Is Addiction a Disease, or is it a Choice?
90
In my previous hub, titled 'The Death of Amy Winehouse (And Why We Should All Be Sad That She's Gone)', I discussed the public's reaction to the musician's death, and why I believed that despite her faults, the public ought to be sympathetic. I went on to respond to the common sentiment that it was shameful to focus on the death of an addict one day after the tragic event in Norway, where 76 died, arguing that it was not only OK to respond in such a way, but that it was to be expected.
In this hub, I address the question that stands between the camps of those who are sympathetic towards addicts, and those who are not: is addiction a disease, or is it a choice?
 | Amazon Price: $9.06 List Price: $14.95 |
 | Amazon Price: $15.95 |
To begin, I would like to note that I'm not an addict, and have therefore never went through the horrors of being an addict. I'm also not a medical professional, and I don't claim to have absolute knowledge on this topic. What you find below is simply my opinion, and I'm completely open to listening to - and considering - all sides of contention on this issue.
- 'The Neural Basis of Addiction'
"Cellular adaptations...promote the compulsive character of drug seeking in addicts by decreasing the value of natural rewards, diminishing cognitive control (choice), and enhancing glutamergic drive in response to drug-associated stimuli" (1).
- 'Genetic influences on...vulnerability to drug abuse and addiction'
"Chronic exposure to drugs of abuse causes persistent changes in the brain" (1450).
When the argument is made against addiction being a disease, it usually begins with the idea that - at some point - the addict made the decision to 'use,' despite being aware of the risks, and is hence responsible for any short- or long-term consequences that might result. Sometimes the argument will go so far as to contend that there is always a choice, that even at the point of being a full-fledged addict, it continues to simply be a matter of having a lack of willpower. While I realize that some subscribe to this latter belief, I'm not going to spend much time addressing it, because I believe that most can at least agree that long-term drug use results in severe cognitive impairment, and thus renders an addict's ability to choose to be profoundly compromised. (If not, however, I did include the video, 'Dopamine's Real Reward,' along with two studies, respectively titled, 'The neural basis of addiction: A pathology of motivation and choice' [2005], and 'Genetic influences on impulsivity, risk taking, stress responsivity and drug abuse and addiction' [2005], all of which can be found to the right.)
The first time a future addict uses, there is no doubt that an element of choice, and of responsibility, exists. However, the idea that because a person chooses to do drugs, or drink alcohol, does not mean that they choose to become an addict. They choose to get high, to have an experience, and are too naive to consider that the most severe consequences don't just happen to other people; particularly while young, people tend to have a sense of invincibility, and while aware of potential consequences, they never actually believe the worst will happen to them. It's the same reason why people engage in unprotected sex, speed while driving, or participate in other 'at-risk behaviors' - they're only thinking of the short-term, and not considering the reality of the risks.
In addition, one's environment also plays a role, and Winehouse was the perfect candidate: wealthy, insecure, self-loathing, and ultimately depressed, the drugs had an undeniable allure for her. The idea that she could blanket herself from the sadness, doing what so many of the great artists had done before her, while being reassurred that 'hardcore' addictions and overdoses only happen to those who don't know what they're doing - that she would just have to be 'smart' about it.
- 'Genetic influences on...vulnerability to drug abuse and addiction'
"[G]enetic factors account for 30-60% of the overall variance in the risk for the development of drug addictions" (1455).
Now, the point here is not saying that people don't make the choice to do drugs, or to drink alcohol, and I'm not even saying that they aren't aware of the potential consequences; the point here is that they make the choice with a short-term goal in mind, and the naive belief that they won't fall into the life of an addict. The fact that some might be predisposed to addiction, or that they could one day suffer the fate that Amy Winehouse did this past weekend, is unlikely to come into consideration.
Finally, I ask you to think about sexually transmitted diseases, or even cancer, and reflect on whether either of those are ever choices? If I smoke for 30 years, and I know the risks associated with smoking, am I choosing to get cancer? Or if I have unprotected sex, and I then contract HIV, do I choose to get HIV? Certainly, there are differences, and I'm not trying to say that these are exactly the same with drug addiction, but there are similarities - in all of these examples, the individual was only concerned with short-term gratification, and overlooked (or perhaps dismissed) potential long-term repercussions.
- 'Amy Winehouse and the Pain of Addiction' (TIME)
"Physiologically, alcohol and opioids like heroin replicate the chemistry of relational connection, with opioids acting directly on the brain's bonding systems and alcohol having a more indirect effect."
In response to this comparison, I earlier received a comment that used anecdotal observations to argue that of the drug addicts this Hubber knew, half had made excuses for their addiction, while half had confessed that continuing to be an addict was a choice, and that the only reason they continued to 'use' was because they were selfish. The Hubber concluded from his personal observations that if it were truly a disease, so many addicts wouldn't confess that their addiction had been self-inflicted and 'unnecessary.' What this Hubber fails to sufficiently recognize is that "a key pillar of addiction is often self-hatred and an inability to see oneself as worthy of love," and that if you therefore tell a drug addict they are useless, selfish, and can only blame themselves for their predicament, they're likely to agree with you. The fact is, as the linked studies demonstrate, "the brain of an addict is fundamentally different from that of the a non-addict," and the argument that the only problem with addicts is that they're selfish - and are capable of simply quitting whenever they'd like - seems rather naive.
Regardless of which side of the fence you're on, however, I have a very difficult time understanding the angry and cruel comments that are often directed towards drug addicts, even subsequent to their passing. I understand that they might have ruined their lives, and wreaked havoc on members of their family - and I feel incredibly sympathetic to the Winehouse family in the wake of Amy's death - but addicts do not calculatedly decide to become addicts. They decide to use drugs to escape from troubling lives, and sometimes - as in the case of Amy Winehouse - pay the ultimate price for it. The fact that some can say they're not sympathetic, because - at some point - the person chose to use drugs, or to drink alcohol... well, I hope the people in your life are a little more compassionate.
vote upvote downshareprintflag
- Useful (6)
- Funny
- Awesome (4)
- Beautiful (2)
- Interesting (14)
CommentsLoading...
Of course. Addiction is a hormone induced psychological disease. As we feel possessive to another person or objects, the type of becoming excess addicted is fatal. Check out my related topic at 7. http://hubpages.com/t/23e6fa
Love the hub :). Personally, I've seen people kick addiction -- but never through determination and commitment alone.
@ Wychic, have you seen anyone kick AIDS?
