Is Addiction A Choice? How Addictions Start, And Why They Can Be Hard To Stop
Some believe drug addiction is a choice, while others believe addiction is a condition or mental disorder beyond one's control. Each of these views may have some degree of validity to them. However, addiction and drug use is often an individual and personal experience. To understand addiction and whether it is a choice, it can be helpful to look at studies on this topic and the different types of dependency one can form.
This article explores the impacts of taking drugs or addictive substances, why it can be difficult to stop, possible treatments, the benefits of receiving treatment, and major factors related to drug use, according to current research.
The two types of drug addiction (formerly “substance abuse” or “drug abuse”)
When you think about addiction, you might think about addiction to substances like alcohol or drugs. However, there are two main types of addiction. How a person engages in them, and their effect on the mind can vary.
Despite this nuance, the beginning of addiction may look similar regardless of the person and behavior. Understanding the difference between behavioral addiction versus substance addiction may help you identify when certain habits are a sign of dependency.
Note: Terms like “drug abuse,” “substance abuse,” and “addict” are not commonplace in today’s psychiatry.
Behavioral addiction
While some may think of a substance addiction before they think of behavioral addiction, the latter is a real psychiatric disorder and can significantly impact the body and mind.
Human ancestors were wired to crave what would help them live and preserve the species. Physical activity, sex, and food released reward chemicals in the body and caused pleasure, which would have been highly sought-after. At the time, reproduction was necessary for the long-term survival of humankind. The human body has its reward system for a reason, even if the brain hasn't caught up with all aspects of a rapidly evolving world.
Some behaviors cause pain. The same or similar chemicals are released to help individuals pass through challenging moments. However, in some cases, these chemicals are released in significant amounts, or behaviors are used to cope with challenges. Too much chemical release causes the receptors in the brain to get worn down. This receptor change means it takes more of a release to experience the same pleasure they once did.
This underlying programming can drive behavioral addiction, whether to sexual intercourse, binge eating, gambling, or another core behavior. Actions that set off the brain's reward system can leave individuals wanting more, even when they have negative impacts. These forms of dependency are often based on behavior, so they can occur in the long term and are difficult habits to break.
Are habits a form of addiction?
Your brain requires energy to make decisions, so it tries to minimize the number of decisions it must make. It does this by recognizing patterns in a routine. This process is how habits are formed, and most people develop habits or are influenced by the presence of habits in their life. In some cases, habits are positive. However, when someone takes on a habit as a way to cope with challenging emotions, it may become a reliant behavior, which can lead to addiction.
Smoking outside is an example of a habit. For example, an individual chooses to smoke because it makes them feel relaxed, even if they don't know how nicotine addiction affects the body and the associated risk of chronic disease. Initially, smoking outside might be a conscious decision to avoid getting smoke in the house. However, when the individual smokes outside often, the brain links the two activities. Suddenly, going outside without smoking may seem wrong to the individual.
Habits aren't the same as addictions. While they can be related, habits may be easier to break. In this example, the habit is smoking outside, and the addiction is smoking cigarettes.
Substance addiction
The natural reward pathways in the body are the same ones involved in substance addiction. However, substance addiction involves taking these chemicals rather than encouraging the body to release them naturally.
Other than the form of chemical release, the mechanics behind substance addiction are the same. Overusing the body's reward pathways makes the individual wear them out, making it increasingly difficult to satisfy the itch to use a substance.
Is addiction a choice? The two sides of the debate
There are two considerations when looking at whether addiction is a choice. It can be helpful to look at both viewpoints to understand whether choices go into addiction.
Addiction is a choice
Some people believe addiction is a choice because many actions considered addictive – whether taking substances or partaking in behaviors – start with a decision. This line of thought supposes a person addicted to a substance chooses, at least at some point, to begin to use it. A person addicted to gambling or pornography may have chosen to engage in gambling or pornography.
In a research paper by Gene Heyman titled “Addiction: A disorder of choice,” he argues that drug addiction is a result of basic choice processes and other voluntary behavior. He acknowledges that this is in stark contrast to the current view of the National Institute on Drug Abuse (NIDA), the American Medical Association, the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and other such associations that drug abuse is a disease akin to asthma, heart disease, and other genetic factors.
