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Is Addiction A Choice?

by Landmark Recovery

July 3, 2019

Many people when trying to show tough love may say that substance abuse is voluntary, however, we need to look more closely at this: Is addiction a choice?

Essentially, people who ask this mean that they think that a person could stop using drugs if they really wanted to. However, addiction doesn’t always work this way. It’s true that not everyone who tries or uses drugs becomes addicted as everyone is different and reacts differently to drugs. It is also true that drug use, in the beginning, is normally voluntary. However, as someone continues to use substances, it can lead to many biological changes and make it incredibly difficult for someone to stop using their respective drug.

While it is a choice to use a drug for the first time, addiction to a drug is not a choice. The first time someone uses a drug they may like the way it makes them feel and they believe that they can control how much and how often they take the drug. However, use of these types of drugs can eventually take away their control. The problem can spiral out of control and cause people to have serious life-threatening problems.


What Is Addiction Considered?

Addiction is not a choice. Addiction is a brain disease.

Drugs and alcohol can change how the brain works and functions and those changes can last for a long time. Unfortunately, if a person continues to use a drug, it can lead to issues related to dependence that can evolve into an addiction.

Addictive drugs and alcohol can lead to biological and psychological changes by binding to specific receptors throughout the body, persistent heavy drug use leads to structural and functional changes in the nervous system. It is widely, almost universally, assumed that neural adaptations play a role in addiction.

There are a number of reasons that someone may first look to take drugs, and continue using them. For example, some people will use them to make themselves feel good and experience a high while others may try them out of curiosity or social pressure.

Unfortunately, using drugs like opioids or alcohol can cause people to quickly look control and these drugs can take over a person’s life. As mentioned before, the decision to take drugs initially is typically voluntary. However, continued use can lead a person’s ability to exert self-control to become impaired.

Brain imaging studies of people with addiction have found major physical changes in areas of the brain that are critical to judgment, learning, decision-making, memory, and behavioral control. These changes can help explain the compulsive nature of addiction.


Addiction Is A Disease

As mentioned above, the reason that it is so difficult for people who are struggling with drug or alcohol addiction to stop is that it isn’t just a habit. Drug or alcohol addiction is a disease.


Brain Changes

The brain structure and function is affected by excessive alcohol or drug use. There is evidence that addiction harms the brain in at least three ways:


Brain Circuits — Repeated exposure to the dopamine-enhancing effect that most drugs (such as heroin and alcohol) causes can lead to adaptations in the brain neural circuitry. Dopamine is a neurotransmitter and chemical in the body that makes a person feel pleasure. Unfortunately, when people use drugs, it causes the natural rewards to no longer give the person pleasure, this causes them to lose interest in things they used to enjoy, such as hobbies or spending time with friends.

Stress — Moreover, some of our brain circuits work to control our responses to stressful situations. In the brain of someone with an addiction, circuits can become overactive which can cause people to feel stressed out even when they aren’t using drugs.

Decision-Making — Drug addiction can affect portions of the brain like the prefrontal cortex. This part of the brain helps a person make decisions and control someone’s impulses. When this is affected it can lead to problematic decision-making.


Tolerance, Dependence, and Addiction

To fully understand addiction, it is important to learn about the steps that can lead to the problem. For example, building tolerance and dependence on a drug or substance are two things that generally happen before a full-blown addiction.



Tolerance is something that occurs when a person has been using a drug. At first, a person will have little to no tolerance for a specific drug. In these cases, the individual will feel the effects without needing to ingest or use a lot of the drug. However, after a period of using the drug, it can lead to higher tolerance, meaning that a user will need to use more of the drug to experience the same effects as a person who is first using it. Eventually, people use more and more of the drug to get the “high” that they seek. Unfortunately, users are at an increased risk of overdose to the increased amount that they use.



Dependence occurs when a person uses enough of a drug that the body adapts and ends up needing the drug to function properly. Essentially, dependence means that when a person stops using a drug, their body will go through withdrawal. Withdrawals refer to a group of physical and mental symptoms that range from mild to life-threatening. Life-threatening symptoms generally occur when a patient is using alcohol or opioids. Opioids have become a major problem in the United States in recent years with many users being prescribed.



Addiction is a disease. Like tolerance and dependence, addiction is something that results from taking drugs or alcohol repeatedly. If a person using a drug can’t stop, despite the negative consequences associated with using the drug, they may have an addiction or a severe substance use disorder. With that said, a person can be dependent on a drug, or have a high tolerance to it, without being addicted.


Risk Factors For Addiction

There are a number of different influences and factors that can lead to someone not only using drugs or alcohol but addiction as well.