@ .josh. This has been a interesting debate to be honest, some great points have been made, i will agree to disagree before I start ranting endlessly, lol. I'm going to vote the hub up, as it is well constructed and it is a good read.
No, but many would argue that addiction is a chronic, incurable illness as well -- even if you're no longer actively using, the chances that you can ever go back to using in any capacity (i.e. social drinking for recovering alcoholics) is extremely low. There are many diseases that can be managed to the point that someone can live a normal life.
I'll agree to disagree on this one too -- I doubt there's any conclusive answer to this one, and I've spent way too much time around end-stage alcoholism to be able to be truly objective, I'm sure :).
I am not a medical professional in any sense, but here's my opinion: I believe addiction is a choice, not a disease. When someone contracts a disease like cancer, they have no choice. If you smoke crack, shoot heroin or meth, that's a choice.
I'm not sure how drug addiction of any kind can be considered a disease in the typical sense of the word. Little Billy woke up today and has leukemia, that's a disease. Little Billy turned 16, started shooting heroin with some friends and is now an addict; that's a choice.
Now, I think some people may be genetically and pre-disposed to become dependent on drugs more than other people. But, doing drugs is a choice. Getting breast cancer is not a choice.
It's a choice to START drinking or using drugs. After that, addiction is a possibility, affecting a person like a disease.
@raxit02 Absolutely, well said. Thanks for the link!
@wychic I really appreciate it, thank you. No doubt people can kick an addiction and live a long life, but there's a reason we say they're an addict for life. Thanks for sharing your wisdom on this - some excellent points. (And thank you for the note as well, that was very nice of you.)
@Optimizers I appreciate it - I definitely understand there are a lot of people on your side of the fence on this issue, and you do raise some good points. No doubt you could find some research, articles and YouTube videos to support the other side (I did, in fact, find a few myself, which I've linked below).
http://www.schaler.net/addictionisachoice/index.ht
http://www2.macleans.ca/2009/05/26/addiction-new-r (Article on the study from Gene Heyman, the professor interviewed in the video above.)
Truly, thank you for your comments - this wouldn't be a very productive discussion if we all agreed on the subject, and you have made some excellent points.
@cooldad I'm not a medical professional either, and I do understand what you're saying.
Obviously, when you use leukemia as an example, the distinction's pretty clear. A drug addict made the choice to do drugs, and subsequently became an addict, whereas 'little Billy' did not make a wrong choice. He simply woke up one day, and had leukemia. However, some diseases can be caused by poor choices - the examples I used were HIV/AIDS from unprotected sex and cancer from smoking. Are they less of a disease because the individual made a choice that led to the infliction?
That's where I struggle with the distinction, but again, I do understand where you're coming from, and certainly don't claim that I'm absolutely wrong, and you're absolutely right. This is just my opinion.
Thanks so much for contributing, and adding so much to the discussion!
@Evil Stepmother Absolutely! Thanks so much for stopping by.
I'm no medical expert either, but recently read that the medical establishment has now recognized addiction treatment as a recognized medical specialty with accredited residency programs. Seems the pendulum is swinging in the direction of the physical disease model.
Hopefully, I've provided a link below.
I want to thank you, Jason, for hosting this debate. It's very cool that a non-addict would do so much research and come up with such a reasonable thesis on this subject.
To those who naively insist alcoholism/addiction can be countered with willpower, I offer this graphic but true analogy.
Try taking a laxative and using willpower to keep yourself from shitting. Yeah. Good luck with that.
[url]http://thecrossroadsdifference.com/2011/07/addicti[/url]
So sad - what a great talent!
I tried imitating the way she sometimes jutted her lower jaw forward while she sang. Try it yourself. As soon as I did it, I felt defiant. You will too.
Her habit with her jaw tells us a lot. Poor Amy had a lot of defiance in her. Her song about rehab is a pretty good example of that: "No! No! No!"
They say that when she was in grade school, she would not stop singing out in class to the point where she got kicked out of class. That's kind of defiant, too, isn't it?
Not to hijack Josh's hub, but yes. That is classic defiance. All that angst and rage. All the frustration with the world as it is.It's an intolerable feeling. Made better, for a brief while, by putting in (drink/drugs).
At least Amy Winehouse channeled hers -- albeit briefly -- into her music. She leaves a legacy that goes beyond destruction of everything around her. RIP Amy.
@Mighty Mom: Please, hijack away! Thank you for making such a fantastic contribution to the discussion - that's a great article, and I absolutely love the analogy (definitely going to be using that one at some point).
Truly, I couldn't agree more with everything you've said. (Though my name's Josh.) :)
@Kelley: That's actually a really great anecdote, I hadn't heard that before. Thanks for sharing!
Thanks for indulging an old memory-challenged lady, JOSH. I've got it now:-)
On the topic of diseases that are a choice at first -- in the medical community, obesity is considered a disease. It's one of the most destructive disease states known to mankind, and is caused by a choice in at least 98% of cases (some medical professionals say even more). That said, I wonder if "disease state" might be a better way to describe addiction. Either way you look at it, regardless of how someone became addicted, the body is diseased by the effects.
I'm not a medical professional either, but my husband is -- and loves to explain how even pregnancy is a disease state ;). The closest I get to being a medical professional is being a professional health writer, and the closest to an addiction expert is years in Alanon. I have spent countless hours researching and viewing the effects of addiction, and it's pretty horrific in the advanced stages -- and kills faster than most types of cancer...and can cause some of the most lethal types of cancer, among other things.
@Josh -- you're welcome, I just hate to see a good writer hold himself back for any reason :D. When I got into the business, the only thing that told me I could do it was that I wanted to.
Really good analogy, wychic. When I see someone who weighs 400+ lbs and has limited mobility and trouble breathing, etc. my first thought is NOT "Well, he brought it on himself. He's weak. He's a pig. He can't control his eating. He has no willpower."
I see the person and understand there's an underlying pain being "self-medicated" with food. My heart aches for the person. I know that person does not want to be that way. How could anyone WANT to be that way??!!
But many people judge the obese as harshly as they judge addicts.
BTW, glad to hear you've got Al-Anon in your life! MM
@Mighty Mom -- my first husband is about 450 pounds, and hasn't been under 300 since about 7th grade. I confess that there were times I would get frustrated and think, "Why don't you just STOP EATING ENOUGH FOR FIVE PEOPLE???" It took a long time to really, truly understand the depths of his self-esteem issues, and the self-disgust that came from early abuse. It may be largely psychological at first, but then so is drug and alcohol addiction.
