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Riley Miller

Rebecca Morean

English 1201.503

14 July 2020

Addiction 

At what point does desire turn into an addiction? Addiction carries a terrible stigma

across the United States and brings up controversy pertaining to whether curbing a person’s

addiction is a matter of will power or something greater. Addiction is a crippling disease that

plagues not only our nation but the entire world. In 2018, 67,367 drug overdose deaths

occurred in the United States (CDC), and because it carries a stigma that only “weak-willed”

or “poor people” are affected by this epidemic, it is frequently overlooked by most as a

real problem. This disease does not discriminate against who it decides to take hold of. It can

affect anyone, CEO’s, judges, and even law enforcement. Addiction is real and cannot be

overlooked or swept under the rug. If something is not done to help contain and prevent this

disease, countless lives will perish. The first step in controlling addiction is understanding at

what point does desire turn into an addiction.

Michael Botticelli (“Addiction is a disease”). gave a speech that emphasizes the

importance that we change the way we treat addiction. He describes if we work to change the

way we look at addiction, the same way that we looked at AIDS, then we can change the way

we view people with addiction. When we start treating people with the care they deserve, the

compassion they need, and medical treatment that this disease requires, the world can reverse

the stigma that is carried with it. Again, addiction is real and cannot be overlooked or swept

under the rug.

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The National Institute on Drug Abuse (NIDA) defines addictions as “A chronic,

relapsing disorder characterized by compulsive drug seeking, continued use despite harmful

consequences, and long-lasting changes in the brain.” (The Science of Drug Use and

Addiction, 10). The idea that addiction is a choice carries some merit. The decision to ingest

any drug is generally voluntary. Desire is defined as a strong feeling of wanting to have

something or wishing for something to happen. The continued use of a drug after the first time

may no longer be a voluntary action and the severity of this involuntary action will vary from

person to person. People decide to take drugs for a variety of reasons. Some may take them to

feel good, to perform better at school or athletics, while others simply do drugs because their

peers are doing it. Different risk factors that affect addiction include age, gender, genetics,

family and social environments, and psychological factors (Cabral 146). There are additional

brain scans that show changes in the brain that are critical to judgment, decision-making,

learning and memory, and behavior control. These scans examine the compulsive nature of

addiction.

Not all addictions are

related to drugs. People

experience behavioral addictions

in food, shopping, sex, or

gambling. Human brains have a

natural order to them which

allows neurons to send messages

back and forth throughout the

Figure 1. “Powerful Visual Representation of Addiction.”
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body. The different messages that are sent by these neurons allow people to perform different

tasks and give us the capability to live our lives. A healthy brain rewards healthy behavior

which is why people exercise or spend time with those closest to them. When these “feel

good” actions are made, our brains trigger signals to release a chemical known as dopamine,

which allows people to feel happy. The brain will also weigh out the opportunity cost or the

loss of potential gain from other alternatives when one alternative is chosen when making

decisions. More simply put, our brain makes quick decisions on whether you should upgrade a

meal at a local fast-food restaurant or stick with the normal size to eat fewer calories. When a

new task or substance is introduced to the body, the potential for something devastating could

occur. Once a person starts to become addicted to a substance or action, the natural setup of

the brain changes, and the focus on maintaining a healthy lifestyle degrades into an

uncontrollable obsession as their brain starts to react abnormally. A substance shuts the

automated piloting system of the brain off that was allowing a person to enjoy a peaceful,

smooth sailing life into a chaotic fight of wanting more.

Desire eventually turns into an addiction as a person continues to use a drug. The flood

of dopamine which is released after consuming any drug alters the way our brains naturally

release this chemical causing an unbalance. This unbalance is what drives addiction and

compromises the brain’s ability to make adequate decision-making, retain memory and newly

learned material, as well as controlling one’s own behavior. The inability to control these

functions helps provide a reason as to why addiction carries such destructive and obsessive

behaviors.

In his book “The Biology of Desire” Marc Lewis addresses addiction as not a disease

but instead, the outcome of a person who has been overtaken by desire. A person’s continuous
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repetitive action and thought to indulge in this desire is what makes it become habitual then

addiction (The Biology of Desire. x). Lewis claims it is through this habitual use that addiction

is developed and learned. He goes on to explain the way a humans brain has a neural circuitry

of desire which controls our anticipation, attention, and behavior. As our brains put a spotlight

on a substance or activity that a person greatly enjoys, then these neural circuitry pathways

will, in turn, be improved and used more frequently, much like how a small road ultimately

gets widened over time as the city it runs through expands and eventually turns into a

highway. What Lewis fails to address is how this desire has the potential to become this

“highway” or obsession after one use of a substance. People become physically dependent on

certain drugs after enough use, and this obsession leads to addiction.