In an article published in The American Journal of Psychiatry titled “The Neural Basis of Addiction: A Pathology of Motivation and Choice,” addiction is similarly examined as a choice. However, while many addictions start with choices, this approach is often used to ignore addiction rather than address it.
It may also belittle addiction's power, as many who experience this challenge perceive a lack of control over their behavior. In addition, a single choice to participate in an activity, whether taking a drink or visiting a casino, isn't necessarily a one-way ticket to addiction.
If addiction stems from choices, it could be challenging to say which individual "choice" or instance of choosing is the problem, which is why this perspective can seem to misunderstand what's occurring. In addition, some people may be more likely to develop an addiction based on a singular choice if that choice has been normalized in their family, culture, or social circle, which may take away some amount of free will.
Addiction is not a choice
The argument that addiction is not a choice takes more varied stances but is backed up by research, making it a fact for many individuals. Addiction has been proven to have a genetic component. If two friends start drinking the same amount in the same social settings, but one of them has a genetic predisposition toward excessive alcohol use, it may be more likely that friend will experience an alcohol use disorder.
While people may frown upon alcohol addiction, far fewer people frown on alcohol. While a person addicted to alcohol may have one day decided to begin drinking, many people make that same decision every day. The person experiencing addiction in this scenario did not plan to become addicted.
Studies have also found that addiction physically changes the brain, especially in the case of substance use. Once someone has started using and developed a dependency, they may not have the cognitive ability to stop without support or an understanding of what is occurring. This phenomenon is also why people may experience a significant behavioral change after experiencing addiction.
In other cases, someone may not have education or know that an activity or substance could activate an addiction when they begin engaging with it. They may not be making an informed decision, and once their choice is made, they may struggle to return from it.
Is it possible to overcome addiction?
Individuals can often manage and overcome the symptoms of addiction, no matter what the addiction is or how it started. Below are a few steps.
Identify the addiction
Identifying the addiction might seem like an obvious step to someone not experiencing this symptom. However, identification can be essential due to preconceived associations about addiction.
Someone addicted to illegal substances may already know they have an addiction. However, some people with addictions do not know they have an addiction until their physical health or relationships with others are affected. Once the individual has identified the substance or behavior causing this challenge, they may move on to the next step.
Identify support
Support networks can provide emotional guidance, suggestions and resources, and accountability, all of which can be helpful as you work to overcome addiction. For this reason, support groups are often one of the most effective forms of peer support for addiction treatment. Some groups pair new members with a mentor or peer leader who can talk to them during stress or relapse. Since the other group members have also struggled with addiction, members may feel that the group understands their journey and knows how to move forward.
Identify habits
Habits and addiction aren't the same but often occur together. For example, you might buy a lottery ticket after you get gas or have a drink with your coworkers after your shift.
Identifying the habits that lead to engaging in addiction can also be a necessary step. For people with strong addictions or who have had addictions for a long time, these behaviors can be fed by any number of habits.
Once these habits are identified, you can do your daily activities without engaging in that habit. It may be enough to keep your lighter in your car, for instance, instead of your pants pocket, so you must think before you smoke.
Set progressive goals
Drastic steps might seem like the best solution for addiction, especially in a severe situation. However, they may not be realistic or sustainable. The most effective and safest step for some addictions is to cut back gradually over time.
In some cases, stopping substance use or behavioral patterns might be dangerous. Having a professional team and support network on your side when you choose to go through withdrawal or stop an addictive pattern may be safest. Harm reduction agencies often offer individuals a safe place to go when using, along with support on how to stop independently and find behavioral health support.
Another reason not to commit to high goals initially is because mistakes and relapses can happen. If the goal is to quit and never look back, someone might be tough on themselves after a relapse, deciding to quit trying. If the goal is to gradually improve over time, relapses can become learning opportunities instead of failures.
Professional support for addiction
If overcoming an addiction is overwhelming, consider talking to a mental health professional. Therapists and counselors can help you understand and overcome the chemical, social, and psychological barriers that make breaking addictions difficult.