Alanon is really a wonderful thing -- though I'm glad I only ever had to introduce myself once...it can take a bit to explain that one is the niece, daughter, wife, cousin, sister, and granddaughter of alcoholics :P.
@wychic: There are absolutely similarities - self-loathing really does seem to be the culprit behind most addictions. At 450 pounds, there's obviously no doubt that the issue goes beyond simply 'liking food.'
Thanks for sharing your stories - I think it all becomes a little more real when someone can relate personal experiences.
@Mighty Mom: I think we're very much on the same page on this - well put, and agreed 100%.
Great coverage of this important issue. Regardless of how you characterize addiction it is a problem for all of us to be concerned about. Crime, broken families and increased cost for health care are all the result of addiction.
I suspect it is not a simple matter of the addicted person having determination because I have seen people kill themselves, loose their children, and go to prison because they were unable to control their addiction. None of those people wanted to suffer these consequences, they simply were not able to stop it.
Awareness is important, thanks for writing this hub.
I couldn't agree with you more, Dan. Very well put.
Thanks for reading, and providing such thoughtful comments. I really appreciate it.
I sort of agree with cooldad, in the sense that what we traditionally see as diseases are not the same as addiction. Cancer, etc. However, I do believe that addiction is not a cut and dry choice. Who would ever logically chose to be homeless, unemployed and lose their family and friends? In their right mind, no one. And some of us are more susceptible to addiction than others. I like to drink, my father has had difficulties in his youth controlling it and my grandfather can't. I like having a few beers or a glass or two of wine, but I have to be careful. Because if I am not aware I ll choose to get a bit tipsy every night. With that being said, consider this definition of disease http://www.merriam-webster.com/dictionary/disease
Absolutely a fair position, Danielle -- I'm not sure the definition does much to sway me, however, as it says a disease is "a condition of the living animal...or one of its parts that impairs normal functioning" -- for those who argue addiction is a disease, the part that impairs normal functioning would be the brain.
In either case, you bring up some good points, and I think your example demonstrates why it's so difficult for some of us to understand addiction as anything but a choice. Alcohol and drugs have a varying effect on each of us, so for those of us who do make the choice not to abuse drugs or alcohol, it's hard to understand why others can't simply do the same.
Thanks for reading, Danielle. Your thoughtful comments are always appreciated.
A pretty interesting update: while it might take months before Winehouse's official cause of death is reported, speculation is now indicating that she might have actually died from alcohol withdrawal, while in the process of trying to kick her habit.
As a friend and family member of many addicts, it is hard for me to think of it as strictly a choice. I've seen people quit through will power, and I do believe that has a lot to do with it, but I've also seen loved ones in bed for days, sick with withdrawal and hopping right back on it. So, I think in the end it does depend on the person and the addiction every case is different. Though in the beginning it is always a choice. Very interesting hub, love the ones that really make you think and provoke good discussion. Thank you for sharing:]
Thanks for the insight, Jennuhlee -- certainly, the individual plays a role in their addiction, and there are those who beat it, but as you said, it's hard to think of it simply as a choice.
I find it particularly sad that Winehouse seems to have been trying to quit at the time of her death, and might have actually died from alcohol withdrawal -- appears she might have even had the willpower to quit, but we'll obviously never know now.
Thanks so much for reading and leaving such thoughtful comments. I really do appreciate it!
This brings up some very valid points. Good information.
Thanks Bobbi! I really appreciate the comments.
You are a deep thinker Josh and a great writer.
I like the fact that you play the devils advocate when you know that addiction truly is a choice.
I am saddened by the loss of Amy but to be honest I am not at all surprised.
I'm following you now so you got a new reader from this hub.
Thanks so much for the kind words, manthy! I really appreciate it.
To be entirely honest, I don't agree that addiction is simply a choice, but I can certainly understand why it seems difficult to perceive as a disease. I also can't really claim to be surprised of Winehouse's death, but it's certainly tragic, especially now that it seems she passed away due to alcohol withdrawal.
Thanks again for reading, manthy. Much appreciated.
Dear Josh,
I have to say after reading your Hub and the following comments, you are not only a great writer but you provoke people to think a little longer about a topic I find extremely interesting.
Being Bipolar wasn't a choice. Staying far away from drugs and alcohol was and still is! Even in my weakest moments, far away from reality, I never gave in to drugs, in order to release the mental pain I was going through.
Don't ask me why. Maybe I wasn't sensitive enough for addictions in the first place. The fact of the matter is. Drugs or alcohol could have easily meant the end of it all.
Having said that: You make me smile and wonder weither I'd lose in this week's Hubnugget, from an excellent writer like you:-)
Congratulations on your nomination! Voted you up and interesting!
This is a wonderful hub. Not really many people know what addiction is and they do not understand anything about it.
@Escobana: thanks so much for the kind words, and congrats on your nomination as well - certainly well deserved (and you didn't do such a bad job eliciting a discussion yourself).
I appreciate you sharing your insight, and you certainly bring up a valid point. It's quite clear from reading your hub what a strong person you are, and you never made the decision to be bipolar, whereas addicts undoubtedly make a decision to use initially. It all essentially comes down to whether or not it was an informed (or perhaps "all-considering") decision, and whether that even matters.
Thanks again for the comments, Escobana. So very much appreciated. (And good luck on the HubNugget!)
@angeladale: thank you! Addiction is certainly far more complicated than most give it credit for, though in fairness, I think it's always difficult to understand that which we've never experienced (and I certainly don't claim to have an absolute knowledge).
Thanks so much for commenting! I really appreciate it.
My brother in law was addicted to heroine for many years. His drug/alcohol using started in his teens as "fun" and progressed to something much greater. It wrecked havoc on the family for a long time and thankfully he is now clean and has been for several years. While drug and alcohol use may be a choice, I do not believe that addiction is. There is a difference between use and addiction.
Some similar points were made about "choosing" to be obese by continuing to eat when you really don't need all of that food. However, I was thinking about things like high cholesterol and type 2 diabetes. For many people who have these 'diseases' their poor lifestyle choices are what created their health problems. Eating fast food or sugar filled foods regularly can cause obesity, high cholesterol, diabetes, etc. Why then are some people able to eat like that and not get those diseases? Perhaps there is a predisposition to get those just as there may be for addiction. Addiction is multifaceted and there is no simple answer for this debate. Great job creating such a vibrant discussion. Congrats on your nomination and welcome to Hubpages.
