“Choose to get clean.”
“I have no sympathy, just another rich bitch on drugs.”
“This is not a disease, it’s a choice.”
These are just three of the MILLIONS of comments that echo this sentiment about Demi Lavato. No, Demi did not begin the conversation, hers is just the latest celebrity overdose to reignite the debate that addiction is not a disease, but a choice. This argument has been fought bitterly on both sides from the outset of the creation of the diagnosis. For the record, whether you agree or not, the American Psychological Association categorizes substance abuse as a disease, it can be found in the DSM, the Diagnostical and Statistical Manual- the bible of mental health disorders- right along with Depression and Social Anxiety Disorder.
I can appreciate the debate, the misconception that it is, indeed, a choice. However, unless you, yourself are an addict and/or alcoholic, you absolutely cannot understand the feeling of enslavement that comes along with having this disease. How can you? Every day, you do have choice. You choose whether to have that glass of wine with dinner, or not to. You choose to share that joint at a concert with friends, or not to. Alcoholics and addicts simply do not have that choice. We are powerless to the substance. I’ve said it before, but it’s worth repeating, no one, NO ONE, wakes up one day and thinks, “Hey, I would just love to be a slave to alcohol or illicit drugs.” Honestly, logic would dictate that if we had the choice, we wouldn’t continue along such a significantly destructive path. A path of obliteration, filled with lies and horror, shame and disgust, and an eternally present, indescribable fear. Why would anyone want to feel like shit about themselves day in and day out? If we could simply put the drink or drug down, why would we choose not to?
No, it’s not a choice, it’s simply a fact. This is how we were born, before we even took our first steps, tried that first taste of mashed bananas, or uttered our first words; we were addicts. We have no more choice over this part of our genetic makeup than we do our hair or eye color.
Now this is when the naysayer comes in and says something like, “It was your choice to try alcohol and/or drugs to begin with.” Well, yes, you got me there*… However, what you don’t understand is that this is a sneaky and progressive disease. Apart from heroin, which is a beast of a different nature, no one is instantaneously addicted to the substance itself. No, it’s subtler than that, it’s so much more sly and underhanded. First, we become addicted to the feeling of emotional relief and comfort that it gives us. With that very first sip, snort, or inhale a switch in our brain is flipped and suddenly we feel “normal” for the very first time. Just like that, life is suddenly manageable. All the challenges that we don’t have successful coping skills for melt away, and we finally feel like we belong in our own skin. Our bodies relax and the feeling of emotional freedom that we have unknowingly craved pins us up against a wall. This is who we are supposed to be, how we were meant to feel! Finally!
Then we want that feeling again, and again, and then again, until eventually we can’t live without it. At this point, it’s too late; we are in over our heads with alcohol and/or substances and we don’t know how to stop. Then, one day, what used to work no longer does, because now you have tolerance, and your search for that relief intensifies.
Finally, your brain stops producing its own happy makers. The dopamine and serotonin that once pumped, plentiful and bounteous, has slowed to a trickle, and without your substance, you can no long achieve any state of emotional regulation. You have no choice; you either use, or you fall so hard you are not sure you will ever be able to get up again.
This descent may take months, years, or even decades. However, once you’re there, the shame and fear take over. You yourself wonder how you let it get this far. You fear that there is no way to live without this substance and you are now stuck in this vicious world called addiction. Even when you “hit bottom” and you decide to get help, you’re unprepared for how much worse it gets before it gets better. The only way your body knows how to live is with that substance, and now, you must learn to live without it. The disease begins to talk to you, like the devil on your shoulder. It reminds you of all the good times, while it completely buries away all the horrid times.
I know that this is a break from my normal blogging subject matter. However, as someone in recovery, but who also works as a mental health counselor with people seeking treatment, I think it’s worth the departure. Two-thirds of families in the U.S. have been touched by addiction. Many who need help do not seek it because they are told that it is their choice to be this way. It is not.
*Unless you were prescribed pain killers by your doctor and you had no idea that you would soon become addicted to opioids- then the choice was made by someone else.