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Is Drug Addiction a Disease or Choice?

By: Jessie Gould

For centuries, addiction to alcohol and drugs has been seen as a moral failing. The person addicted was viewed as lacking in willpower. But while that view is still held by some individuals, a new model for understanding addiction has risen to the forefront in the scientific community. The reality is that addiction is a disease, and the research is there to support it.

Drugs physically change the brain and create a compulsive drive to continue using while inhibiting normal decision-making abilities.

This development has huge implications for those who are living with and fighting against addiction.

What is addiction and is it a choice?


The key here is that the addicted person will continue using even when they see the harm their addiction is causing. They know it’s bad for them, and they don’t want to be addicted. But addiction is characterized by the inability to stop.

Why is addiction considered a disease?

Drug addiction follows a similar pattern to other chronic diseases such as asthma and diabetes. The patient will go into remission, but may have several relapses before beating the disease entirely. And like these diseases, addiction too can be treated and managed.

Many people who combat the disease model of addiction will make the point that the addicted person chooses to start using drugs or alcohol. This is true, but beside the point.

Some people try drugs or alcohol and never get addicted. Others, however, have a biological or situational predisposition to addiction.

Once they begin using, the addiction takes on a life of its own and is much harder to control.

Addiction is also considered a disease because it can cause changes to the brain. Not only does it create a physical dependency in which the individual cannot stop taking the substance without experiencing withdrawals, but it also affects the individual’s ability to make reasonable decisions.

How drugs change the brain

Every drug, including alcohol, disrupts the reward system in the brain. Unfortunately, long-term usage can cause changes in the reward circuit that influence the brain’s ability to function. Specifically, the areas of the brain that are tied to making decisions, learning, remembering, and controlling behavior are all affected.

According to a paper published by Ruben D. Baler and Nora D. Volkow (both from the National Institute on Drug Abuse), “there seem to be intimate relationships between the circuits disrupted by abused drugs and those that underlie self-control […] the time has come to recognize that the process of addiction erodes the same neural scaffolds that enable self-control and appropriate decision making.”

With addiction eroding self-control, it’s no surprise that it’s supremely difficult for a drug abuser to quit on their own. Volkow drives her point home in a TEDMED 2014 presentation that, “for us to be able to exert self-control, we require the proper function of the area in our brains that regulate out behaviors.”

What this means to the addict

Why is it so important to recognize addiction as a disease? The answer is that the way we view a condition heavily influences the way we treat those who have it. When you learn that addiction is a disease, three truths become clear:

It’s not all about willpower

When a person loses their life to a drug addiction, someone undoubtedly says something along the lines of “they made their choice.”

The thought goes that the addicted person made the conscious decisions to continue their drug addiction and they got what was coming to them. But this perspective is not only unhelpful, it’s untrue.

While there is an element of choice involved, making the right choice is so much harder for someone with an addiction. The vast majority of addicted individuals are not addicted because they want to be, but because they feel they need the substance. And in many cases, their bodies are so dependent on the substance that they really do.

Treatment is effective

Getting sober and staying sober on your own is difficult. And unfortunately, for some substances, detoxing can be extremely dangerous. This is where a rehab center comes in. Just like other chronic recurring disorders, repeated treatments are often necessary to achieve success in the long run.

At a recovery center, these treatments will take the form of talking with your counselor, taking medication to help ease the withdrawals, and taking part in activities that are focused on helping you heal. You’ll regain abilities that you may have forgotten about, as well as learn techniques for managing cravings and continuing sobriety long-term.

Relapse is normal, expected, and manageable

Following the model of addiction as a disease, relapse is not a failure of treatment. Relapse happens, and it simply means that treatment needs to be changed in order to continue being effective.

You can overcome addiction

At The Recovery Village, we full heartedly believe that addiction does not have to rule your life. We’ll guide you throughout your recovery, from preparing for detox to getting treatment to experiencing your new life. Learn about our treatment options, and feel free to reach out to one of our compassionate representatives with any questions you have by calling us today.


Baler, Ruben D., Nora D. Volkow. “Drug addiction: the neurobiology of disrupted self-control.” ScienceDirect. Elsevier Ltd.,  27 Oct 2006. Web. 7 June 2016. <>.

“DrugFacts: Understanding Drug Abuse and Addiction.” National Institute on Drug Abuse. U.S. Department of Health and Human Services, Nov 2012. Web. 8 June 2016. <>.

Leshner, Alan I. “Science-Based Views of Drug Addiction and Its Treatment.” The JAMA Network. American Medical Association, 13 Oct 1999. Web. 8 June 2016. <>.

Volkow, Nora. “Why do our brains get addicted?” TEDMED. TED Conferences LLC., 2014. Web. 8 June 2016. <>.

“When and how does drug abuse start and progress? National Institute on Drug Abuse. U.S. Department of Health and Human Services, Oct 2003. Web. 10 June 2016. <>.

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Is Drug Addiction a Disease or Choice? was last modified: February 22nd, 2018 by The Recovery Village