subject: Is Addiction A Choice? [print this page] Even in medically advanced societies, the myth that addiction is a matter of choice pervades. To active and recovering addicts and their families and close friends, this is a ridiculous notion. Overwhelming evidence suggests that addiction is a physiological condition, and that physical changes in the neurons of addicts brains are responsible for their destructive behavior patterns. In this way, addiction is similar to other clinical diseases such as cancer, heart disease, and AIDS. A better education regarding the true nature of addiction will help society cope with and mitigate the problems it causes.
Because addiction is a physiological condition, it can afflict any human. A person who has surgery or undergoes intense dental work can become addicted to her prescribed painkillers. A manic-depressive or schizophrenic can develop an addiction to his anti-depressants. Even college students who use Ritalin or Concerta to focus on their studies can become addicts. The notion that only irresponsible, recreational drug users develop addictions is patently false.
In fact, even the strongest-willed person cannot alter the way an addiction develops in his or her brain. A future addict at first takes only enough of a substance to feel the desired effect. For instance, a regular dose of a painkiller brings relief, or a small amount of heroin produces a high. As the body adapts to a substance, however, the brain requires ever more of it to illicit the same hormonal response. At an alarmingly quick rate, a persons frequent use of a drug can develop into a tolerance, then into dependency, and finally into a full-blown addiction.
The reason why people use certain recreational or prescription drugs is that they trigger the brain to release dopamine, the same feel-good neurotransmitter responsible for our desires for food, sex, and other pleasurable aspects of human life. This process eventually leads the brain to develop permanent, physical pathways of neurons. These pathways produce cravings for the abused drug in the same way that healthy pathways produce the human urge to eat. This is why it makes so little sense to look at addiction as a matter of willpower or choice. Addicts truly crave drugs as strongly as starving people crave food.
These neurological paths also involve associations with certain environments, people, and even physical objects that an addict encounters while getting high. It is for this reason that drug abusers typically have many triggers for their habit. They may feel fine one moment but develop an instant craving when they hear songs they listened to while getting high, or when they visit the places where theyve previously used drugs.
Because the human brain tends to create permanent pathways, these associations can linger for months or even years after a successful recovery. This phenomenon often causes a set of symptoms called Post Acute Withdrawal Syndrome; a condition responsible for the vast majority of relapses among recovering drug addicts. These symptoms include depression, drug cravings, social anxiety, memory loss, and poor motor skills. In fact, the way alcoholics and addicts relapse due to PAWS is similar to the way cancer patients spontaneously enter remission. Remission isnt the patients choice; it is the result of permanent physiological changes in their bodies.
Addiction is a clinical condition. It may begin with an addicts choice to use a drug, but once dependency sets in, avoiding the compulsion for that substance is far from a simple matter of willpower. Society will be able to cope with the struggles of addiction far more productively when more people understand the all-consuming nature of this disease.
