Addiction is Not a Choice Nor is it Selfish

Lately I have heard two comments from different people in regards to addiction.  “Addiction is a choice” and “Addiction is selfish”.

Some Facts

The DSM-5 includes addiction and provides its diagnostic criteria.  The American Psychiatric Association, American Medical Association, and American Society of Addiction Medicine all recognize addiction as a disease.  

Addiction is NOT a Choice

As a disease, addiction is no more of a choice than diabetes or cancer.  When a person has cancer, those around them rally to get them through treatment and get them into remission.  Why should addiction be any different?

Those who I have heard argue addiction is a choice say that If the person didn’t take that drug or have a drink of alcohol, they would not have become addicted.  This theory is correct only if you are willing to extend it to other illnesses that have behavior/lifestyle contributing factors. Someone who is diagnosed with diabetes after not taking care of themself for years on end is not blamed.  If they break down and eat a cookie, they are not blamed. If someone takes a drug with a group of friends and they become addicted why should they be blamed? That entire group made the same choice, but one of them had the brain chemistry that created addiction.

What about the countless people who were prescribed a painkiller by their doctor and ended up addicted?  They didn’t choose drugs, they took a medication from someone they, and generally society as a whole, trust.  Their brain unfortunately reacted differently.

Addiction is NOT Selfish

If someone does not understand addiction, I suppose I can see why they may believe this.  From the outside you can see addiction tearing families apart, destroying friendships, and extensively utilizing emergency resources to name a few.  

Addiction can be so overwhelming and painful that a person who is  addicted may act in ways that on the outside seem selfish, but to the person feel vital to survival.  In some cases this life threatening feeling is true. It can be deadly for an alcoholic whose body has become dependent on alcohol to stop drinking entirely without medical intervention.

Addiction can affect a person’s view of their hierarchy of needs and so ingrains in a person the feeling of needing more that it can begin to feel like nothing is enough.  More drug or drink, more food, more time, more clothes, more drug or drink. More. More. More.

Have a Better Conversation

I’m a strong believer that if you don’t know something, you should avoid making blanket statements about it.  This is especially true when your statement is one that belittles those in a stigmatized community. This is why I think the first step to a better conversation about addiction is to learn about it.  Read about it on reputable sources and talk to someone who has been there.

As science has progressed, we are far past a point where addiction as a personal flaw can or should be accepted.  Addiction is a disease and needs to be treated as one not only by the medical community, but also by society as a whole.  

So let’s all arm ourselves with knowledge and go out there ready to educate others when they make inaccurate, judgmental statements.



Center on Addiction


American Psychiatric Association

One comment

  1. I think that sometimes people think the first time using a substance is a choice, and therefore addiction is a choice, and they don’t realize that those are two very different things.


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