I think everything is related to the environment, the mental health and the consequent state of mind of the individuals. It's not crazy to find addictive personalities in a world where you don't seem to find love, where your equals are fighting against each other over their cultural differences, where there are higher interests than yours controlling everything you and your loved ones do.
People choose to get high on drugs or on food and don't take into consideration any long-term consequences. Same thing happens with ambitious companies who are only thinking of their profit and are basing their strategies on the short-term results, no matter how awful long-term consequences are. I think our society is living the short-term.
We need to make a change as a whole and I think this Hub is a great first step. It's good to read such a passionate writer explaining where he's standing and needing to explain where we are standing one by one. We need to discuss these matters because we all suffer as a society and this needs to change.
As we go through life we see actual versions of good and bad choices within our own lifes. Yet we agree that addiction is a common factor in our life. We conquer one and we lose ourselves to another common addition. Cause and effect have no faces or value in addition. The medical model holds no water if you are looking for good choices. For medical personnel it is always a common guess that if you take these two pills very six hours it will be a short-term cure all for your additions. I believe in common sense to senseless remedies.
@cardelean: That really is such a brilliant point, and thank you for offering your insight. Certainly, some are predisposed to certain illnesses, and I don't think addiction is an exception.
"While drug and alcohol use may be a choice, I do not believe that addiction is. There is a difference between use and addiction." You said it perfectly, and I couldn't agree with you more.
Thank you so much for reading, and leaving such thought-provoking comments. I really appreciate it.
@giselenmendez: Very well said, and thank you. I truly appreciate the kind words. You're definitely onto something with regards to the issues discussed here being part of a greater symptom, and our often apathetic and naive outlook is something that needs to be addressed. Perhaps this could be the subject of a later hub.
Thank you so much for reading, Gisele, and for leaving such an eloquent response. So very much appreciated (and congrats again on your nomination!).
@brownBear: Certainly an interesting take, and I can appreciate where you're coming from, but I'm not so sure I'd concur that "cause and effect...have no value in addiction." I think that only by understanding addiction, and understanding addicts, can we ever make progress, and perhaps find a way to decrease the rate of addiction in the future. Assuming that there is a biological element to addiction, I further find it difficult to agree that science plays a futile role in remedying addiction, and hope that through scientific investigation we can one day better understand how addiction works, and how to overcome it.
Frankly, I think this notion that addiction can simply be defeated by making good choices is where the problem lies, and why so many fail to feel sympathetic towards addicts. I've personally consumed alcohol in the past (sometimes to excess), experimented with drugs, and smoked cigarettes, but I have never become an addict. I believe this is largely because I'm fortunate enough to not be predisposed to addiction, and that for some, that one time might have been enough to become an addict.
My point? We all make bad choices. It's human nature. The fact that these choices impact each of us so differently is precisely why we need to rethink this notion that the blame simply lies with the addict, and they are undeserving of our sympathy. From my perspective, it really is so much more than a matter of good vs. bad choices.
Thank you so much for reading and commenting, brownBear - it's great to have a variety of perspectives, and you undoubtedly raise some great points.
@EVERYONE: I'm extremely excited to say that this hub has been nominated for a HubNugget Award under the 'Health' category (largely, I suspect, due to your fantastic contributions in the comments section).
For those who would like to read the other entries and vote for their favorites, please go here (HubPages membership not required): http://enellelamb.hubpages.com/hub/A-HubNugget-Pot
@everyone: Yes I am excited about this chance to express my own views of addition. What I see, what I experiment with and how it is used. I grew up in a large family and I am a child of an alcoholic; this factor gives me my experience to addition as first hand. I am the eldest child of 13 children we have over 150 living members in our family; or six living generations. We are close knit family and Alaska Natives or Tlingit .
A wide range of additions come to mind when I think of my parents and my siblings. This thought brings to my mind a defesive chuckle. We have grown up in a cause and effect environment that has generated countless role-models for us to live and learn by. No matter what we say about how we understand your addition-do we really understand?
Justification has many faces and creates havoc with our minds. When our mind works it throws out many things at random order causing much inner-confession. Our human nature never has a chance. When this happens so we usually end up in a high-risk situation and ignore any consequence thrown at us.
I am not without the experence of addiction as it is a part of who I am. I have learned over time how to mange my heart and mind; as a working team. This action gives me the balance that I need to be a teacher, mentor and role-model. More importantly I am an mother, aunty and grandmother.
My final thought is to overcome a negaitive addition we must do it together, look at it closely. Open your mind to accept your mis-judgement as yours to correct. Change is important and gives to us the experenice that we need to advance to a positive path. Yes stay on the path; it is a lot easier than going through the devils club and alder to get to the top.
A very interesting take, brownBear, and I appreciate you sharing your insight. It's clear you've had far more experience with addiction than most of us (including myself), and you obviously bring a lot to the discussion with so much firsthand knowledge.
The fact is, unless we've been addicts ourselves, there is no way to truly understand what it's like being an addict. I completely agree with you. I do think, however, that we can come to understand some of the causes of addiction, and it does seem that genetics play a role. The fact that so many members of your family struggle with addiction would seem to indicate that you are predisposed to the addictive trait, and while their influences might also contribute, I think there is a genetic element here. If I were to have been adopted into your family, would I be as likely to become an addict? Perhaps, at some point, I would give into the pressure and drink or do drugs (as I have in the past), but would I be as likely to become an addict? I'm not sure I would.
Whatever the case, brownBear, I greatly appreciate you sharing your knowledge with the rest of us, and commend you for overcoming addiction in an environment that seems to have been quite challenging. You're clearly a very strong person, and I suspect an excellent role model for the children, nieces, nephews, and grandchildren around you.
well. . . . .i dnt think v r de 1s 2 judg her . . .nw dat she s dead . . . . . I mean . .it seems kinda unfair . . . . . I duno who she ws . .sm celebrity ??? . .hd drug problems n stuf. . . . Bt who realy knws. . . . Ppl do crazy stuf wen dey hv problms . . . Nt dat i aprov it . .bt drugs is 1 dat stuf . . . .
Any way . . .death shud b an end 2 certain things . .lyk criticism . . . .
Nice hub budy. . .