Because addiction can be a sensitive issue, some people feel unsafe looking for help in their community. Online treatment through platforms like BetterHelp can also effectively manage addictive behaviors because it creates distance between patient and provider. One 2019 study found that online therapy could effectively reduce behaviors related to excessive gambling, a form of behavioral addiction.
Online therapy platforms allow users to have sessions from the comfort of home. In addition, you can choose between phone, video, or live chat sessions and select a time that fits your schedule. You can message your therapist outside of sessions if you need to reschedule or have questions during a difficult moment.
Takeaway
What is the choice theory of addiction?
The choice theory of addiction, conceived by William Glasser, presents a unique perspective on addiction, diverging from the conventional view of it being a disease. Instead, this theory categorizes addiction as a maladaptive behavior, one that arises from an individual's attempt to satisfy five core psychological needs. These needs include survival, love and belonging, power, freedom, and fun.
In the context of this theory, the actions associated with addiction are seen as choices, although often made unconsciously, aimed at meeting these fundamental needs, but in ways that are ultimately harmful. For instance, a person living with alcohol addiction may turn to drinking as a means to alleviate feelings of isolation or loneliness, thereby addressing their need for love and belonging. Alternatively, they might use alcohol as a way to escape from challenging emotions or situations, aligning with the need for freedom.
Glasser's theory emphasizes the role of personal choice in these behaviors rather than viewing addiction solely as a result of biological or environmental factors. This perspective opens the door to different approaches in addressing addiction, focusing on understanding and fulfilling these psychological needs in healthier ways, and empowering individuals to make more constructive choices.
Is habit the same as addiction?
Habits and addiction, often conflated, are actually distinct concepts within the framework of psychology. A habit is a behavior pattern that's developed through frequent repetition. Over time, as we repeatedly engage in a behavior in response to specific environmental cues, this behavior becomes more automatic and requires less conscious effort. This concept of habit formation is pivotal in understanding human behavior efficiency.
Psychologists explain that habit formation is part of what's known as an impulsive pathway. In this pathway, upon encountering specific triggers, certain behaviors are automatically without conscious thought or consideration.
On the other hand, reasoned actions, like deliberate decisions or intentions, fall under the reflective pathway. Here, behavior is guided by thoughtful deliberation, a process that's naturally slower and requires more cognitive effort.
As habits become more entrenched, our actions in response to certain stimuli in our environment become more automatic, lessening our reliance on direct attention or conscious motivation. The automaticity of habits suggests why they can be so enduring, even when there's a decline in conscious motivation or intent. This endurance of habits, regardless of conscious intent, underscores why psychologists advocate for habit formation strategies in long-term behavioral change and health interventions.
Addiction, however, is a more complex concept that's typically associated with the loss of control over behavior, accompanied by a strong desire to engage in it despite its harmful consequences. While it may include habitual components, addiction encompasses an intense compulsion or craving and typically has profound effects on one's physical health, social life, and overall functioning. Unlike habits, addiction involves deeper psychological and physiological elements, making it a more challenging and impactful condition.
What role does society play in addiction?
Society plays a significant role in shaping the perception and management of addiction, particularly in how it is understood and addressed. The view of addiction as a chronic condition rather than a choice has been gradually gaining acceptance, but there is still a considerable stigma surrounding substance use disorders and behavioral addictions.
Traditionally, addiction was often seen as a moral failing, a perspective that led to stigmatization and judgment of those struggling with it. This view implied that addiction was a result of weak character or poor choices. However, modern understanding, supported by scientific research, recognizes that addiction is a chronic medical condition. This shift in perspective is crucial as it influences how society, including healthcare systems and policymakers, approaches addiction treatment and support.
Recognizing addiction as a chronic condition means acknowledging that it involves complex interactions between genetic, environmental, and psychological factors. This understanding fosters a more compassionate and supportive approach, focusing on treatment and rehabilitation rather than punishment or moral judgment. The perspective also highlights the need for long-term management strategies, much like other chronic diseases such as diabetes or heart disease.
