Reader Mailbag – Addiction is a Choice or a Disease?

Reader Mailbag – Addiction is a Choice or a Disease?


“Addiction is a choice and until that is realized, it gives the addicted the worst enabling possible. AA says to let them hit rock bottom. Why? If it’s not a choice and is actually a disease, then how will hitting rock bottom help?”

Now this logic I take issue with because I believe that in order to make sense of addiction, recovery, and of the struggling addict or alcoholic in general, then we have to make a clear separation between two things:

1) The “choice” to become an addict or an alcoholic.
2) The choice to take action and get help for your addiction.

The person who wrote in with this comment has lumped those two things in together. They are making not one assumptions here, but two assumptions. One, that people choose to become addicted, and two, that people can either choose to accept their problem and try to deal with it or they can stay stuck in their addiction.

When someone says “addiction is a choice,” notice that such a person saying that is never an addict or alcoholic themselves.

- Approved Treatment Center -


I have evidence in my own life of exactly how screwed up this logic really is.

You see, I used to be a “normie.” When I was growing up, I was not an addict or an alcoholic. In fact, I had never used drugs or alcohol my entire life. And when I learned about the concept of addiction and alcoholism, I thought “that is just stupid. Why would people hurt themselves with drugs or alcohol? How could they be so foolish?”

And then, of course, I became an addict and an alcoholic myself one day. Through no choice of my own, I became an alcoholic.

I did not want to become an alcoholic. I did not choose to become addicted to anything. It just happened. Now it is true that I was the one who “chose” to put the alcohol in my body to begin with, but society cannot fault me for that really. Drinking is a part of the culture. It was bound to happen sooner or later. And I did not choose to become a raging alcoholic, I just chose to take a drink. The fact that I became addicted was not my choice and was beyond my control, beyond what I would have chose for myself.

I am not a stupid person and to be honest I used to look down on drug addicts and alcoholics because I thought they were simply lazy or foolish, until I suddenly became one myself. Then I had to acknowledge that addiction really was a disease, even though I had originally believed that it was more of a weakness, a lack of fortitude, a failure of character. But I believed that I was smart and a good person and not overly selfish and here I was, addicted to alcohol and other drugs. Somehow, addiction had crept into my life even though I did not fit the description of someone how (I thought) should have become an addict. I did NOT give my permission. I did not choose to become addicted to anything.

So when people say “addiction is a choice” I can now look at that person and realize that they have more to learn, more to experience, and that their short-sighted view of the situation is exactly what my own short sighted view used to be. Today I know better. Today I realize that addiction is NOT a choice, and that people who are completely unsuspecting and truly undeserving of this disease can be afflicted with it from out of left field.

So I totally understand why there are thousands of people today who walk around this planet and declare that “addiction is a choice.” I used to be one of those people. But then, without giving my permission at all, I became an addict myself, and now I know better. I am no longer short sighted about the true nature of the disease.

Now this discussion thus far only focuses on the idea that someone might choose to be an addict or an alcoholic. We know today that addiction is not a choice in this manner, but perhaps it is still possible that people can choose to seek recovery, or they can choose to continue on with their addiction? Is that possible?

This becomes much more tricky because many people in recovery have had exposure to treatment, to rehab, to recovery, to AA meetings, to a solution. They know that a solution exists and that recovery is possible, but if they remain in denial then that individual does not believe that recovery is possible for them.

This is very important and it may sound like I am trying to absolve the addict of their responsibility but I am not. I have been there. I have been stuck in denial and I have been to treatment and I felt trapped by the fact that this solution did not seem to work for me.

In reality I was still in denial. It was not that I did not want to stop using drugs, because honestly I was pretty darn sick of addiction at the time. But the solution that was offered to me was rehab and AA and NA meetings, and I felt that this would never work, that my personality was just too wrong to fit into that mold of a solution, and I had too much anxiety to go to meetings, and so I felt like this was to be my death sentence.

Could I “choose” to just get sober, buck up, and go to meetings anyway, in spite of my fear and anxiety? I could not. At the time, I could not muster the courage to accept this as my solution. I wanted to change, I wanted for things to be different, and I did not want to keep using drugs and living a life of chaos. But I was too scared to go to the meetings and I had tried in the past and it had never worked for me.

I could not “choose” to get sober until something else happened, and that “something” is known as “hitting bottom.”

Which brings us to the next point. The reader says:

“AA says to let them hit rock bottom. Why? If it’s not a choice and is actually a disease, then how will hitting rock bottom help?”

We do not choose to become addicted. And we do not choose WHEN we get to hit bottom and surrender, either.

But the fact remains that any addict or alcoholic who continues to abuse drugs and alcohol will eventually (if they do not end up in jail or dead first) arrive at a point where surrender finds them. They will be “sick and tired of being sick and tired” and through no choice of their own they will have found that level of extreme desperation that allows them to finally take serious action and ask for help.

AA is arguing that you have to let them hit bottom first, or any recovery effort will ultimately fail. This may or may not be true and many of the young people’s groups in AA and NA actually argue that this is false. They say that they have direct evidence that very young addicts and alcoholics can, in fact, get clean and sober without having to hit absolute rock bottom first.

Opponents of this argue back that “people who can get clean and sober without hitting bottom first are not REAL alcoholics and drug addicts….they just had a drinking problem or a drug problem, but surely they are not true addicts or alcoholics of the hopeless variety.”

I tend to side with the die hard AA fanatics, arguing that there IS, in fact, such a thing as a “real alcoholic” and a “real drug addict,” and that such people are designed in such a way that they are not going to “get” recovery until they hit rock bottom. I believe that this is the case because it matches up with my own experience. I had plenty of opportunities and trips to rehab, even after I genuinely wanted my life to be different, but I could not make significant changes until I had fully hit bottom. Therefore I label myself as “a real alcoholic” and I would also add that I was “of the hopeless variety.”

Hitting rock bottom is probably necessary for many addicts and alcoholics out there. They cannot choose to hit bottom and they cannot choose their point of surrender. This is my experience and it is not necessarily factual. Others may disagree, but I have discovered that those who disagree are not people who are addicted to anything.

People who self identify as “hard core alcoholics or addicts” or if they self identify as an addict or an alcoholic “of the hopeless variety” they tend to agree with my opinion as stated here. That they did not choose to become addicted, and that they wanted to change their life but could not do so until they had hit rock bottom themselves.

Your mileage may vary. If you can get help and change your life before hitting bottom, by all means, please do so. It just never worked for me.

- Approved Treatment Center -call-to-learn-about