” If you don’t want to, you won’t get hooked”: Why addiction is a disease, not a personal choice 

Posted onJune 6, 2021 in Medical news

THE ATTITUDE OF THE OVERWHELMING MAJORITY OF PEOPLE to destructive addictions is still based on the belief that their formation is an exclusively personal choice of a person. ” If you don’t want to, you won’t get hooked.” Or, alternatively, “you can get rid of any addiction, you just want to.” This is the difference between addiction to most diseases. There are hardly many people who are sincerely convinced that, for example, peptic ulcer disease appears only in those who themselves wanted it. And it seems clear that a person suffering from obsessive-compulsive disorder should not be advised to “just be less nervous”. However, when it comes to addiction, these rules seem to cease to apply, which leaves an imprint not only on the public image.  addicted people (they are considered to be weak and vicious), but also on approaches to treatment for addiction.

This attitude is beginning to change, especially in the light of sociological and medical research: they indicate that addiction and any addiction in general (hereinafter, addiction means dependence on the intake of any chemicals permitted or prohibited by law; addiction means a psychological disorder , leading to addictive behavior, but not necessarily caused by addiction to a particular substance) is not always a consequence of a lack of will. There are both a predisposition to addiction and social factors that push a person to form it. Does this give an undeniable right to say that addicts are not to blame for their addiction – just as a diabetic is not guilty of their diabetes? Is it true that a predisposed person is doomed sooner or later to get hooked, no matter what? And what is the real reason for addiction?

Addiction as a genetic malfunction

Studying the question of whether a person can be programmed from birth to any addiction, the National Center for Biotechnology Information came to the conclusion that genetics is at least half responsible for the predisposition to one or another addiction. Another study cites similar figures – 40-60%. However, these findings only indicate a potential vulnerability. By themselves, they do not confirm or deny that addiction is something that a person brings on himself. A predisposition does not mean neither the disease itself, nor a tendency to a particular addiction.

Addiction as a social phenomenon

While statements like “society made me this (that)” are more often perceived as an excuse to remove personal responsibility, in the case of addiction as a “social illness” they are partly true. There are many historical examples of how poverty, unemployment and social depression have proven to be ideal environments for the spread of hard drugs. Whether it’s the crack epidemic in the US in the 1980s, the heroin plague in the withering industrial cities of Thatcher’s Britain, or the sharp rise in opioid use in Russia since the early 1990s. From a more recent one, the global economic crisis of 2008 can be distinguished, which entailed progressive unemployment in European countries, followed by an increase in the use of cannabinoids and so-called new substances among people aged 15 to 24 years.

However, sociological calculations unambiguously speak only about the connection between addiction and social depression: poverty contributes to an increase in the number of addictions – but growth, in turn, leads to impoverishment . To determine what was the cause and what was the effect, it is necessary to consider the case of each person individually and in detail – sociologists often do not have the resources for this. The second nuance, which is also worth considering: social disorder can encourage the development of addiction and accelerate self-destruction, but not be the cause. If a person was born and raised in a dysfunctional environment, this does not mean that he will certainly become dependent.

Addiction as a protective psychological reaction

Anna Sarang, President of the Foundation for the Promotion of Health and Social Justice. Andrey Rylkov (included in the register of foreign agents), insists that drug addiction should be considered together with other addictions, focusing on its psychological aspect: “In Russia, drug addiction is usually separated from other addictions and compulsive disorders and is considered as a set of reactions and behaviors that caused by this or that substance. It seems to me that this is a dead-end path. The study of the genetic nature of addiction also does not seem to me a promising direction.

In my experience, most addicted people usually have some sort of childhood trauma. Addiction for them is an attempt at self-medication. And it’s worth focusing on identifying this injury. This is not necessarily a childhood trauma – it can be a social trauma, disorder associated with the organization of modern society and the economy, the inability to find a job, to realize oneself, to find a relationship that suits him. A person cannot cope with it – and not because he is weak or bad, but because life is difficult. Often, addiction is a response to external circumstances. “

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