Society's role extends to providing adequate resources for treatment, creating supportive environments for recovery, and promoting policies that address the underlying factors contributing to addiction, such as mental illness and social inequities. Additionally, public education and destigmatization efforts are crucial in changing societal attitudes towards addiction, encouraging individuals to seek help without fear of judgment.
What role does family play in addiction?
The role of the family in addiction is complex, potentially influencing both the development and recovery of addictive behaviors. Adverse childhood experiences (ACEs) within the family, such as emotional neglect or exposure to substance abuse, can be pivotal in initiating addictive behaviors. These negative experiences during formative years can lead to psychological distress, making individuals more susceptible to using substances or other addictive behaviors as coping mechanisms.
Family members can also inadvertently contribute to the continuation of addiction through enabling and co-dependency. Enabling involves actions that safeguard the addicted individual from the consequences of their behavior, which might include making excuses for them, providing financial support, or downplaying the seriousness of the addiction. Co-dependency is characterized by a relationship pattern where a family member prioritizes the needs of the addicted person over their own, often to the detriment of their own well-being. This behavior can create a cycle that perpetuates the drug abuse or alcohol abuse.
On the other hand, families can also be a crucial support system in the recovery process. Providing a nurturing and understanding environment can significantly aid in the treatment and long-term recovery from addiction. Family members who actively participate in therapy, offer emotional support, and educate themselves about addiction can be invaluable in helping their loved ones overcome addictive behaviors.
What is the cause of an addiction?
The cause of addiction is often rooted in the concept that addiction is a disease, a perspective that emphasizes biological and neurological factors. These include genetic predispositions, imbalances in brain chemicals, and alterations in the reward system of the brain. However, while these biological factors play a significant role, they are not the sole cause of addiction.
Environmental factors, such as exposure to drugs or alcohol during childhood or adolescence, can also contribute to the development of addictive behaviors. For example, individuals who grow up in households where substance use is prevalent may be more likely to develop an addiction themselves. Additionally, traumatic experiences or adverse childhood experiences can also increase the risk of addiction.
Psychological factors, such as underlying mental health conditions like anxiety or depression, can also influence the development of addictive behaviors. These individuals may turn to drugs or alcohol as a form of self-medication to cope with their symptoms.
This disease model of addiction highlights how substance use or certain behaviors can alter the brain's reward system. Initially, substances or behaviors that lead to addiction may provide a sense of pleasure or relief, largely due to the release of neurotransmitters like dopamine. Over time, with repeated exposure, brain chemistry begins to change. The brain adapts to these high levels of neurotransmitters, leading to tolerance (needing more of the substance or behavior to achieve the same effect) and dependence (experiencing withdrawal symptoms without the substance or behavior).
Addiction also affects areas of the brain responsible for judgment, decision-making, learning, memory, and behavior control. These changes explain why individuals with addiction continue to seek out substances or engage in behaviors despite knowing the negative consequences. In the same way, chronic diseases can cause changes in the body. Addiction causes significant alterations in brain structure and function.
As with any illness, understanding the underlying factors contributing to addiction is crucial in developing effective treatment strategies. By recognizing that addiction is a complex condition influenced by biological, environmental, and psychological factors, we can approach it with compassion and empathy, promoting healing and recovery for those experiencing addiction.
How does addiction develop psychology?
Psychology views addiction as a complex condition that develops from the interaction of biological, environmental, and psychological factors. While there is no one specific cause of addiction, there are various psychological processes involved in its development.
One key factor is the concept of reinforcement. When an individual engages in substance use or addictive behaviors, they experience a sense of pleasure or reward due to the release of dopamine in the brain's reward system. This positive reinforcement reinforces the behavior, making it more likely to continue.
Negative reinforcement also plays a role in addiction development. Individuals may turn to substances or behaviors as a means of coping with negative emotions or stress. These substances or behaviors provide temporary relief, leading to their continued use as a coping mechanism.
Another psychological process involved in addiction is classical conditioning. Over time, individuals may associate certain stimuli or cues with the substance or behavior that provides a sense of pleasure. These cues can trigger cravings and lead to relapse even after an extended period of sobriety.
