As more than 23 million Americans struggle with addiction to one substance or another, there are many critics decrying medical intervention.

They wonder “Is addiction a disease or a choice?”, and in some cases even legislate based around the idea that it must be a choice. However, our whole frame of thinking should be examined before we settle that debate.

Here are 5 reasons to consider the argument that addiction is more of a disease than a choice.

1. Most People Would Choose Health

If given the choice between being in great health and being in poor health due to an addiction to the substance, anyone would choose health. No one would choose to be unhealthy if they could control themselves.

People have an urge to stay alive and to thrive. People suffering from addictions try to make it through the day in hopes of getting past their addiction the next day. Being addicted to a substance is the last thing anyone would want to wish on their health.

While some people do make that first decision to try a drug or choose alcohol over their priorities, there’s a point when “choosing” isn’t an option. In order to get through the day, the addiction takes over the brain. People become myopic and focused on their addiction.

Rather than being able to choose health, the substance chooses for them. They don’t even know that health is an option, because the substance is in the way.

2. Would You Choose to Ruin Relationships?

Addiction can ruin your most intimate and closest relationships with the people who you love. No reasonable person would ever choose to ruin their relationships. However, to the people who think that addiction is a choice, it seems like they would.

Your family, your friends, your intimate partners will try to stay with you as you suffer from your addiction. You watch your closest relationships suffer. It’s clear that there’s an answer and yet you can’t seem to take the action that you know that you need to.

If you’re in love, you would never choose to hurt the person you’re with. You’d do everything in your power to protect them and to let them know how much you care about them. And yet, when addiction has a role to play, it can cause you to ruin your relationships.

Is this something you’d call a choice or would you call it the nagging result of a troubling disease?

3. It Changes Your Personality

If you’re a happy-go-lucky person who sees the glass as always half full, you might not be able to maintain that attitude when you’re in the midst of an addiction. You might end up not only changing some of your behavior, but your whole attitude could change. Things that you once found deplorable could become normal behavior.

How often have you heard about people who are addicted to substances robbing their family, friends, and loved ones?

People in the throes of addiction will forget about their allegiance to the people who care about them the most. They’ll start making decisions that they would never have before. They’ll take action in ways that are both surprising and seemingly uncharacteristic.

No one would choose to become a thief or a liar, especially to the people they hold dearest unless something made them change. The disease of addiction causes changes to the chemical makeup of our brains. And during those changes, the drive for more of a substance supersedes all other interests.

4. Medical Intervention Is Necessary

One of the strongest arguments for why addiction isn’t a choice is that when you make a choice, you don’t usually need a medical intervention to reverse it. If I choose pepperoni over sausage on my pizza, it wouldn’t take a staff of dozens of medical professionals to change my mind.

When you’re suffering from an addiction, you need help dealing with things like withdrawal. Withdrawal can be fatal if it’s handled incorrectly. If addiction were a choice, there would be no withdrawal whatsoever.

If it were a choice, the decision to stop being addicted would be just as simple as choosing to go up or down on an elevator. With the concept of relapsing thrown in, it’s clear that it’s not a choice that anyone wants to make.

5. Choices Can Improve Your Life

Think about the very concept of choice. When you’re given a choice, let’s say between which college you go to, you could have a better or a worse outcome for your life. When you choose a substance, it’s rare you end up in a better place than you started at.

Even if you do end up in a better place, whether emotionally or through relationships with other users, those changes don’t last. If you choose a great college where you have a great experience, there’s no point where it all turns around and you end up worse than you started. Good choices beget other good choices.

Addiction can’t be a choice because there’s no permanent lasting impact that leads toward the betterment of your life. You never hear someone talk about their addiction as the greatest choice they ever made. They talk about their choice to put the substance first or to try the substance for the first time, but after that, things start to go downhill.

After that, it’s no longer a choice because who would want to end up powerless to a substance?

Wondering “Is Addiction a Disease or a Choice” Is the Problem

The longer that we continue to ask “is addiction a disease or a choice”, the longer we’ll continue to give addicts improper medical treatment. Addiction requires serious medical intervention and if we don’t give people what they need, we make them suffer unnecessarily. While it might look like a choice, it’s definitely more of a disease and should be treated as the health crisis that it is.

To get a better understanding of alcohol use disorder, check out our report on what it’s all about.