Aphayrath 1

Jesse Aphayrath
Holly Guile
English 2010
28 March 2014
Addiction: A Disease or a Matter of Choice?
Being an addict is not a consequence of a serious character flaw or a lack of will
power; it goes farther beyond that. Addiction is defined as a chronic, relapsing brain disease
distinguished by compulsive drug seeking and usage (Drugs: The Science of Addiction). Sure,
one can argue that a person smokes or takes drugs voluntarily, while, this is true initially, once
the hand of abuse grasps the user, the persons judgment and self-control becomes severely
challenged. This is the argument from its a disease perspective. From this point of view,
addiction is considered a disease because of the changes that occur in the brain drugs change
its framework and how it works (Drugs). But the changes in the brain in this manner do not
hinder its function. This is evident in the fact that smokers can still live a normal life. To call
addiction a disease is too broad and contradictory, for the brains activity and structure is
constantly changing. Neural dysfunction is not neural impairment (Levy).
I believe that in some cases it is indeed both in a sense. There are too many factors
contributing to have it just be classified as one. In a sense, addiction does not have the
credentials to be called a disease. The important aspect often over-looked is the solution, in this
case, it is the treatment. Not its classification.
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It is important for us not to simplify and dismiss such a complex discussion that has
affected most Americans (Califano). And a highly relevant discussion at the very least; abuse
and addiction of nicotine, alcohol, and illegal substances cost Americans about half a trillion
dollars each year including medical, economic, criminal costs, as well as social impact
(Volkow). Not only are the costs astronomical but the number of deaths associated with drugs
are also astounding; of more than the 2.4 million deaths each year in the United States, tobacco
claims around 450,000; alcohol, more than 100,000; illegal drugs, estimated to be around 20,000.
These are numbers are from substances specifically. But, if one looks at the major causes of
death in America, like heart disease, cancer stroke, lower respiratory diseases, and accidents;
Substance abuse is the underlying associate in all those killers (Califano, 65).
But is substance abuse voluntary? A drug-addicted individuals brain undergoes changes
in areas critical to judgment, decision-making, memory and learning, and behavior control. Some
scientists think that these changes refine how the brain works (Drug). Which is correct but
doesnt all brain activity alter how we think? Any amount of effort on our part induces brain
activity. Drugs take on the brains reward system by overflowing the receptors with dopamine
(Drugs). Treatments providing alternatives to drugs are based off the same concept. The
concept of behaviorism; reward is very cause and effect based. The most effective solution is
behavioral treatment; also known as Contingency Management. This method uses the concept of
behaviorism to influence what a person is doing or not doing (in this case, drugs) by rewarding
dependent on behavior (Principles). The key here is to reinforce positive behaviors with rewards,
like money. It is very important that we work on treatment than debate about its classification.

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Works Cited
Califano, Joseph A., JR. High Society: How Substance Abuse Ravages America And What to
Do About It. New York: PublicAffairs, 2007. Print.
"Drugs, Brains, and Behavior: The Science of Addiction." Drug Abuse and Addiction. National
Institute on Drug Abuse, n.d. Web. 28 Mar. 2014.
Levy, Neil. "Abstract." National Center for Biotechnology Information. U.S. National Library of
Medicine, 11 Apr. 2013. Web. 28 Mar. 2014.
Murphy, Sherry L., Jiaquan Xu, and Kenneth D. Kochanek. "National Vital Statistics
Reports." Deaths: Final Data for 2010 61.4 (2013): 1. Web. 28 Mar. 2014.
Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition)."Contingency
Management Interventions/Motivational Incentives (Alcohol, Stimulants, Opioids,
Marijuana, Nicotine). N.p., n.d. Web. 30 Mar. 2014.
Volkow, Nora D. "Media Guide." The Science of Drug Abuse and Addiction. Drugabuse.gov,
n.d. Web. 29 Mar. 2014.