Individual risk factors such as impulsive behavior, low self-esteem, and poor coping skills can also contribute to the development of addictive behaviors. Additionally, underlying mental health conditions like anxiety and depression can increase vulnerability to addiction.
These psychological factors play a significant role in addiction and must be addressed in treatment. Therapy can help individuals identify and address underlying issues, develop healthy coping mechanisms, and learn to manage triggers and cravings. Cognitive-behavioral therapy may be particularly useful in challenging distorted thought patterns and developing new, healthier behaviors. By understanding the psychological processes involved in addiction, we can better support those managing this complex condition on their journey toward recovery.
How does addiction affect the brain?
Addiction impacts the brain in various ways, and these effects can differ based on the type of addictive behavior or substance involved. For instance, the way some drugs affect the brain may vary significantly from the impact of other drugs or behaviors.
One common thread in many forms of addiction is the alteration of the brain's reward system. Drugs and certain behaviors trigger the release of neurotransmitters like dopamine, which creates a feeling of pleasure or euphoria. Over time, with repeated use of drugs or engagement in addictive behaviors, the brain's chemistry and structure begin to change.
For some drugs, these changes may result in a heightened need or craving for the substance as the brain becomes accustomed to high levels of dopamine. Other drugs might affect the brain's ability to control mood, leading to increased anxiety or depression when not using the substance. Additionally, addictive behaviors, even non-substance related, can also rewire the brain's reward circuitry, leading to compulsive behaviors despite the knowledge of negative consequences.
Fortunately, the brain has a remarkable ability to heal and adapt. With sustained abstinence and proper treatment, some of these changes may reverse over time. However, it is vital to recognize the impact of addiction on the brain and seek professional help to address any potential damage.
What are the two psychological explanations of addiction?
There are two main psychological explanations of addiction: the disease model and the choice model.
The disease model views addiction as a chronic, relapsing brain disease caused by changes in the brain's reward system. This model suggests that individuals with addiction have a biological predisposition to the condition and that factors like genetics and environmental influences play a significant role.
On the other hand, the choice model sees addiction as a series of choices and behaviors ultimately within an individual's control. This model emphasizes personal responsibility and accountability for addictive behaviors.
While both models have their merits, many experts believe that addiction is best explained by a combination of these two approaches. The disease model recognizes the biological aspects of addiction and the importance of seeking treatment, while the choice model acknowledges individuals' agency in seeking help and managing their condition.
Where does addiction start in the brain?
Addiction is a complex condition that involves various regions of the brain and their interconnected circuits. However, research suggests that addiction primarily starts in the brain's reward system, specifically the nucleus accumbens.
The nucleus accumbens is a small but essential region located deep within the brain. It plays a crucial role in motivation, pleasure, and reinforcement. When we engage in pleasurable activities, such as eating or spending time with loved ones, the nucleus accumbens releases dopamine, a neurotransmitter that creates feelings of pleasure and reward. This dopamine release reinforces our behavior and makes it more likely to continue.
In addiction, substances or addictive behaviors hijack this natural reward system, causing an overstimulation of dopamine release. Over time, this can lead to changes in the brain's chemistry and structure, making it harder to experience pleasure without the addictive substance or behavior. As a result, individuals with addiction may experience intense cravings and seek out the substance or behavior to feel pleasure, leading to a cycle of dependency.
What is the difference between a clean mind and an addicted mind?
A clean mind refers to a state of mental clarity where one is not influenced by substances or addictive behaviors. It involves being free from the grip of addiction and having control over one's thoughts and actions.
On the other hand, an addict mind is characterized by the constant urge to engage in addictive behaviors or use substances despite negative consequences. In this state, rational thinking and decision-making are often impaired, and the individual may prioritize obtaining and using their substance of choice above all else.
A clean mind is associated with a sense of peace and well-being, while an addicted mind can lead to feelings of guilt, shame, and turmoil. With proper treatment and support, individuals can transition from an addicted mind to a clean mind, leading to improved mental health and physical well-being.
- Previous Article
- Next Article