I enjoyed your article. I, too, have never been an addict, however, I have observed two smokers in my family. Both my father and his sister smoked during their adult lives. While my father was able to give it up cold turkey, my aunt was never able to "kick the habit." She tried the patches, gum, hypnotism etc. but was never able to completely give up smoking. She died of emphysema from her smoking. My father, on the other hand, quit smoking cold turkey and never picked up a cigarette again nor smoked again; however, he said he always had the urge to smoke - it never went away. My aunt always cautioned my sister an I never to start smoking, because we might not be able to stop as she had not been able to. I do think it depends on the person and their genetic make-up and on willpower. Why was my dad able to quit but his sister couldn't? Each person is an individual case with an individual genetic and chemical body make-up. So, I do sympathize and empathize with Amy Winehouse and her family and friends. It is tragic that she turned to drugs to fill the emptiness inside of her. It is a shame that she couldn't find fulfillment through her work, or family or friends or husband or herself. Somewhere along the way she was missing the coping skills necessary in life. Therefore, we need to look at the individual causes of drug taking and addiction. I have never had the need to numb myself or "change my reality" with drugs. But, Amy Winehouse and others like her do. We need to get to the root of these problems in our society and each addict needs to get to the root of his/her problems so that these tragedies don't happen. What is our lifestyle doing to cause these people to turn to drugs for comfort? Many things cause drug addiction. There is not just one reason or one choice involved.
I believe that addiction has a physiological 'disease' component and a psychological 'disease' component. The brain of an addict (physiologically) is wired differently than a normal person's. A normal person has a drink and doesn't 'have' to have another. An alcoholic has a drink and is 'compelled' physically to have another, and another. There's nothing that turns the faucet off, no quit neuron. After years of abuse, dopamine is depleted and now the addict has no 'happy' neuron. The drink or drug of choice replicates that dopamine and drives the addict to drink/drug. It's far more complicated than that. No matter how much willpower an addict uses, the never having enough mechanism will never be fixed. The dopamine depletion may take years to be fixed, which is one of the reasons why relapse is so common. I have never seen a more committed and dedicated group of people than those I see in AA daily. And still, there is a high failure rate. When we do not view this disease with the compassion that it deserves, we end up with tragedies like the death of Amy Winehouse. I was personally devastated by her death.
@SerLeon: I appreciate it, and criticism is absolutely among the things that should come to an end at the time of a person's death (aside from perhaps people like Hitler, as another member mentioned earlier). Thanks so much for your comments!
@suzettenaples: Very well said, and thank you for sharing your story. I'm sorry to hear about your aunt, as I have also had people close to me pass away from smoking-related illnesses, and it's a very tough thing to witness. I really couldn't agree more with you - it truly is a case-by-case basis, and we need to stop simply relating others experiences to our own. We simply are not all wired the same.
Thanks so much for your thoughtful comments, Suzette. I really appreciate it!
@J Burgraff: Wow, well put - perhaps you should have written this hub! I appreciate you sharing your wisdom, and making such a wonderful contribution. While not Amy's biggest fan musically (though I could appreciate her enormous talent), I too was quite devastated. It was undoubtedly tragic, as is the death of any 27-year-old.
Thank you so much for stopping by!
Hey this is a well-written and informative Hub. In my opinion, I believe addiction begins as a choice then turns into a disease. For many people, that choice turns into e necessity after time.
Hi, I am new at Hubpages, and this hub caught my eye. Addiction is a touchy subject for some. I would say, really, anyone who has not personally dealt with it, or has lived with someone with an addiction, should never pass judgement or condemn those with the addiction.
My husband has been an alcohol addict for about 2 yrs, and has tried multiple times to quit. I used to get really upset at him until I read a few books on addictions. It made me understand that the person himself was not in control, or they would be able to quit whenever they wanted. Also, there were almost always underlying issues that were the root cause of the addiction.
To wrap it up, some people do seem to have higher tendencies to get obsessed or addicted to things. For example, having ADD or ADHD has been known to make it harder to break addictions.
So we are still searching for answers...I am just praying that my husband's health will not collapse before we find his cure.
This was a very interesting hub. I have seen friends and family deal with different kinds of addiction and it is true that we should not criticize or judge. Everyone has their own struggles and weaknesses but we also have choices. Its hard to say that addiction is either a choice or a disease. Maybe a little of both.
This has been a great debate and awesome conversation. I couldn't read it all so if I say something that has already been said, I am sorry. I just wanted to add that in my experience, I definitely believe there is a psychological disorder (depression, defiance, etc) that is the underlying cause for the addiction. The addiction itself is not the disease. I say cure the mental part of it. Seek therapy. Learn why you are unable to pull away and say no, whether it is gambling addiction or shopping, eating, drinking, pill popping, whatever. I would hate to say I am an addict for life even if I were clean and sober. I would not want that to define me. As far as mourning the loss of an addict, they deserve the same sympathy as someone who lost their life to cancer. You all are great with your researched links! Great post!
@Little PayDay: That certainly seems to be a common opinion amongst the HP readers. Thanks so much for stopping by and sharing, I really appreciate it!
@healthwealthmusic: I appreciate you sharing your story, and absolutely agree - only those who have experienced it can even begin to understand the complicated workings of addiction. I truly wish the very best for you and your husband, and hope he can overcome his addiction. I can only imagine how difficult it must be.
All the best, and thank you again for sharing.
@AM Lehrer: Thanks so much for the kind words, and leaving such a thoughtful comment. I do agree that there's an underlying psychological component, but wonder if it's still that simple once it becomes a full-blown addiction. Certainly, as I said in the actual hub, a key pillar of addiction is self-loathing and the perception of oneself as 'unworthy of love,' but there are 'persistent changes' occurring within the brain of an addict, and I wonder if, at some point, it goes beyond being simply 'psychological.'
Thank you again for the kind words, and leaving such thoughtful comments. I really appreciate it.
This is a heated debate. I am not a health care specialist but according to my hours of studying celebrity rehab, addiction is very much a disease. Dr Drew will back me up on this one. But seriously, addiction is a disease.
Just because the "disease" is the result of a choice (choice to do drugs) does not negate the fact that it is a disease.
What if:
I chose to go tanning now I have a disease: skin cancer.
I chose to smoke tobacco now I have a disease: lung cancer.
I chose to eat poorly now I have a disease: diabetes.
Anyone get my point?
Well said, Jennie, and I really couldn't agree with you more. Thanks for the comments, and for stopping by! Much appreciated.
@The Optimizers, and others of the same simplistic opinion.
You commentary would actually hold some water if it wasn't for the fact that you are working from an incorrect definition of disease.
http://www.answers.com/topic/disease
"A pathological condition of a part, organ, or system of an organism resulting from various causes, such as infection, genetic defect, or environmental stress, and characterized by an identifiable group of signs or symptoms.
