Addiction Is Not A Choice

I work with individuals seeking treatment for addiction every day, whether by self-referral or court order, and I have personally seen the harm that is done to people when they are trying to get better. Despite this desire to get well, their history of involvement in the justice system, as well as the societal stigma present even in the very facilities they reach out to, have become a barrier for them in achieving recovery. Individuals with substance use disorders need to receive evidence-based treatment instead of being sent to jail or prison because addiction is a disease that requires treatment of one’s mind, body, and spirit, and incarceration causes more harm than good.

Some argue addiction is not a disease, but a choice. According to one neurobiological review, the disease of addiction is often present years before the first substance is ever ingested. Individuals who experience childhood traumatic events such as emotional, physical, and/or sexual abuse, as well as experiences of poverty, having a parent who is incarcerated, homelessness, bullying, or any other chronically stressful situation, have a much higher risk of developing an addiction to substances later in life.

The treatment for addiction is aimed at correcting the root cause of the disease while also helping the individual learn skills to change thoughts and behaviors. There is no one-size-fits-all treatment regimen for addiction as each individual person requires a unique, personalized treatment plan. According to The American Society of Addiction Medicine, six dimensions of wellness are evaluated, looking at the whole person, including risk for withdrawal and need for medication-assisted therapy, co-occurring biomedical diagnoses, co-occurring mental health diagnoses, risk for relapse and quality of recovery environment, and addressing social determinants of health.

Addiction is a chronic disease that can be successfully managed over the course of one’s life, but there is no cure. When pointing to addiction as a disease, it is interesting that the relapse rates, compared with diabetes and hypertension, are forty to sixty percent compared to thirty to fifty and fifty to seventy percent respectively. In order to reach a state of recovery, it is important that the six dimensions of one’s wellness are maintained, much like how a person with diabetes and controlled blood sugar must continue the healthy behaviors that lead to that success. The risk for relapse increases when a person loses access to medication-assisted therapy or experiences physical or mental illness, instability socio-economically, or any other variety of life stressors.

If it is known to be true that addiction is a disease with one of the characterizations being continued use despite negative consequences, then why are so many people arrested and sent to jail or prison when they are caught with drugs? In 2023, 360,000 people were in prison for non-violent drug offenses despite the evidence showing incarceration does not deter substance use. This is a travesty, especially when treatment costs far less than incarceration and has positive, long-lasting results such as decreased crime, decreased healthcare costs, and fewer outcomes resulting in death. Once in prison, people are subjected to violence, poor nutrition, isolation, disease, drug use, and emotional and physical abuse. All of these issues in and of themselves are known to make the disease of addiction worse because they re-traumatize the traumatized and have been shown to increase the likelihood of overdose after being released.

Once involved in the criminal justice system, those who are released face the added stress of not only managing their chronic disease and worsened mental health due to incarceration but also navigating getting a good-paying job and obtaining safe and affordable housing. Many organizations will not hire or rent to a person with drug-related charges, and this makes it harder to achieve the socio-economic stability that is conducive to successful rehabilitation of substance use disorder. Beyond these stressors is the reality that once released, people are put on strict community supervision programs where people face the threat of going back to jail for even minor offenses such as being out after their curfew. This stress increases the risk of relapse and puts addicted parents at risk of losing their kids, which puts kids at risk of entering into group homes and foster care, which increases the risk of childhood trauma, which increases the risk of the children growing up and developing addiction, and the cycle continues on and on.

Addiction is not a choice. A person with addiction no more chooses to be harmed by substance use than a person with diabetes chooses to be harmed by sugar. Taxpayer dollars continue to be funneled toward operating prisons despite the fact that rehabilitation is cheaper and more effective, and continuing to respond to the disease of addiction in ways that do not result in improvement for the individual, their loved ones, or society is simply a waste of time and money for all involved. The good news is it doesn’t have to stay that way. As we make advances in scientific research and learn new information, we can change laws and practices accordingly. Each of us can become educated about such matters and be part of true, lasting change, right where we are, that improves the world for everyone.

If you or someone you know is struggling with addiction, we are here to assist them on their Recovery journey. To learn more about our approach to treatment, visit nlccwi.org.

Kelly Martin is a Behavioral Health Intake Specialist at NorthLakes Community Clinic – Hayward. NorthLakes Community Clinic. NorthLakes Community Clinic offers Recovery Services in Ashland, Eau Claire, Hayward, and Turtle Lake.