With the sociological values and norms changing so rapidly throughout the country, drug use is now seen considerably more than it used to be.  Due to this normality and ease of access to drugs, substance abuse and addiction have become a widespread pandemic that has numerous people talking. However, these conversations are not one-sided.  People either think that drug addiction is either a choice or a disease, with a few who are still unsure which side to agree with.  Those who view addiction as a choice often argue that doing drugs is an individual’s own decision, therefore, made voluntarily, while people who view drug addiction as a disease are quick to relay scientific facts as to why victimized individuals are unable to consciously make cognitive decisions on their own. Although there are multiple perspectives on this topic, the answer of whether addiction is a disease or a choice remains unclear.  I argue that addiction is a disease; however, the person victimized by addiction is, in fact, able to make the right decisions to lessen the effects of addiction on themselves if they are determined and receive the help they need.  In order to supply these needs, we must know how to fix the problem, which can only be done if society understands that addiction is neither a disease nor a choice, but rather a combination of the two.

 According to Jefferey Schaler, a psychologist and consultant for addicted patients, “addiction is a behavior” that is  “clearly intended by the individual person,” meaning that they have full control over their decision to take the drug or not (Schaler). On the other hand, the National Institute on Drug Abuse explains that the people who argue that addiction is the victim’s own choice “fail to grasp that an addicted persons brain has a disrupted choice mechanism,” which can alter their decision-making processes altogether (Abuse). With a faulty choice mechanism in the brain, making your own cognitive decisions alone becomes considerably more difficult, especially when the victim feels they need the drug to proceed through the remainder of their day.  Although Schaler presents a strong point about behavior, The National Institute on Drug Abuse is able to transcend his statement because they offer scientific reasoning, rather than opinion, explaining why addiction should not be considered a choice.  

In order for professionals to classify something as a disease, they must meet certain requirements.  These requirements include the presence of symptoms as well as the disease being acquired by external or internal dysfunctions.  With that being said, Tim Holden claims  “addiction is self-acquired,” meaning addicts have brought it upon themselves through their actions, rather than acquiring it naturally (Holden). This concept of addiction being obtained unnaturally contradicts with the previously stated requirements of a disease.   In accordance with Holden’s viewpoints, Alan Leshner states that “drug addiction is a chronic, relapsing disease” because it inhibits the function of the brain disallowing it to perform in a physiologically correct way due to a “voluntary prolonged use of drugs” (Leshner).  At first, it may appear as if Leshner is in opposition to Holden’s statements until he mentions that the individuals drug use was prolonged and voluntary.  With that being said, one can realize that addiction usually begins with an individual who continually and consistently decides to consume drugs, but it can evolve into much more quite rapidly. 

Furthermore, the reason that the constant consumption of drugs will give rise to addiction is because of how the drugs interact with the reward systems present in one’s brain.  These reward systems allow the drug consumer to experience sensations of being happy and relaxed  because “they increase the levels of dopamine being processed in the neurotransmitters” (Goldstein).   When this process takes place, the individual’s brain changes slightly and they will experience a positive sensation and involuntarily associate the drug with the feeling of pleasure and reward, which is dangerous because the addicts are focused on the drugs effects rather than the dangers the substances propose.  This scientific process aids in explaining addiction as a disease because it highlights the involuntary and biological factors of addiction, rather than just what people see happening outside of the body.

Although there are changes made to the brain when people consume drugs on a regular basis, making the claim that addiction is either a disease or a choice is still difficult. The changes in the brain alone do not provide enough evidence to classify addiction as a disease because many everyday actions make physical changes to your brain as well.  There is a section of the brain called the hippocampus that controls memory and direction and when someone uses this area of the brain to sharpen a skill of theirs, it changes the physical shape of the brain (Addiction).  This theory can be seen in a study done on taxi drivers by Jeffrey Schwartz, a British neurologist.  He explains that “the longer you drive a cab...the more your brain physically changes” because you are forced to exert more mental effort in order to remember the fastest way around a city in a relatively short amount of time (Addiction).  Using this same concept, the changes in brain shape due to prolonged addiction can be explained.

