Is dependence a choice? Whose fault is it?



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The Oxford dictionary defines "addiction" as "the fact or condition of being dependent on a particular substance or activity", but this does not reflect what an addiction implies, why people become dependent and effects that it is imposed on an addict.

I think the American Society of Addiction Medicine captures these missing pieces, with a rather detailed definition of "Addiction":
"Addiction is a primary and chronic brain reward, motivation, memory and badociated circuitry. The dysfunctions of these circuits lead to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically seeking reward and / or relief through the use of psychoactive substances and other behaviors.

Substance abuse is characterized by the inability to abstain consistently, impaired behavioral control, cravings, reduced recognition of important behavioral and interpersonal problems, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or participation in recovery activities, addiction is gradual and can result in disability or premature death. "

Let's start with the basics: the causes of addiction.

Some may say that addiction is a choice, that people deliberately impose this "chronic disease". Gene Heyman, in his book "Addiction: A Disorder of Choice," says that portraying addiction as a "chronic illness," placing it in the same category as schizophrenia and diabetes, is misleading. It focuses on the choice and how addicts choose to become addicted.

Consistent with the biological model of substance abuse, addicts may have weaker impulse control, which would make it more genetically vulnerable to the development of addiction. Our genes influence how our body responds to different drugs, which can speed up or slow down the development of an addiction. In fact, according to the National Institutes of Health (NIH), genes account for 50% of the risk of developing an addiction.

On the other hand, the addiction model of temperance says that simple exposure to addictive substances increases the risk of developing addiction. Lack of social support, socio-economic status, family status, peer drug use, coping with stress, and a history of neglect or compulsive behavior all contribute to climbing and attachment to an addiction. This highlights the social causes of an addiction, which often escape the control of the individual. The presence of a member of the blood family who has or has been addicted, and mental health problems in the individual also puts a person at greater risk.

Life experiences may have formed certain cognitive beliefs that compel an individual to develop an addiction.

Self-fulfilling prophecy prevents people with addictions from seeking or completing treatment. These individuals may be treated with the misconception that recovery will not benefit them or that they are not able to recover it. The role of the therapist would be to discover these beliefs and change them to promote growth. This is an additional indication of how dependence stems from deeper roots in cognition.

The biological, social, cognitive, and familial influences on addiction all testify to the fact that addiction is caused by certain factors that, for the most part, escape the control of the person. These various factors, such as genetic predisposition and education, interact to decrease or increase the risk of developing an addiction.

Currently, treatment programs are based on Heyman's addiction opinion that addiction is a choice. Maybe it's time to change the conversation and focus on treating the causes rather than the addiction. This will not only prevent new relapses, but will also improve the social life, health, family life and personal life of an individual.

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