A condition or tendency, as of society, regarded as abnormal and harmful."
http://www.thefreedictionary.com/disease
"1. A pathological condition of a part, organ, or system of an organism resulting from various causes, such as infection, genetic defect, or environmental stress, and characterized by an identifiable group of signs or symptoms.
2. A condition or tendency, as of society, regarded as abnormal and harmful."
http://www.biology-online.org/dictionary/Disease
"An abnormal condition of an organism which interrupts the normal bodily functions that often leads to feeling of pain and weakness, and usually associated with symptoms and signs.
A pathologic condition in which the normal functioning of an organism or body is impaired or disrupted resulting in extreme pain, dysfunction, distress, or death.
Supplement
It may include state of injuries, disabilities, disorders, syndromes, infections, isolated symptoms, deviant behaviors, or atypical variations of structure and function."
And the list could go on and on and on and on, all resulting in the same kind of exact results that would make obvious that addictions can be diseases.
I am very sorry if the entire rest of the English speaking world understands the word "disease" to mean something different than you would like it to be.
I know exactly how you would like it to be defined, as follows:
"A disorder of purely physical origin that has no part in any mental component that may produce a disorder of some kind on its own"
And unless your some rare breed, the reasoning behind the thinking of that sort, although its clearly wrong by definition, without any doubt, is that you have no interest in sympathizing with any such inflicted individuals because you feel your current...appearant lack of any such infliction is a testament to your ability to be a better person then those who have such mentally related disorders. Its your self esteem that rides on this completely misguided theory and thats unfortunate for you because it factually lowers your value as a self aware compassionate person.
And this isn't just one mans opinion. Its in the English language. Try looking it up next time before your prejudiced jaws start flapping. While I completely appreciate the authors wonderful capacity for posing his opinion about addiction being a disease as nothing more than his opinion, I'm afraid not only has the medical world taken that out of his hand and declared such addictions as a disease but the common English language has as well.
If one would like to debate the moral issues behind addiction based on another theme then "is it addiction", then fine, but the disease debate ended a very long time ago.
If you cant live with that start speaking another language that defines it more to your personal liking, but here in the English speaking world thats the way it is.
Nuff said.
Such an interesting hub you have written here. It's definitely a choice to start doing drugs, drinking and such, but once you do start I think the addiction takes over and then it may be out of your control, causing your disease.
Congratulations on winning your category of hubnugget nominations. I'm noting the comments which are quite heated-which I usually try not to read whenever the hub has a topic that causes strong feelings. That's easier said than done when going down to the bottom of the comments. As I expected, there are always someone who is ticked off. Too bad. To me, addiction is a disease. Even some first time users don't have a choice as pregnant women give their babies their addiction. I am so happy for you. But I want to scream at the person who wrote your first comment-oh, and by the way-I have never smoked, drank, or done any drugs at all. Not once-and I still say it is a disease. But I won't be able to follow this hub, because I'm just going to get angry. Take care.
Whether we rate addiction as a choice or disease it is still a major problem that affects our society at individual,family,community and even globally through for example drug trafficking.Families lose loved ones and it impacts us all at different levels.Most addictions from my professional experience and observation as a member of society are triggered by some incident in early childhood or abuse like being bullied.
We have responsibility as society to curb this monster that is devouring our loved ones."I am my bother's keeper" and not judge and should therefore play my role in ensuring that we address the root of the problem rather than treat symptoms!We have a problem that needs addressing.
Thanks for the great hub.
I am kind of split on this debate as I currently have a friend suffering from drug addiction and I lost a brother to alcohol addiction a few years ago. I am more sided toward the "choice." It really frustrates me and I try not to say or do anything to hurt anyone with this problem, but I get a bit angry when people tell me they have a problem, but are not willing to do anything about it.
Hi there congrats on your Hubnuggests win.
Very interesting Hub! No wonder it is a winner!!
Addiction is an escape reaction to personal pain. I speak as a former barbiturate, Valium, Nicotine and Caffeine addict, all of which I got over. Valium was the hardest. I was on that crap for seven years!
Very interesting article and discussion. The fact is that "disease vs. choice" is a false choice. Addiction is both at once.
It is a disease, brought on by a choice. And then (usually) continued choices over and over again. Over time, the level of "choiceness" decreases as the addiction becomes more severe, to the point where "using" is no longer a conscious effort, but rather more of an irresistible bodily function.
This applies to hard drugs, alcohol, obesity, etc.
But that does not change the conscious nature of the action (or actions) that started it all. Few people will become fully addicted to something after just one use. It requires at least several uses.
This means that we should be very willing to treat addicts, just as we are willing to treat other choice-induced afflictions such as diabetes, lung cancer from smoking, a broken leg from jumping from a 4-story building during a dare, a bullet wound from freely participating in a gang, an STD from unprotected sex.
However we are, at the same time, legitimate in making a judgment on the character of the person, assuming they had access to information. They knew that eating Big Macs every day for years would eventually cause problems; they knew that smoking was poisonous to health; they knew that jumping from the building was a risk to their health and life. And the drug addict knew that putting addictive chemicals into their body was dangerous. In fact, the danger and risk of drug use is what is so exciting for many first timers.
So the answer, as is typical with these kinds of issues, lies in the middle.
One last thing. I will note that when someone loses 400 lbs. and gets back to a normal, healthy size, we are happy to praise them and say "wow, what an accomplishment!" Rightly so. I am always impressed by that kind of willpower and strength of character. Yet why are so many uncomfortable with applying the same standard in the other direction?
Thanks Josh for a very interesting debate on if addiction is a choice or disease. I think we'll be debating this question for years to come. In my own life, I have seen alcoholics beat it and others who died trying. Great discussion here!
Overall, I agree with Josh - addiction is ultimately a disease.
Let's consider first and foremost that most people don't just start doing meth at 40 years old. Most people who are heavily involved in the drug culture have been since they were very young. In their youth it was initially a choice, usually due to curiosity, peer pressure, and ignorance. At first it's just for fun but as life goes on and things get more difficult, a person who may have just done drugs/alcohol for the fun of it now comes to understand that drugs are also a great way to escape problems and numb pain - so they start self medicating.
Soon, every part of their being becomes accustomed to having drugs/alcohol. If they don't have it, they can't function. The level of an addict's "function" is debatable, all the same, an addict's mind, body, and soul becomes dependent. It's a part of their make up now, and without it they are incomplete. At THAT point - how can someone really say that addiction is a CHOICE? The drug/alcohol is IN CONTROL. How can a person have choices if they are not in control?
