Running Head: IS ADDICTION A DISEASE RATHER THAN A CHOICE?

Is Addiction a Disease Rather Than a Choice?

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Institutional Affiliation
IS ADDICTION A DISEASE RATHER THAN A CHOICE? 2

Student Name

COH318

Point/Counterpoint Essay

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Is addiction a disease rather than a choice?

The biological basis of addiction has attracted a lot of research. The results have swayed

the opinions of the public as well as experts to view the use of drugs by addicts as compulsive.

But in biology, the word compulsive deals with behavioral patterns which all have a biological

basis. By definition, addiction is a disorder- a persistent and destructive pattern of using drugs.

Media outlets and scientific journals cite such observations to highlight that addiction is a

lingering, degenerating brain disorder that involves the compulsive use of drugs. Nonetheless,

research shows that most people who come out of addictions successfully did so not by the help

of a medical professional and medicinal drugs but rather by personal decisions such as, financial

constraints, pressure from the family, and the need to be respected in the society. The choices

and decisions to quit using drugs evoke a question on whether addiction is a disease or a choice.

According to the American Society of Addiction Medicine (ASAM), addiction is a

chronic disorder of the brain, and not a behavioral problem or the results of making the wrong

choices[CITATION ASA19 \l 1033 ]. When the discussion about drugs arises, society often

focuses on the obsession, the use, and behaviors of addicts as the problem. ASAM authors argue

that these noticeable behaviors are mere indicators of a disease that has affected several areas of

the brain. Dr. Miller Michael, the former president of ASAM, supports their argument by stating

that addiction cannot be classified as criminal or a moral problem. It is a brain disease that is
IS ADDICTION A DISEASE RATHER THAN A CHOICE? 3

manifested in the mode of actions taken by the addict. In asthma and diabetes, patients usually go

through remission stage and can experience several relapses before they successfully heal.

Similar to these diseases, addiction can be managed and treated. Critiques to the disease concept

model of addiction often outline that an individual chooses to begin using a drug. While that is

accurate, addiction takes on a different life and becomes harder to manage[CITATION ASA19 \l

1033 ]. Addiction also fits perfectly into the disease model since it leads to functional and

structural changes to the brain. Not only does it make it harder to withdraw because it creates a

physical dependency, addiction negatively affects a person’s ability to make reasonable

decisions. All drugs affect the reward system in the brain when there is the prolonged use of the

drug; the reward circuit is altered, affecting brain regions responsible for behavior. According to

the National Institute on Drug Abuse (NIDA), there is a close relationship between the disrupted

circuits and the circuits underlying self-control[ CITATION NID18 \l 1033 ]. Nora Volkow and

Ruben Baler who are both from NIDA argue that it is high time the society understood that the

brains of addicts are altered and do not have full control of their behavior[ CITATION NID18 \l

1033 ].

Scientifically, the above points prove that addiction is a disease rather than a choice.

However, many critiques have risen with satisfying counterpoints against addiction as a disease

concept. Is addiction a disease or a choice? To answer this, Jeffrey Schaler argues that one

should first discern an activity and a result. The world is filled with events that are not diseases

but lead to diseases[ CITATION Sch11 \l 1033 ]. Thus, it is not accurate to categorize an

activity, a self-destructive one in this case as a disease. With a clear distinction between the two,

one is left pondering whether the pattern of consuming drugs is the disease, rather than asking if

the pattern is self-destructive or causes disease. Diseases cause some body parts to experience
IS ADDICTION A DISEASE RATHER THAN A CHOICE? 4

unusual bodily functioning leading to some unwelcome symptoms. In cancer, for example, the

mutated cells show there is some abnormality, in diabetes, low blood sugar production is the

bodily abnormality that can be accompanied by unpleasant symptoms. People with any of the

above diseases cannot rightfully decide to stop either the abnormality or the accompanying

symptoms. Such a person counters the abnormality by seeking medical help[CITATION

Hey13 \l 1033 ]. Addiction does not have such bodily malfunctions. Their outstanding tangible

evidence (below) presented by the disease model supporters only show normal brain changes and

not a deformed brain.

The above evidence was presented by NIDA but has been faced with much criticism. The

organization outlines addiction as a chronic and a relapsing brain disease regarded as the

compulsive seeking and use of drugs disregarding any harmful repercussions. In their own
IS ADDICTION A DISEASE RATHER THAN A CHOICE? 5

definition, NIDA fails the disease model by blatantly stating that addiction is a disease since it

changes brain functioning as shown in the brain scans above, and the changes lead to conduct

(addiction) characterized as uncontrollable seeking and use of drugs[ CITATION Beg04 \l

1033 ]. The model fails since the brain changes do not represent a brain that is

malfunctioning[ CITATION Hey09 \l 1033 ]. As neuroplasticity shows, the brain changes as

different neuronal pathways and regions are strengthened and grown. Neuroplasticity is the

brain's ability to alter its function and structure by strengthening and growing circuits that are

often used while weakening and shrinking those that are seldom used. As the discovery states,

there is nothing abnormal about the continuous and life long process.

After weighing the arguments in the above paragraphs, I consider addiction as a choice

and not a disease. This is because the arguments arguing for the disease concept have failed to

scientifically prove that the actions of drug addicts are compulsive or reflex. Though an addicted

person can have very strong urges to use a drug, he or she has to choose whether to use the drug

or not. In Heyman Gene’s book, Addiction: A Disorder of Choice, two groups were regularly

tested for cocaine with members of one of the groups being rewarded with vouchers for testing

negative. In the group that rewards were introduced, 70% of the members remained abstinent

through the period. In the control group, only 20% of the members remained

abstinent[ CITATION Hey09 \l 1033 ]. This test demonstrates that addiction is a choice rather

than a disease. Nevertheless, a person who chooses to stop using a drug may need medical help

to deal with the withdrawal symptoms.

IS ADDICTION A DISEASE RATHER THAN A CHOICE? 6

References
ASAM. (2019, March 12). JOURNAL OF ADDICTION MEDICINE. Retrieved from American
Association of Addiction Medicine:
https://www.asam.org/resources/publications/journal-of-addiction-medicine
Begley, S. (2004, November 5). Scans of Monk's Brains Show Meditation Alters Structure,
Functioning. Retrieved from Wall Street Journal:
https://psy.phz.psych.wisc.edu/web/News/Meditation_Alters_Brain_WSJ_11-04.htm
Heyman, G. M. (2009). Addiction: A Disorder of Choice. Harvard University Press: London.
Heyman, G. M. (2013, April 18). PubMed Central. Retrieved from Addiction and Choice:
Theory and New Data: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3644798/
NIDA. (2018, June 1). Understanding Drug Use and Addiction. Retrieved from National
Institute on Drug Abuse:
https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction
Schaler, J. A. (2011). Addiction Is a Choice. Chicago: Open Court.