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Is addiction a disease or a choice?

Over the last two weeks, I have seen multiple people that I highly respect speak about, and post articles, presenting “conclusive” evidence that addiction is a disease. I have also seen people–that I highly respect–post “conclusive” evidence that addiction is a choice. This subject has kept me awake most of the night, that’s why I’m up typing a blog post at 1:30 am. I have a genuine desire to add my two cents, for what it’s worth. So, let’s jump in with both feet and see where we land. Stick with me to the end, please.

Addiction is a disease

Again, I would like to say that people I highly respect say that Addiction is a disease. Well, I don’t know that I can completely agree with that. Defining a disease is difficult. Here is one set of definitions for a disease:


1. a disordered or incorrectly functioning organ, part, structure, or system of the body resulting from the effect of genetic or developmental errors, infection, poisons, nutritional deficiency or imbalance, toxicity,or unfavorable environmental factors; illness; sickness; ailment.

2. any abnormal condition in a plant, animal, or human that interferes with its vital physiological processes, caused by pathogenic microorganisms,parasites, unfavorable environmental, genetic, or nutritional factors,etc.

3. any harmful, depraved, or morbid condition, as of the mind or society:

His fascination with executions is a disease.

When I look at these definitions of disease, I think, “Yes. Addiction is all of these things.” My mind then carries me back to “settled science” That phrase is an oxymoron, however, because science, by definition, is never settled. What is true today may be overturned tomorrow by a new study. To rely on science alone as evidence of something’s nature, or even existence is a flawed point of view, to begin with. For something to be true in science, it must meet three criteria:

If it exists, according to science, then it must meet three requirements:

1.) It must be observable.

2.) It must be measurable.

3.) It must be able to be reproduced

So you see that according to its very core beliefs, that science says God cannot exist. God is certainly not measurable or able to be reproduced, and he’s only observable when He wants to be. We as believers cannot rely, solely, on what science says when it tells us that God doesn’t exist, creation didn’t happen, and that Jesus wasn’t born, and wasn’t resurrected from the dead. Science also tends to “evolve” over time. “Settled science” has told us that the Earth is the center of the universe, that the Earth was flat, that heroin is the best thing to break an addiction to morphine, and that homosexuality is a disease. Science, today tells us very different ideas on each of these issues today. Science gives the best interpretation it can with the limited knowledge and ability to interpret information that it possesses at the time.

But Greg we can see in brain scans…yadda, yadda, yadda. No test can prove who will be an addict. Yes, we can see what drugs do to a brain, but we cannot scan all people and determine who will and won’t be an addict. Some new tests indicate (at age 14) who MIGHT develop into an addict in 2 years, based on how their brains respond to rewards, but there is no exact litmus test for who will definitely be an addict. Yes, we do know people are genetically predisposed to addiction, but even this does not guarantee addiction likelihood.

There is a great article here that covers this issue in more detail if you would like to read it:

What is a disease?

We cannot escape the idea that there are often times medical conditions that mimic psychosomatic diseases. Sometimes a person will have every symptom of a disease, but never actually a disease. My wife is a perfect example. This is a true story; you can ask her parents. If my wife hears a story on tv about a specific disease, she will begin developing many of the symptoms. Also, I try never to let my wife read the insert that comes with medication listing all of the possible side effects because once she reads it, she will begin to develop every symptom on the page. I know it is relatively humorous, but it is also entirely accurate. We have to understand that labels have power, whether they are accurate or not.

Calling addiction a disease removes personal responsibility

The labels and descriptions we place on things have a profound ability to impact how we view them, and how we respond to them. During my addiction, I went to Pine Grove (a secular, residential treatment and detox facility in Hattiesburg, MS). I was there to check myself in. When the doctor came out to assess me, I explained to him that I didn’t go through withdraws. I could stop cold turkey and be fine. I just needed tools to help me not use again. He told me that I wasn’t an addict, and I didn’t need to be there. I left, and I told myself that this “addiction doctor” told me I didn’t have a problem, so I could continue as I had been doing all along. The problem was that he didn’t have all of the information, but his label was very powerful.

The main problem with labeling addiction as a disease is that an addict hears that label and thinks, “this is not my fault. I can’t help the way I am.” They believe that if they didn’t help create the circumstances they are in, then it isn’t their responsibility to get themselves out. It’s just how they are. Yes, I can see the lunacy in that mindset, but that doesn’t change that it is oftentimes how they think. Calling addiction a “disease” is helpful in one arena of treating addiction, but it is also a stumbling block sometimes as well.

Addiction is a choice

Again, let me say that there are people I highly respect that hold to this point of view. I do not think I can completely agree with it either, however. This definition is a little more straightforward:

1. an act or instance of choosing; selection:

2. the right, power, or opportunity to choose; option:

Labeling addiction as a choice is such a vast oversimplification of the condition that it makes my head want to explode. Is there a component of choice? Absolutely. Does that mean we window shop around and say, “Oooooh, Honey look. Isn’t heroin beautiful? Please, Mr. Salesman, can I take it for a test drive? Yes, I’ll take that one.” I apologize for the sarcasm. I was hooked under a doctor’s care. I spent my entire time growing up choosing not to drink or do drugs. I had a very serious issue with migraine headaches. After years of having debilitating headaches almost every day, running every test they asked me to, and trying every treatment they gave me, a doctor said, “Here, Greg. You can take these pills when the really bad headaches hit, and it will stop them. There were no warnings. There was no cautioning that this stuff could be addictive. I knew the very first time I took those pills, at 22 years old, that I probably liked them too much. But a doctor gave them to me, right? I did not choose that. I trusted my way into that. Yes, I am aware that many, if not most addicts make a choice to try drugs for the first time. But I can guarantee you that almost none of them–upon choosing to try a drug–thought, “There is a chance this will destroy every relationship I have, take every dime I have, wind me up in jail, or rehab, and if I’m really lucky, maybe I’ll overdose and die.” No addict starts out choosing that outcome.

