Addiction: Choice or Disease?

The destructive world of addictions touches almost everyone. Whether you’ve personally struggled with an addiction or you love someone who has, you are almost certainly emotionally involved with addictions. Friends struggle to find a way to approach an addict’s battle in the most nonjudgmental, healing way possible. Addicts fight to find the root of their problem. But no matter how addiction has impacted you, you know the discussion of addictions matters.

When I was eleven, I descended into a long fight with bulimia nervosa, an eating disorder. As I reached out for recovery years later, I was faced with two interpretations of my addiction. One claimed that my eating disorder was a disease, the other that it was a choice.

Addictions are all consuming. Though part of you longs to be a whole, healthy person again, you feel powerless to change. You become a slave to your cravings. So the disease interpretation wasn’t just comforting, it seemed true. It said I had a choice to start that first diet, but I didn’t choose to be addicted to hunger, to weight loss, or to food. I had been infected by my circumstances, and now my disorder was attacking me from the inside like a virus, injecting disease into healthy thoughts and multiplying.

The choice interpretation does acknowledge a corrupting disease, but that disease is not alcoholism or anorexia: it’s sin. The blame is shifted from outside factors to the addict. I was called to take ownership of my choices and repent.

I had to choose, because each interpretation had a different path to healing, and only one could lead to freedom. As I examined both options, I discovered that the truth was clear: addiction is a choice, not a disease. Factors like a disordered brain can influence an addict’s choices, but they can’t make choices for him. The consequences of sin impact the brain and the rest of the body, but those are only the results of the problem, not the problem itself.

The disease model of addictions blames physiology, childhood, abuse, and a myriad of other factors as if they have the power to infect a person with addiction. Calling an addiction a disease sounds attractive, because you’re off the hook. You’re just a puppet tied to a kite, flopping and leaping wherever the wind tugs. Popular psychology prescribes that you cut your puppet strings and step free of the factors that made you an addict, but puppets with cut strings aren’t very lively. You lie on the grass, wooden, and after you muster all your self-esteem, still wooden. If a person is powerless to choose evil, a person is powerless to choose good.

There is no logical option for full recovery within the disease model. The addict can change her circumstances. She can take medication to fill the holes in her circuitry. But as soon as bad things happen, or as soon as her medication falls short, she spirals back into addiction. We can’t blame her for it; her disease has just flared up again like a stubborn cancer. The recovered addict is forced to live in constant fear of relapse.

Outside factors can only influence choices, not make them. Because the addict chooses to engage in their addiction, they are not suffering from a disease, but choosing to sin.

“[An addiction] is something we do rather than catch.”

-Edward T. Welch

Within addiction you do become a puppet controlled by your appetites, you are powerless to choose good – but through the recognition of sin comes the possibility for repentance. And through repentance God breathes life into wood, transforming the addict into His free, alive child.

What about the brain?

 “At its core, addiction isn’t just a social problem or a moral problem or a criminal problem. It’s a brain problem whose behaviors manifest in all these other areas…The disease is about brains, not drugs.”

–  Dr. Michael Miller, past president of the American Society of Addiction Medicine

If our choices are merely the products of our brains, where the reward circuits dictate whether or not we fall in love, go to work, or eat a chicken sandwich, the addict is the logical one. They opt out of the complicated networks of choices that may or may not lead to brain-satisfying results and hack into their brain’s pleasure system. If we are our brains, non-addicts are equally enslaved to pleasure-releasing behavior as an addict. The non-addict just chooses more socially acceptable means.

The addict really lives the life the neuroscientist thinks we are by nature born to endure.

– Alva Noë, professor of philosophy at Berkeley

As soon as you isolate the brain as the only factor, you destroy what makes life fruitful and beautiful. To choose, to love, to worship, or to fellowship becomes a function of chemistry rather than an outflow of the heart. And addiction is no longer a disease, but a logical evasion of the brain game. But this is not true. Addictions are created from the involvement of the whole person, through your brain, your history, your emotions, and most of all, your worship.

When you look an an addict, do not do him the injustice of seeing merely an abusive childhood or misfiring synapses. An addict is a multi-faceted human being with a shattered soul, struggling against the flesh, thirsting for escape, and hungering for wholeness. Addicts are sinners. But they are sinners with a chance for full redemption.

This is the greatest comfort you can give an addict, not blamelessness. The freedom of accepting addiction as a sin is overwhelming. Instead of living in fear of outside events or brain malfunctions triggering a relapse, the addict is secure in repentance. Instead of trading one brain game for another, he has the potential to be renewed from the inside out. He is not only recovered, he is redeemed.