then and there.

I have been brought up in a household where my parents and older brothers smoked , i was addicted to nicotine through them , where is my choice ? Again i am not critisising just trying to pull the elastic Off course in the end i stopped smoking and that is the best choice ever , but i am still addicted if you know what i mean

MartaLina wrote: There is an interesting discussion going on on facebook, i think that addiction stems from an underlying cause , like disbehaviour and that its not just a matter of choosing the easy option out of not feeling anything , what do you think ?

I believe it's important to distinguish between the factors that initiated addiction and those that perpetuate it. In drug addiction, the initiating factors (while perhaps being brought about by a certain degree of predisposition) might just have been bad luck or bad choices. Once you're addicted, however, the reward system (and physiological reactions to the substance or the absence of it) will keep the dependency going.

For other addictions, I could definitely see predispositions playing a major role - people who gamble a lot, for example, often have underlying psychological issues. It's interesting, for example, that people who have to take dopamine to counteract the symptoms of Parkinson's disease sometimes develop compulsive gambling habits. So the dopamine imbalance in the brain in combination with the medication bring about addictive behaviour.

Cyan Sarden wrote:

MartaLina wrote: There is an interesting discussion going on on facebook, i think that addiction stems from an underlying cause , like disbehaviour and that its not just a matter of choosing the easy option out of not feeling anything , what do you think ?

I believe it's important to distinguish between the factors that initiated addiction and those that perpetuate it. In drug addiction, the initiating factors (while perhaps being brought about by a certain degree of predisposition) might just have been bad luck or bad choices. Once you're addicted, however, the reward system (and physiological reactions to the substance or the absence of it) will keep the dependency going.

For other addictions, I could definitely see predispositions playing a major role - people who gamble a lot, for example, often have underlying psychological issues. It's interesting, for example, that people who have to take dopamine to counteract the symptoms of Parkinson's disease sometimes develop compulsive gambling habits. So the dopamine imbalance in the brain in combination with the medication bring about addictive behaviour.

Yes , so you argue that not only is it always a choice as such but that one circustance can even worsen the other , one could argue that the person with Parkinson is better of with his symptoms than with an added addiction , in those cases its a choice between two evils , i feel for everyone who has to make such a choice , it does not seem fair somehow

Addiction is a pretty broad term and there are many different types. We can become chemically addicted to a substance and suffer physical symptoms of withdrawal, or be psychologically addicted to something or someone that can lead to co-dependence, OCD, or simple habits.

Disease is a broad term too. Applying it to addiction would depend on what specific definition we decide to use for disease.

It could be said that I am addicted to brushing my teeth because it is an activity I do every day and it affects my mood and state of mind if I don't, but I don't consider it a disease or a conscious choice. It's just something that has become a habit.

It is also hard to define when someone is choosing something versus being compelled to do it outside of their control. Being addicted to heroine is not the same as being "addicted" to running. A runner may feel compelled to do it every day for the physical and emotional lift they get from running, but there isn't really a negative consequence to skipping a day or even a week of running, so it is most often considered a choice. There are very real negative consequences for a heroine addict when they suddenly stop using it, but the consequences of quitting are less harmful than the consequences of continuing to use, so we most often consider it an addiction. The question becomes, then, can either be considered a disease? I don't know.

MartaLina wrote: Yes , so you argue that not only is it always a choice as such but that one circustance can even worsen the other , one could argue that the person with Parkinson is better of with his symptoms than with an added addiction , in those cases its a choice between two evils , i feel for everyone who has to make such a choice , it does not seem fair somehow

Oh no, I just meant that addiction can also be caused by psychopathology, or that predispositions can play a role in getting a person addicted. But it always needs action on behalf of the person (or another person, which can be especially sinister) to get into the reward cycle. Even if you have a predisposition to be a gambler, you still need to start gambling to develop the actual addiction. Without that step, you have the predisposition but not the addiction.

Senan wrote: Addiction is a pretty broad term and there are many different types. We can become chemically addicted to a substance and suffer physical symptoms of withdrawal, or be psychologically addicted to something or someone that can lead to co-dependence, OCD, or simple habits.

Disease is a broad term too. Applying it to addiction would depend on what specific definition we decide to use for disease.

It could be said that I am addicted to brushing my teeth because it is an activity I do every day and it affects my mood and state of mind if I don't, but I don't consider it a disease or a conscious choice. It's just something that has become a habit.

It is also hard to define when someone is choosing something versus being compelled to do it outside of their control. Being addicted to heroine is not the same as being "addicted" to running. A runner may feel compelled to do it every day for the physical and emotional lift they get from running, but there isn't really a negative consequence to skipping a day or even a week of running, so it is most often considered a choice. There are very real negative consequences for a heroine addict when they suddenly stop using it, but the consequences of quitting are less harmful than the consequences of continuing to use, so we most often consider it an addiction. The question becomes, then, can either be considered a disease? I don't know.

Yeah i dont know either thats why i am asking you lot