Biological Factors

There are a few biological factors that can influence and affect a person’s risk of addiction. For example, genes, stage or development, and even gender or ethnicity can all lead to an increased chance of addiction. Scientists are still learning about the influence that genes can have, however, there is some evidence that genes, including the effects of environmental factors on a person’s genes, called epigenetics, account for between 40 to 60 percent of a person’s risk of addiction. It should also be noted that teens and others with mental disorders are at a greater risk of drug use and addiction than others.


Environmental Factors

Environmental factors that can influence a person’s risk of addiction are generally broken into two categories: home life and school life.


Home and Family — The home environment, and parents, siblings, and loved ones can all majorly influence someone’s well-being and can lead them to try certain substances. This is especially true during childhood and adolescence. Parents or older family members who misuse drugs or alcohol or who break the law can increase children’s risk of future drug or other substance abuse problems.

School — Along with home influences, friends and peers can all have an increasingly strong influence on a person’s risk of drug or alcohol use, especially during teen years. Generally, teenagers and young adults who use substances can sway those without risk factors to try drugs for the first time. Along with friends who use substances, struggling in school or having poor social skills can lead someone to have an increased risk of becoming addicted to drugs.


Other Risks

While taking drugs at any time can lead to addiction, there is evidence that the earlier a person begins using substances, the more likely he or she is to develop a serious problem. This may be, in part, due to the harmful effect that drugs can have on the developing brain.

Another risk factor that can lead to addiction is the way in which the drug is taken. If a drug is injected into a vein it can increase its addictive potential. When a drug is injected or smoked, it enters the brain within seconds and produces a powerful rush of pleasure. While the substance is felt nearly instantaneously, the intense high can fade within a few minutes. Scientists believe that this abrupt change can lead people to repeated drug taking in an attempt to recapture the fleeting feeling of euphoria.

As one can see, there are a number of different risk factors that can lead to and influence someone’s chances of addiction. Understanding these risk factors can help you take preventative measures to mitigate them. With that said, there are treatment options available for anyone dealing with any sort of substance abuse issue.


Treating The Disease

Despite the harmful and disastrous effects it can have on the body and mind, addiction is a treatable disorder. Like many other chronic diseases such as heart disease or asthma, there is no silver bullet for treating drug addiction. No cure. However, addiction is something that can be managed successfully. Treatment generally involves changing deeply rooted behaviors through the help of medication and behavioral therapy.


Treating Withdrawal

For patients who are taken to a treatment center, they will likely go through a medically supervised detoxification program to help them get through the withdrawal symptoms that are commonly associated with short-term sobriety. Going through a detox program will help patients safely withdrawal from their respective drug in a medical setting. This frees their mind up for when they go through the behavioral portion of therapy.



There are a number of therapies that clinicians and counselors utilize to help patients learn about the processes of addiction and how to deal with things like urges and cravings that may lead to relapse. Some of the common therapies used to help those struggling with substance abuse problems include cognitive-behavioral therapy and family therapy.



It should be noted that relapses are not out of the ordinary for people who are going through recovery. And, the chronic nature of addiction means that for some people relapses can be part of the process. In fact, relapse rates for drug use are similar to those for other chronic medical illnesses such as hypertension and asthma and the reasons for relapse are generally the same: if a person stops following their medical treatment plan, they are likely to relapse.

Overall, if you or a loved one is suffering from some type of problem with addiction, it is best to go through some type of treatment program. Learning more about what treatment centers near you can offer in terms of services and care, can help you decide upon the best option for achieving long-term sobriety.


Next Steps

As noted before, addiction is not a choice. Many who do not fully understand the processes of substance abuse may believe that to stop using drugs it’s as easy as just telling yourself you’re going to stop. Unfortunately, drug use leads to a number of biological changes in the brain and can affect a person’s judgment and impulsivity that causes them to keep using their respective drug and makes it incredibly difficult to stop. Luckily, there are a number of substance abuse treatment centers that can help patients overcome their problems with alcohol or drugs.

Landmark Recovery is one Indiana treatment center that can help you gain the tools and knowledge to help you overcome your addiction. While many still pose the question “is addiction a choice?” Landmark understands that addiction is a disease and if not treated properly, it can lead to disastrous and life-threatening consequences. If you would like to learn more about Landmark Recovery and what specific treatment options that we can offer, please visit our website and reach out to our admissions staff today.

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About the Author

Landmark Recovery

Landmark Recovery

Landmark Recovery was founded with a determination to make addiction treatment accessible for all. Through our integrated treatment programs, we've helped thousands of people choose recovery over addiction and get back to life on their own terms. We're on a mission to save one million lives over the next century. We encourage all those struggling with substance use to seek professional help.