Is Addiction A Choice? How Addictions Start, And Why They Can Be Hard To Stop

Medically reviewed by Paige Henry, LMSW, J.D.
Updated April 22, 2024by BetterHelp Editorial Team
Content warning: Please be advised, the below article might mention substance use-related topics that could be triggering to the reader. If you or someone you love is struggling with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357). Support is available 24/7. Please see our Get Help Now page for more immediate resources.

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. 

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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.

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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.


Addiction isn't a choice, but recovery is. The first step to moving forward is understanding the resources available, accepting you may be living with an addiction, and knowing how to get help. If you continue to struggle with these steps, consider contacting a professional online or in your area to get started.
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