The obsession that comes with an alcoholic’s next drink, a junkie’s next fix, the next

bet to be placed, or even the new pair of shoes will often bring destructive behaviors in

finding the relief from which a drug or purchase will provide to the addict due to the

imbalance of chemicals that has occurred inside the brain. Key action which need to be

fulfilled for addiction to occur are:

 A person faces mental or physical health consequences as a result of their behavior.

 A person experiences relationship problems at home or work because their behavior

has become disruptive.

 Additional negative consequences are brought forth as a result of continued

engagement in their behavior.

A person is unable to stop engaging in the behavior despite these consequences.

Attempts to reason with someone in the throes of addiction will often result in failure. Those

who are facing problems of addiction will most likely deny any wrongdoing and attempt to
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convince you they could stop whenever they want to. People cannot force someone to stop

taking drugs unless someone is planning on confining the addicted person to a room for the

rest of their lives. Talking with the affected person is generally considered the best way to let

them know that something may be wrong. Signs of addiction are difficult to notice and are

more invisible the closer to the individual you are, however, some key items to take notice of

are:

 Their behavior becomes more frequent (daily or multiple times a day).

 The person chooses not to do regularly enjoyed activities that they were previously

inclined to do.

 Serious problems at work, home, or an inability to stop the behavior.

Topics to consider before discussing why you think someone may need help are to educate

yourself on the addiction and different treatments available to control addiction. The more

informed a person is about the addiction the more they will be able to explain why an addict

should receive help from a professional. Talking directly to the person and being upfront with

them is another good way to get them to listen. Chances are the person already knows

something is wrong, and they may be going down the wrong path. Never attack them verbally

or physically and avoid talking down to the person. Tell them what events have led up to this

conversation and what options are available from here. Remember to keep as much emotion

out of this conversation as possible. This is a sensitive topic for all parties involved and

confronting someone about a possible addiction will likely result in that person feeling

defensive. If they become agitated, it is important to stay calm and meet their frustration with

compassion and understanding. Do not judge them, the reason they are using could be very

personal and difficult to put into words. It is near impossible for someone who has never
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experienced addiction to know what it feels like to be helpless and unable to stop. The idea of

stopping whatever activity they are currently engaged in would be comparable to pulling a

newborn baby from its mother’s arms. Both would fight tooth and nail to get back what is

being taken away. Lastly, provide them options for treatment and suggest they seek help

immediately and not in a few days once they get their affairs in order. If someone waits, their

addiction will take back control of their thoughts and convince them they do not need help,

and everything is under control.

Withdrawal from addiction has the potential to be life-threatening and must be

monitored by a medical professional in some cases. Withdrawal manifests as physical and

mental symptoms a person experiences after stopping or limiting their consumption of a drug.

There are different stages and lengths from which withdrawal will occur in a person

depending on what their drug of choice is. The two drugs which may result in death because

of withdrawal are alcohol and benzodiazepines (Medlineplus.gov). Alcohol withdrawal

symptoms can occur within eight hours after a person’s last drink and symptoms may last

between twenty-four to seventy-two hours and may continue for several weeks (Surgeon

General). Common symptoms include anxiety, depression, irritability, shakiness, and an

inability to think clearly. Depending on the amount of alcohol a person was consuming on a

regular basis will determine the severity of the withdrawal symptoms they experience. The

more severe forms of withdrawal are cases which need to be monitored by a medical

professional as these symptoms may be life-threatening. Symptoms include sweating,

headache, insomnia, nausea and vomiting, rapid heart rate, and delirium tremens. If an

alcoholic is experiencing delirium tremens, then they are in a critical stage of withdrawal and

are facing severe health consequences. This stage of withdrawal may bring the previously
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mentioned symptoms as well as agitation, fever, hallucinations, seizures, and extreme

confusion. An important step in ensuring an individual does not have to experience the pain

and agony which comes with withdrawal is to educate them about the consequences of drug

use before their introduction to a drug.

