Addiction, Choice or Disease? My Answer Won’t Make Me Popular With Some Folks

Compassionate Love Blog: Displaying compassion for those who struggle with mental illness   (c)2016  Nancy Virden, Always the Fight Ministry

Addiction  and disease – are they the same?

A next-door neighbor once asked for $20 to pay for a doctor’s visit, so she could get painkillers for her sick toddler. Her daughter was playing in the driveway and looked fine. I pointed this out, to which my neighbor replied without a hint of shame or even recognition of wrongdoing, “This way we can get the pills. We can get $400 for them. C’mon, I’ll pay you back.”

History with this family was evidence enough I would never see the $20.  The bigger issue was what she was asking me to risk without apology.  I’m not going to be a drug-dealer or help one conduct business; that’s a no-brainer. My thoughts focused on her use of her child, and how nonchalant and blatant was her request. It was striking, as if she’d asked to borrow some milk.

Then I thought about the $400, and the desperate addicts who would pay such a price.

Today, a news report in the Pittsburgh Gazette seems to focus at least partial blame for West Virginia’s horrifying opioid overdose rate on doctors. In a recent podcast interview,  I was asked if I believed soaring addiction rates are the fault of pharmaceuticals and the medical field.

Whether victims of disease, or of other people and external events, why is anyone an addict  to anything? Is it all choice?

My opinion forms around personal experience and limited yet significant observation. That is, we tend to run from pain yet many race toward self-destruction. Some people break old habits and change while others drown in addiction. It is easy to sit in whatever armchair fits in the moment and make assumptions about everyone else.

I believe addiction is a disease and in some significant ways is not the addict’s fault. People with abnormal physical reactions to painkillers may end up addicted while others who take the same dosages do not. Hard drinkers and alcoholics are not different in consumption rate- they are different in their physical dependence. I believe I was born with some weird reaction to food that leads to mental obsession and compulsive eating, while friends and family members who regularly overeat can choose to stop. 

I never became a roaring drunk. However, my reaction to alcohol has been abnormal too. With certainty I can say if I choose to drink it won’t be because I’m thirsty and I will not be able to stop on my own. It does not matter how much or little one indulges, if the disease of addiction is present, it makes a person powerless to stop. 

The defining difference between an addict and hard eater/drinker/drug abuser, is the ability to stop. In 12-step groups we are taught we can do nothing apart from a power greater than ourselves. The steps include complete and daily surrender to God and commitment to the psychic change that takes place when we do that. 

No matter how long we go in recovery, we will never be able to return to the addictive substance. That is because we are wired for doom if we do. The disease, the physical abnormality is not cured because we do not indulge. That is why people become 12-step lifers. We lean on each other through sponsorship and meetings, establishing an international, cross-cultural family of support.   

In recovery, it is my responsibility to manage the disease. It was and remains my choice to go for the fix while heading straight to the morgue, or to go to meetings and call out to God. I set my values in place and decide who I want to be. 

I’m an addict. I do not blame the grocer or McDonald’s or my friends who shove dessert at me. The makers of alcohol are not my enemies. This is my disease. Like diabetes or cancer, disease influences us, it does not own our decisions. 

In my humble opinion, that is the how addiction and disease are the same, and why we need to defeat judgement and stigma that prevents people from finding treatment.



NOTE: I am not a doctor or mental health professional. I speak only from personal experiences with and observations of mental illness. In no way is this website intended to substitute for professional mental health care.

If you are struggling emotionally today or feeling suicidal, or concerned about someone who is, please call the National Suicide Prevention Lifeline 1-800-273-TALK (8255). Hope and help is yours.


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