I feel that like with smoking people will do drugs to get away from pain without thinking that negative things will happen to them. I really don't have any compassion for a lot of drug addicts anymore because they fully know what their getting into. However, when they die I would never say anything cruel because unless they committed horrible acts they have to deal with what they did.
A lot of good stuff here. Nice job. Just like to add that anyone who uses a chemical of any kind to change the way they feel, addict or not, is avoiding some part of themselves or their life. Maybe loneliness, some tragic event, plain old boredome, or whatever. There are endless possible options besides escaping reality, if the temptation should arise. I've tried a wide variety of mind and mood altering chemicals, all of which were empty and fruitless life experiences.
Well .josh. looks like you've stirred up a right old hornet's nest of views here!
I can see all sides and so I do not have a clear handle on this subject ... okay, so one chooses to either 'do' or 'not do' drugs or alcohol - I get that ... and that choice, to risk the outcome when one does them is understandable, especially in the young when most of us are often reckless one way or another (unless we're just the type who is born old!)
What is important is to try to understand why they feel the need to choose 'for' in the first place, what is so lacking about their young lives that they feel they need so desperately to escape. If we had the answer to that ... and if we could supply some solution ... then we could perhaps save many of them.
What is overwhelming is that they need our support and understanding ... not our taking the moral high ground and writing them off.
Many thanks .josh. for a powerful hub ... good luck with all your future writings ...
Hey Josh:-)
Congratulations from me to you! I really want you to know that I find you a very good and inspiring writer. Hubnuggets is a nice challenge and I must say...a bit jaelous I am :-) but I don't mind losing from such a great writer!
Keep going!!! Greetz Escobana:-)
I like the feedback that I see on addition or choice. Very eye opening to most people from all walks of life. Inner-strength wishes to all.
@cayble: Wow, quite the informative post, and I agree that the true definition of diseases does support the notion that addiction is one. Thank you for such a well thought out contribution to the discussion.
@TinaLynn: Thank you! I'm glad you enjoyed it. There is undoubtedly an element of choice in the beginning, though - as I said in the hub - I suspect in most cases the choice is one to 'escape,' without much consideration for the long-term consequences. I appreciate your comments, and thank you for reading!
@FloraBreenRobison: Thank you for the kind words, and I completely understand where you're coming from - it does get a little out of hand at times, and I also prefer not to get into heated debates. There are, however, some things I feel too strongly about to remain silent, and this is one of those things; not necessarily with regards to addiction in particular, but just with how we often perceive those who make bad choices, and the subsequent lack of compassion or understanding we show. To me, it's upsetting. I think we all - at some point - make bad choices, and we all have our weaknesses, but they simply come with varying consequences.
Thanks again for your comments, and I really appreciate you stopping by.
@journeyforth16: Well said, and I think you're absolutely spot on. At the end of the day, regardless of where you stand on this issue, it is a problem, and one that will not be remedied by our judgment. Thank you for sharing your thoughts, I very much appreciate it.
@VonShanks: That's a perfectly reasonable position, and I'm very sorry to hear about your brother. I can't even imagine how difficult that must have been. I appreciate you sharing your story, and offering some insight from someone with such an experience.
@rembrandz: Thanks so much! I really appreciate it.
@Bard of Ely: Wow, I can only imagine the strength that'd be required to beat an addiction like that. You're certainly a shining example to the fact that addicts can turn their lives around, as it appears Ms. Winehouse was trying to do herself. Thanks for stopping by, and sharing your experience. Much appreciated.
@secularist10: Very well said, and all excellent points. I think where we differ, however, is in the belief that these people deserve our judgment. As I said to FloraBreenRobison above, I think we all make poor choices throughout our lives, and all that differs is the severity of the consequences. And I believe much of it depends on the 'cards we're dealt,' largely beyond our control, rather than some of us somehow being better (or even stronger) people. During my undergrad, I consumed copious amounts of alcohol, and even experimented with some drugs, fully aware of the potential consequences, but simply not able to comprehend the notion that I could be 'one of those' people. And, fortunately, I wasn't, but was that because I was any better than Ms. Winehouse? No. I was just lucky enough to not be born susceptible to addictions like she was.
In any case, with that said, yours is a perfectly legitimate argument, and I appreciate you leaving such a well-written and thought-provoking response. Thank you for stopping by!
@Minnetonka Twin: I appreciate the kind words. Certainly, there are those who beat it, and considering Ms. Winehouse seemed well on her way to overcoming her own addictions, addicts are certainly far from hopeless. My hope is that other addicts learn from Winehouse's mistakes, and don't ever try to overcome such serious addictions on their own.
Thanks so much for stopping by!
@dd greely: Very well said, and I agree with you 100%. Thanks so much for such a thoughtful response, and I appreciate you stopping by.
@Rodney R: Well said, and an excellent point. There are undoubtedly other options for 'escaping,' but unfortunately for many, drugs and alcohol seem to be one of the easier options. (And I'm with you - the results of these 'escapes,' while sometimes momentarily effective, always end up being very disappointing.)
Thanks so much for your comments!
@Angie Jardine: Thank you so much for the kind words, and I couldn't agree with you more. At the end of the day, drug addiction is a problem for society as a whole, and is not something that can be conquered through our superiority complexes and our judgment.
I suspect if we all took your stance on the issue, we would all be much better off for it. Thanks so much for such a thoughtful comment, and the kind words. I really do appreciate it. All the best to you as well.
@Escobana: Thank you so much! Certainly, your hub was just as deserving of a win, and I think the controversy of my topic (and subsequent discussion that has ensued) is what gave me a bit of a bump.
I appreciate the kind words, and look forward to reading more of your work! You've still got some time for another HubNugget nod, so keep on going!
@brownbear50: It really has become a fantastic discussion, and I have to say I'm quite impressed as well. I appreciate your comments, as you've certainly made quite the contribution here yourself.
Josh, congratulations on writing a hub that has had such tremendous response. You really know how to start a conversation and keep it going.
I really appreciate the discussion. The ideas are really good! But anyway, to comment on this issue, addiction is not a choice, to become an addict is.
Addiction is a result of continuous doing of the same act, a repetition. When you do things in repetitive ways, it will become a habit, an addiction.
In the medical realm, addiction is a disease. It will occur when Opioid receptors in the central nervous system are active causing a person to do things and crave things repetitively. Opioids are used as analgesics. example of these are morphines, which are prescribed in yellow prescriptions.