Preventing desire from turning into addiction may be significantly reduced in an

individual if proper education and prevention programs are set in place. If the public has more

education about the negative effect’s drugs place on people and society then there is more

hope for people to choose not to participate in that first use temptation. One key problem to

address when trying to prevent the misuse of any substance is the age of an individual from

which they first decide to use a substance. Generally, people start misusing a substance in

their adolescent years and their misuse increases with time. It is important to remember that a

person may develop and mistreat a substance at any age and have it progress from their initial

contact. The Institute of Medicine (IOM) has defined three categories of prevention which are

geared toward the intervention of drug misuse. Universal interventions which are aimed at all

people of a given population, selective interventions, which are aimed at a subgroup of people

who have been deemed as high-risk individuals and indicated interventions which are

individuals who are already using substances but have not developed an addiction yet

(“Prevention Programs and Policies”). The combined use of all three intervention programs

and proper implementation is likely to reach the majority of individuals who are targeted for

misusing a substance.

The Universal intervention program is intended to address all people across a

population by focusing on the different risk factors which increase the likelihood of an

individual misusing a substance. Some current programs in place include a minimum legal
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drinking age, limiting the availability of a substance in communities, school programs such as

the Drug Abuse Resistance Education (D.A.R.E) and the Gang Resistance Education And

Training (G.R.E.A.T.) have been effective at targeting young adolescence and educating them

about the dangers of substances and ways to say “no” to drugs. These types of prevention

techniques have the greatest probability of impact as they reach a broad group of young

people.

Selective interventions are a more targeted approach to curbing substance misuse.

These programs would be aimed toward people who are considered “high risk” of developing

a substance disorder. The intended audience for this group would be families living in

poverty, or densely populated areas as well as individuals who grew up in homes where

parents or other family were actively engaged in substance abuse.

Indicated interventions are targeted towards individuals who are active substance

abusers or near becoming an abuser. Some programs may include The Caring School

Community Program, which focuses on creating a feeling of community between the

classroom, school, and family settings. The Life Skills Training Program, which is a program

taught to middle schoolers and is part of a three-year curriculum with focal points on drug

resistance, self-management, and general social skills. The Project Towards No Drug Abuse,

which focuses on students who have failed at being a productive student and are active drug

users in addition to having behavioral problems. All three of these programs were built around

three core elements of structure, content, and delivery from which an effective research-based

program should be centered around.

Other prevention programs which are geared towards adults in the workplace include

“Team Awareness” and “Team Resilience.” Both programs were taught in three, two-hour
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sessions and were originally presented to restaurant workers in a military, tribal, and

government settings as well as ex-offenders.

Another program that evaluated primary care practices for current drinkers over the

age of sixty was The Computerized Alcohol-Related Problems Survey or CARPS. The results

from this assessment which was completed by elderly people before an existing physician’s

appointment concluded that

There were forty-four percent of patients who were hazardous and nine percent who were

harmful drinkers. About twenty percent of men and twenty-six percent of women were

binge drinkers. Most (eighty-five percent) patients agreed that alcohol is an important

topic, sixty-seven percent reported learning new information, seventy-eight percent had

never discussed drinking with a physician, and thirty-one percent intended to do so. After

reviewing CARPS data, physicians concluded that alcohol use in the elderly is an

important quality improvement topic (Nguyen et al. 7).

Elderly people face an increased risk or health risk associated with substance abuse. Even

smaller levels of abuse would have a greater negative health effect on them. Elderly people often

are on different medications which may have an adverse effect when combined with another

harmful substance that has not been prescribed by a physician. Often too, with an older

population, it will be more difficult to convince someone they should seek treatment to recover

from the abuse a substance takes on their body.

Recovery from addiction is real and can be achieved. It will not be easy or enjoyable at

first, but as a person learns how to live life as they once knew it, they will be a stronger,

happier, and more resilient person. They will still face hardships and be tempted for the rest of

their lives to return to what provided the most comfort in their times of need. Just as people
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with diabetes are constantly checking their blood sugar and managing what they eat along

with exercise, a recovering addict must find a program which works for them to stay sober.

Whether it be one of the popular twelve-step programs like Alcoholics Anonymous or

Narcotics Anonymous or a faith-based program from a church, the affected individual must be

vigilant about their recovery and desire to remain sober. Their sobriety must come before

anything else in life because they will not be able to function or help anyone else until they

put themselves first. As members of A.A. will tell you, “This is a selfish program.” An addict

must take care of their own house before they will be able to do anything meaningful for

another human. Establishments built to aid those seeking recovery do so to treat addiction as a

disease, however not all people believe addiction is a disease.

