Many diseases are laced with judgment. If a person struggles with obesity, for example, they’re sometimes viewed as lazy. Or someone with a mental health disorder just needs to “snap out of it.” Individuals dealing with substance and alcohol misuse also face many stigmas, including the perception that all recovery takes is willpower. Acknowledging addiction as a brain disease is a powerful first step to destroying this myth and pointing the way toward acceptance and access to treatment.
Addiction Isn’t a Choice
The American Society of Addiction Medicine (ASAM) defines addiction as “a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.” This definition is accepted across the medical community.
It’s important to note that acknowledging addiction as a disorder is only one part of the equation. While the ASAM also states that “prevention efforts and treatment approaches for addiction are generally as successful as those for other chronic diseases,” addiction science research is constantly evolving. Some studies suggest that defining addiction as a brain disease may actually affect some people’s ability to believe they can achieve lasting recovery.
However, when family, friends, co-workers, and even healthcare providers believe that substance use disorder (SUD) and alcohol use disorder (AUD) are simply a choice, this magnifies the damaging myth about willpower and addiction. Yes, someone often makes a conscious decision to use substances. But once these chemicals alter brain processing and bodily functions, they create an uncontrollable pattern of compulsive use. No amount of willpower can completely combat this result.
The stigmas surrounding addiction as a choice prove to be even more damaging in certain populations. For example, a lack of health equity in the LGBTQ+ community or discrimination against military personnel and first responders often prevent these individuals from seeking and receiving the essential SUD treatment they deserve.
Understanding the Myth of Willpower and Addiction
The APA defines willpower with the following points, which we provide verbatim:
- The ability to delay gratification, resisting short-term temptations in order to meet long-term goals.
- The capacity to override an unwanted thought, feeling, or impulse.
- The ability to employ a “cool” cognitive system of behavior rather than a “hot” emotional system.
- Conscious, effortful regulation of the self, by the self.
- A limited resource capable of being depleted.
Now how does willpower or determination apply when someone has AUD or SUD? Here’s an example.
When you have success with a particular habit—such as developing an exercise routine—your willpower to stay the course is easier to develop because you want to do it.
But if you have a problem with alcohol, narcotics, or prescription medication, your brain and body chemistry have changed because of the substances. You might also be struggling with an elevated tolerance for them—meaning it takes more to get the same effect. Other critical neural networks—including executive functioning, how we form habits, and what’s known as the salience network that influences what we consider to be important—are also impacted. So why isn’t willpower enough to stop?
- You have the willpower to exercise after overcoming minor challenges because consistent movement releases dopamine, endorphins, and serotonin—natural brain chemicals that help you associate short-term discomfort with end goal achievement. Conversely, an addicted brain’s reward center is fed false chemicals that require a higher or more frequent push each time, so delayed gratification doesn’t result in accomplishment.
- If you wake up one day and don’t feel like exercising, there’s no compulsion forcing you to do so. You can take this morning off and know it will be okay. But uncontrolled compulsive behavior is a catalyst to addiction—there’s rarely an option to avoid using alcohol or drugs.
- Because of natural “feel good” chemicals released during exercise, it’s easier for your parasympathetic nervous system to keep you calm and collected. When someone has SUD or AUD, chemically induced compulsivity overrides logic and rationality, which negatively changes behavior.
- When you choose exercise to help clear your head or release nervous energy and stress, you’re using what psychologists call an internal locus of control to maintain well-being. Someone whose brain has been affected by untreated AUD or SUD no longer has the ability to consciously self-regulate.
- Even people who suffer a minor injury and can’t exercise for a while often find different ways to stick with it if their routine is important to them. They can employ a “mind over matter” principle to some degree. Unfortunately, a person whose mind, body, and spirit is damaged by AUD or SUD might lose faith, hope, and purpose in themselves because of how their brain chemistry is altered. When these negative emotions are compounded, “just quitting” through willpower alone simply isn’t an option.
Find Strength at Ivory Plains
At our addiction rehabilitation program in Adair, Iowa, our board-certified professionals have no doubt that clear intentions and strong determination will eventually power your sobriety. However, to begin AUD and SUD recovery, you first need the right form of customized treatment to guide you safely through withdrawal, understand the underlying reasons for addiction, and identify key triggers so you can learn how to manage them. Our admissions specialists can outline more of our philosophy and why we believe it will work for you.