@J Bergraff: I appreciate it - it really has become quite the conversation, hasn't it? I think it's as much a reflection on the quality of HP as it is to this particular article. Thanks for the kinds words.
@sarasotadui: Thanks for stopping by! While I generally agree with you, I'm not sure addiction is always the result of continuously doing the same thing (assuming you mean prior to becoming an addict); certainly, in many instances that is the case, but there are addictions that are the consequence of a single choice/mistake. One time - or a couple times - is sometimes all it takes.
Thanks so much for your comments & insight, and I truly appreciate you stopping by.
Josh,
A final plea for judgment, if you'll indulge me. You are right that some people are physiologically more susceptible to addiction than others. But the choice factor remains. It is precisely the lack of knowledge of how that pill will affect me that should prevent me from taking it. (This applies to legal drugs as well, btw.) In any case, as I said, it takes at least several uses to become really addicted to something, and that spells choice.
I agree that the "cards we're dealt" have a profound impact. No doubt about that. Who is likelier to become a gang member--a child born in a wealthy suburb who is enrolled in a nice private school, or a child born in a ghetto to a drug-addicted single mother? Obviously the latter.
But that's not what we're talking about, is it? We are talking about people who are equal, as much as possible, in their lot in life. Otherwise, it's mostly environmental factors.
I don't think any reasonable person will jump to criticize someone who is obese because of a real physical health problem (a tiny percentage of all obese people). Nor someone who is addicted to drugs because their mother took them while pregnant. Nobody will argue that someone born and raised in a poor town in a developing country is "lazy" because they have $50 in the bank.
But two people who have been given similar opportunities and chances (including physical abilities)--certainly you would agree that if one succeeds and the other fails, it is due to a significant degree to talent and character?
And again, many people are happy to judge when the judgment is a positive one, but not when it is negative. Something to think about. Thank you again for this interesting discussion.
Listen brother, there is no one in here who has seen what I have, or knows what I do. I worked at Devereux for ten years and have worked with addicts on the streets as well. I quit cigarettes. Here's the skinny. We call things addictions because of dopamine or endorphins, like sex or gambling. That is compulsive behavior, and should be treated as such.
Real addiction is a different beast. The Netherlands have the most enlightened approach, but it isn't all the way there, yet
Drugs are a mental health and spiritual issue. Stigmatizing, stereotyping, judging, categorizing, labeling are detrimental. That includes most American rehab.
The addict is forced outside of the camp, when he/she needs the warmth of the fire.
"I have a very difficult time understanding the angry and cruel comments that are often directed towards drug addicts, even subsequent to their passing" That's right, mate!
The bottom line is this; for every single solitary reason that any reply here has been given why addiction is not a disease there is alternate factual explanations show them to be incorrect, if not completely irrelevant.
First off, its not a question of addiction being "choice or disease". One is clearly, without a doubt not exclusive to the other. The only reason I can possibly think of why one would even think choice and disease are mutually exclusive is that a person who thrives on that theory must be using that principle to relegate addicts to a weaker minded rung in life.
AIDS was mentioned before right? We know as a fact AIDS is a disease and is contracted by high risk behavior that transmits the disease from one person to another. The decision to engage in that behavior that could lead to contracting AIDS is a choice, much the way indulging in drugs or alcohol to excess is a choice that can lead to addiction. Which just happens to be another kind of disease.
While its no so common in the western world as it once was, there are still many places around the world where people are in jobs that are well known to be jobs that are at high risk for developing certain related diseases, and people do CHOOSE to take these jobs as opposed to living in poverty in many places in the world and then they do contract diseases from those jobs. Many kinds of cancer come about largely by choosing to engaging in risk related behavior. We know these things to be a scientific medical fact. Those who somehow live in a fantasy world where choosing to engage in a particular behavior that results in contracting some kind of health issue means the health issue is then no longer a disease are simply wrong. No debate, simply wrong by the unequivocal facts that plainly show they are wrong.
One guy said "with addiction, you can also beat it by determination and commitment alone... something you cannot do with a disease. It's that simple" He is so wrong it would be laughable if it wasn't such a quick poorly thought out off the cuff ludicrous comment.
Again, diseases and addictions come in all kinds and sorts of types and severities. A common cold and the flue for example are diseases. Cut and dried they are diseases. Its a medical fact. Both those diseases can be beat with considerably less then commitment and determination. Some chicken soup and a good rest at home will often do the trick. Can anyone see here what happens when one makes comments based on pre conceived notions about the nature of addicts because it makes them feel better about themselves? If you cant see it, I will tell you. It makes people who say such things look very dumb. Like wise, some people with very very strong addictions cannot seem to beat them with all the will power they can muster along with all the professional medical attention the world can bring to them and their addiction kills them.
The unfortunate part about this debate, that many don't seem to understand here, is that its a long long way from the first time this debate has been held. Medical practitioners held this debate over and over and over and over again until they ran the argument right into the ground. To the point where every possible consideration was re argued ad-infinitum. And the debate resulted in what has come to be accepted as the definitive answer many years ago around the world by people with PH D's.
Addiction IS a disease. Cut and dried, like it or not. It meets every criteria to be a disease and leaves none out. We are arguing here like thoughtful pundits trying to figure out who will win World War II. Sorry to tell you, that particular debate was over and known as a fact a long time ago. Its not up for debate.
There are many interesting questions to be debated about addiction, but is it a disease isn't one of them.
You do not simply Use Heroin at 16 and become an addict. Just like a 50 year old diabetic man didnt just turn diabetic after eating a donut at age 16, or like My 49 year old mother didnt just go to work at a paint mixing factory and catch Aplastic Anemia.
Shooting the dope, eating the junk food, or going to work in an unsafe environment were choices, but the Addiction, diabetes, or Anemia were not.
An excellent Hub and one I enjoyed reading greatly; nicely thought out and poses some interesting fodder for debate, which you got in spades. As a recovering alcoholic I don't choose to be a part of the debate but I loved reading the other comments. Thumbs up!
The Optimizers 10 months ago
Unfortunately I don't have the kind of time that appears to be available to you in order to go into as much detail with my response, though I suspect, as with most things that if I did have the time to seek and research, I could probably post as many counter argument sources as you have in your argument.
Anyway. To me it is as simple as this:
For both diseases and addictions you can get medical care and attention. That is somewhere they are similar. However, with addiction, you can also beat it by determination and commitment alone... something you cannot do with a disease. It's that simple.