There are others who claim addiction is simply a matter of choice and people continue

to use drugs because they want to and could stop if they chose to. In the article “Addiction is

a choice and not a brain disease,” Slate provides an argument that “The brain disease concept

of addiction is false because the evidence provided by disease proponents—brain scans

showing abnormal changes in neuronal pathways and circuitry—does not hold up to scrutiny.”

Slate maintains that changes in the brain are perfectly normal and can actually occur through

one's own volition. As a former substance abuser, Steven Slate brings up some interesting

ideas which should be considered when determining whether curbing addiction is a matter of

will power or something greater. Slate argues if one were to study the brains of taxi drivers in

London, the brain scans would provide enough information for a doctor to determine the

changes in the brain that had occurred over time and differentiate between those who recently

started driving a taxi versus those who had spent many years behind the wheel helping people

get around the hard to navigate city. He suggests by doing any task repeatedly and over time,
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this will ultimately affect any person’s brain and allow it to appear different after a brain scan.

He goes on to apply this reasoning to pianists versus non-piano playing individuals saying the

scans of a pianist would effectively show the same signs that a person facing addiction would.

One topic Slate does not mention is, in no circumstance would a taxi driver, pianist, or

any person whose brain would change as a result of these repetitive tasks, lie, cheat, steal, or

even harm themselves in attempt to drive someone across town or play the piano at home. The

people he tries to use a counter-argument against do not have a problem with addiction, only

desire and passion.

The point in a person’s life where desire turns into addiction is not a clear defining

moment. People will continue to fuel their desires with repetitive use and without proper

education and communication about future consequences, they will most likely have their

desires turn into an addiction. Recognizing the signs of when your desire is starting to control

you is an important step in curbing an addiction before it starts. Providing education to people

in their adolescent years is crucial to prevent future addiction, however, it is never too late

nor, should society stop educating people at this stage of development. Society will continue

to do its best to reach every individual to educate them on the dangers of drug use, but society

cannot rely on government officials, teachers, or medical professionals alone. It is the

responsibility of every individual to look out for signs of irregular behavior, loss of enjoyment

from activities a person once regularly participated in, and new problems that have surfaced in

a person’s work and home life of those who they hold close to help curb an addiction before it

manifests.
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Works Cited

“Powerful Visual Representation of Addiction.” 9GAG, 26 Jan. 2016, 9gag.com/gag/aW6YQ54.

Botticelli, Michael “Addiction is a disease. We should treat it like one.” TEDxMidAtlantic

https://www.ted.com/talks/michael_botticelli_addiction_is_a_disease_we_should_treat_it

_like_one?utm_campaign=tedspread&utm_medium=referral&utm_source=tedcomshare,

Keynote speech

Cabral Barata, P., et al. “A Systematic Review on Substance Addiction: Medical Diagnosis or

Morality Flaw?” The European Journal of Psychiatry, vol. 33, no. 4, Oct. 2019, pp. 143–

151. EBSCOhost, doi:10.1016/j.ejpsy.2019.07.001.

Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, “Drug

Overdose Deaths.” 19 Mar. 2020, www.cdc.gov/drugoverdose/data/statedeaths.html.

Lewis, Marc. The Biology of Desire: Why Addiction Is Not a Disease. PublicAffairs, A Member

of the Perseus Books Group, 2015.

MedlinePlus, U.S. National Library of Medicine, “Health Information from the National Library

of Medicine.” 2 July 2020, medlineplus.gov/.

Nguyen, Katherine et al. “Feasibility of Using an Alcohol-Screening and Health Education

System With Older Primary Care Patients” January 2001

NIDA. 2020, June 3. “The Science of Drug Use and Addiction: The Basics.” Retrieved from

https://www.drugabuse.gov/publications/media-guide/science-drug-use-addiction-basics

on 2020, June 25
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NIDA. "Drugs and the Brain." National Institute on Drug Abuse, 29 May. 2020,

https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drugs-

brain Accessed 25 Jun. 2020.

Slate, Steven. "Addiction Is a Choice, Not a Disease." Addiction, edited by Christine Watkins,

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https://link-gale-com.sinclair.ohionet.org/apps/doc/EJ3010103402/OVIC?

u=dayt30401&sid=OVIC&xid=9c959df8. Accessed 25 June 2020. Originally published

as "Addiction Is NOT a Brain Disease, It Is a Choice," www.thecleanslate.org, 2010.

Substance Abuse and Mental Health Services Administration (US). “PREVENTION

PROGRAMS AND POLICIES.” Facing Addiction in America: The Surgeon General's

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