Although addicts feel they need these drugs to survive, they are still able to monitor the amount that they consume each time they “drug up”.  As Jefferey Schaler mentions in his online journal about alcoholism, “alcoholics never drink all the alcohol they can. They plan ahead, carefully nursing themselves back from the last drinking binge while deliberately preparing for the next one” (Schaler vol. 9).  By doing this, the addicts are using their hippocampus’s to create a routine for their drug use, which uses memory, once again changing the brain’s shape.   This backs the argument of addiction being a choice because they are purposefully making these decisions in order to continue their way of life, whether is it detrimental to them or not.

Another main component of a disease is the fact that it must be treated in order for the symptoms to lessen or for the disease to dissipate altogether.   For this reason, some people believe that addiction is a choice, instead of a disease, because treatment is not necessary for the addict to sober up and restore their health.  For example, addicts can quit consuming drugs at any point in time without any negative consequences, other than occasional withdrawals, occurring as a result, but if a cancer patient was to stop receiving medication and therapy their condition would worsen and their chance of death would increase significantly. However, refraining from drugs is much easier said than done, therefore many of the people who try to quit commonly return to drug use in the first year, again making the decision consciously to do so. Once this decision is made, the person will most likely relapse, leading to addiction once again.

A concept that people commonly bring up when discussing addiction is its inheritance patterns.  When looking into this, the fact that addiction can be influenced by genetics becomes apparent.  In a study done by David Nutt, a psychology professor at the University of Cambridge, the inheritance of genes related to addiction was researched. The results of the experiment show that  “the male children of male alcoholics are likely to have alcohol addiction themselves even if they are adopted to non-drinking families” (Nutt).  This goes to show that even someone who has never consumed any drugs in their lifetime can still inherit certain genes from their parents that will make him or her more susceptible to becoming addicted to drugs of any type.  Therefore, swaying the classification of addiction towards a disease rather than a choice because diseases can be inherited, whereas choices cannot.  

By the same token, people that classify addiction as a choice argue that although the choices made by parents cannot be inherited, they can be and usually are still present in their children later in life. Jacqueline Goodnow, a cognitive and developmental psychologist, further explains that if children grow up exposed to their parents drinking or taking drugs, they are more likely act similarly because they were exposed to these substances at an impressionable age by the people who are supposed to help them decide between right and wrong (Goodnow).  Since these substances have been present for most of the child’s life, they will be less hesitant than other children to make the choice to try them when they are old enough to make decisions on their own, therefore providing a gateway to addiction by choice.

Granted there will always be a conversation as to whether drug addiction is a disease or not, finding ways to help those who have fallen to addiction and thinking of ways to prevent it from becoming more widespread than it has already become is more important.  The book Hooked by Lonny Shavleson’s features five personal accounts of addicts in rehab and why they believe the public rehabilitation system is inadequate. One prominent example of an inadequacy in the rehab centers that the book depicts is the fact that the rehab centers often give patients medications to wean them off drugs, however they fail to realize that the addicts are looking for any way to get the high they are used to (Shavelson).  Therefore, they will begin to crave that drug instead of the one they were previously longing for.  Overall, the five, featured stories show the rehabilitation program’s lack of understanding about how addiction affects both the body and the mind (Shavelson).  After hearing these stories, it is evident that there is a significantly more information about how addiction works that we must learn, as well as what we must do in order to help those struggling to live with it. For starters, we must understand how drugs affect the human body and whether or not the individual can actually control it in order to have the ability to provide them with the most beneficial form of help they can receive. Reaching a consensus on this topic will allow us to do just that because we will know exactly what the addicts are facing both physically and psychologically, therefore understanding what must be done to aid them in their fight back to sobriety. 

In accordance with the previous arguments, it is almost impossible to classify drug addiction as strictly a choice or strictly a disease. With that being said, I argue that addiction begins as a choice, that can then develop into a syndrome or disease due to the brains inability to process drugs and function as it should. With an outlook allowing addiction to be a combination of the two, rather than strictly a disease or a choice, finding a way to lower the amount of drug addicts in America will be easier and more effective than continuing our broken and still uneducated rehabilitation systems.  