Even if addiction starts with a choice, it does not make it not a disease

People do not start out in life choosing cancer. There is a reason why almost all of the countries in the world that top the cancer percentage rates are in the western world. We choose processed foods. We smoke. We use chemicals that cause cancer more than other less-developed countries. There is a very clear and present choice factor in cancer. Nobody says, “I think I’ll smoke so I can get lung cancer.” Nobody says, “I believe I’ll go out of my way to choose foods that are processed and have preservatives that cause cancer.” Do we not classify cancer as a disease? I don’t hear many voices at all shouting from the rooftops, “You people are choosing cancer!” Likewise, sexually transmitted “diseases” happen with a choice. It is a fact that if we practice abstinence and monogamy, the odds of contracting an STD are almost zero. People make a choice to engage in risky sexual behavior and contract disease. And oddly enough, these choices hurt other people and destroy families similar to addiction. But they are still diseases. So, I will concede that often times, addiction starts with an initial choice, one single choice, but that doesn’t make the entire condition a condition of choice.

So what is the answer, wise guy?

I hear you, “Ok, Greg, you’ve argued against both points of view. So what is addiction, smart guy?” First, I appreciate you calling me smart, although I believe the description is unwarranted. Second, I believe there is a third point of view that answers the question. Addiction emanates from sin and brokenness. You can call it a disease of choice if you’d like. Man chose to do what they wanted, not what God wanted, and the relationship was broken. Sin and disease entered the world. If addiction is a choice, then it is a choice that causes disease. If addiction is a disease, then it is a spiritual disease, that leads to a choice, that causes a physical disease, that removes all choice.

Addiction has its roots in sin and brokenness

I honestly believe that every negative condition we face in life comes down to sin and brokenness. I’m not saying that an addict becomes an addict because he sinned and God cursed him with addiction. What I’m saying is that original sin separated us from God and allowed disease, disorder, and brokenness to enter the world. We just continue to suffer the consequences. We as people–every single human being on earth–have a gigantic hole in the middle of our souls that can only be filled with Jesus Christ. We can try to fill that empty spot with other things, and they will quiet the cry of our soul (for the relationship with Christ) for a short time, but every attempt to fill that void within us that does not involve Jesus Christ, will ultimately disappoint and fail. Everybody has something other than Christ they use to fill that void (that isn’t Christ) until they find Him. Money, sex, power, fame, alcohol, drugs, whatever. Every sin that man is involved in is an attempt to control our lives without Jesus. Sin is the futile attempt of man to be God. We seek to make ourselves complete, apart from Him. We as people seek, as Frank Sinatra put it, to do it “My Way.” And our way falls short every time.

At the end of the day, labels make us feel better, nothing more

To ascribe something a label helps us to deal with a situation. To label addiction as a disease removes personal responsibility and gives the addict an excuse to continue using if that’s what he wants. To label addiction as a choice removes the genetic predisposition for addiction and takes away the fact that the brain physically transforms and fights against any desire the addict has to quit. To attach either label may gain you some better understanding, but 6 of one, a half dozen of the other. You lose ground in one area and gain it in another. To label it as a condition of sin and brokenness leaves the only avenue of recovery as Jesus Christ. I can assure you that when addicts go to Him, genuinely, sincerely, and of their own free will He will set them free, because he’s been in the setting free business for 2000 years. We need only point them to Him.

So how did Jesus treat those in need?

Jesus didn’t go around worried about labels. He knew that what the people need was to be forgiven of their sins and have a relationship with Him. He would love them, forgive them, and send them away with one admonition, “go and sin no more.”

Is it possible for people to walk in recovery without Jesus?

Yes and no. Yes, it is possible through secular programs to help people walk in sobriety. That does not fill this void, however. There is a high probability of cross-addiction, or continued addict behavior (living out unhealthy patterns but not abusing substances). We can even give tools to learn how to react in certain situations that one can live a relatively successful life, but they will never be complete without Jesus. So I would ask, “If we set people free from hell on earth (addiction) but leave them destined for hell in eternity, what was the point?” They may be better off temporarily, but, the worst is yet to come.

So what do we do?

I’m not bashing either approach. They both have their merits. All I’m saying is that they both fall short. If we can get people to stop using with science, then fantastic. If we can get people to see it as a choice and empower them to make better choices, then wonderful. I am 100% for setting people free from addiction. It is my passion in life, but that only solves their earthly problem. The eternal condition is of much more pressing need.  And I can guarantee that if we solve their eternal condition, introduce them to Jesus Christ, and train them to seek Him first, and His righteousness, above ALL things, He will set them free from addiction, and any other scientific problem, spiritual stronghold, or other condition they may have. People can argue over the label all they want, but Jesus is the only permanent answer.

Just my two cents. God bless.

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1 Comment

  1. Great perspective on addiction. I have to admit, been struggling between the 2 views during these times, but much clearer now. As you said, as healing begins, a void must be filled. Thank you Jesus.

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