Addiction A Choice? Hell No!

Is Addiction A Choice?

Addiction: A Brain Disorder, Not a Moral Failing

Hello, folks! Let's buckle up and embark on a journey today. A journey that's serious, We’ll explore that age-old question around drugs and choice. We're going to dive into the deep, often misunderstood world of addiction. In the process, we’ll try and remove some of the typical guilt trips associated with addiction. In our voyage, we’ll hopefully add understanding and empathy. Let’s begin.

Addiction: A Misunderstood Concept

First things first, let's address the elephant in the room. Addiction is often seen as a moral failing or weakness. But let's get this straight: it's not. It's like blaming a car for breaking down when it's out of gas. It's not the car's fault, it's just not equipped to run on empty. Similarly, addiction is a brain disorder, not a character flaw. It's not about being 'weak' or 'bad', it's about being human and having a brain that's wired in a certain way.

Also, let’s be crystal clear here. Not everyone who uses substances becomes addicted.

Many people using the most powerful unregulated drugs available do not have substance disorders. The last time I checked the scientific evidence, only 10 per cent of people who use unregulated drugs spiral into substance disorders. Sort of like lots of us who might take a drink once or a while, smoke an occasional cigarette, or buy a loto ticket every so often. We also don’t want to be frivolous here – unregulated drugs are incredibly powerful. The risks are extreme, both in the toxicity (risk of dying) and the potential of addiction.

Sucks when your particular circumstances, brain chemistry and other factors put you in the 10 per cent. It’s also a wake-up call for the rest of us – It’s kind of like watching a car accident unfold in front of us. If we’d been another 10 seconds further down the road, it would be us.

Frankly, us humans crave and thrive on risk. Pushing a bit more on the gas pedal, jumping off diving boards, bungee jumping, rock wall climbing, etc, etc. The first part of all risky decisions in our brains is,  “I can do this. Nothing bad will happen to me.” Those bad outcomes happen to other people. So, it should not come as a surprise to the rest of us that when people choose to use an unregulated substance for the first time, they have absolutely no intention of being the person who gets an addiction.

The Brain and Addiction

Now, let's imagine your brain as a bustling city, with the cerebral cortex being the city's traffic control centre. It's the part of your brain that helps you make decisions, like whether to have that extra slice of pizza or not. Now, imagine addiction as a sneaky, uninvited guest who barges into the control centre and starts messing with the buttons and levers. It's like having a mischievous toddler in charge of your city's traffic. Now some intersections have all red lights, and no one is moving. Other intersections are all green, and crashes are everywhere. The resulting traffic chaos is horrific, or in the case of the brain, it creates poor or no impulse control.  Anybody who’s accidentally gone through a red light or stop sign knows this feeling. Where was my brain in that moment? We clearly see the calamity we could have caused and redouble our attention while driving. For people with substance disorders, there is no reflection on how close they come to disaster when using unregulated drugs. Not a pretty picture, is it?

The Choice and Addiction

I hear you thinking and you probably want to ask, "But the first use of drugs is a choice, right?" Well, yes and no. The first use might be a choice, just like trying that suspiciously spicy taco at the new food truck might be a choice. But after the first bite, when your mouth is on fire and you're chugging milk to cool down, absolutely nothing you do is going to stop that hell fire in your mouth until it lets you go. It's like stepping on a piece of Lego. The first step is a choice, but the dance of pain that follows? Not so much.

Now the real point of my taco and Lego story is that after 10 minutes or so, you'll probably stop breathing fire or jumping around on one foot and your life will return to normal. Once substance disorder has set in, THAT hell fire won't let go for years or even decades and probably you'll need serious help to overcome addiction. There is no simple way back from substance disorders.

This is where our title comes in: "Drugs Are A Choice - Hell No!" It's a common misconception that drug use is purely a choice. But as we've seen, it's not that simple. Imagine using drugs as a powerful whirlpool that sucks you in. The first choice to experiment is like standing too close to the edge because you are curious and you just want to dip your toe in it or take a quick peek. It's a lot like that scene in the Raider of the Lost Ark where the onlookers are captivated by the radiant light that mesmerizes those who watch it it. Just like stepping too close to the edge of the whirlpool or not closing your eyes to the light from the Ark, before you know it, it is too late. The light has destroyed you and the whirlpool will never let you out of it's grasp. I can’t tell you how many people have told me that had they only known where their first use of drugs would take them, they would have run screaming away from that moment.

All of us make mistakes. Some are so horrendous that they become life altering. My dad use to tell me. "Ron, you get to make mistakes. Everyone make's mistakes, Keep doing it and you are choosing." There in those words in the problem with addiction and drugs. I'm sure my dad's word's of wisdom are the source of how many people view others who keep using substances. But here's the point. Often the first few times using drugs is all that a person gets. For them, the physical and phycological dependencies becomes so great in an unbelievably short time that they have not ability to choose. That, folks is the root definition of the word addiction.

And there is more yet to consider. People don't usually start drugs unless there are some other extreme forces at work in their lives.

Factors Leading to Addiction

Many factors push people to try drugs, including peer pressure, unresolved physical or emotional trauma, and social determinants like poverty and homelessness. It's like being pushed into a pool. Once you're in, it's not really your choice to be wet. And let's be honest, life can sometimes feel like a never-ending pool of challenges. Some people get more than their fair share and in an attempt to stay afloat, might reach out for a lifebuoy, which for many in today's world, ends up being drugs.

The Complexity of Addiction

And to those who say, "Some people with addiction stop voluntarily, so why can't all addicts?" Well, some people can eat just one slice of pizza, but for the rest of us, it's a whole pizza or nothing. Everyone's different. It's like expecting everyone to fit into the same pair of jeans. It's just not going to happen. Every single one of us is unique. Some of us can cold turkey when we’ve finally had enough. Others will need lots of support when they are ready. Addiction is a complex disorder, and it's high time we start treating it as such. Let's replace judgment with empathy, and stigma with understanding. After all, we're all just trying to navigate life the best way we can, aren't we?

Recovery: A Journey, Not a Destination

But let's not stop there. Let's also talk about recovery. Yes, recovery is possible. It's not easy, and it's not the same for everyone, but it's possible. It's like climbing a mountain. It's hard, it's exhausting, and it's different for everyone. Some might reach the top faster, while others might take a little longer. I have talked with people who said, "they'd had enough!" For them it was like throwing a light switch to off. After they made that decisions, they never used again. For most the healing journey is much more difficult. Relapse is often inevitable. In fact, it should be expected. Recovery is a journey. But the view from the top? It's so worth it.

Conclusion: A Call for Empathy and Understanding

So, let's start a conversation. Let's talk about addiction, not as a moral failing, but as a brain disorder. Let's talk about the factors that push people towards drugs. Let’s talk about the social determinants that drive people to drugs and keep them there, and let's talk about recovery. Let’s talk about the lack of recovery resources. Let’s talk about the timeliness of available resources. Let's replace judgment with understanding, and stigma with empathy. Because at the end of the day, people with substance addiction disorders are human just like you and me. We can not just throw people away, because their health problems are too complex. These are family, friends and neighbours – all part of our community.

The Author: Ron Merk – Ron advocates for people and families experiencing concurrent disorders. Much of this article is evidence-based (do a Google search on the research papers below). Any opinions are mine.

References:

1. National Institute on Drug Abuse. (2018). The Science of Drug Use and Addiction: The Basics.
2. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
3. Volkow, N. D., Koob, G. F., & McLellan, A. T. (2016). Neurobiologic Advances from the Brain Disease Model of Addiction. New England Journal of Medicine, 374(4), 363–371.