Addiction Is a Health Issue, Not a Moral Failing

For decades, researchers studying addiction worked against deep-rooted myths about what drives substance use. Much of the research in the 20th century carried a view that people with an addiction were morally flawed or simply lacking in willpower.

Yet modern research is telling a different story. Breakthrough research implores us to see addiction as a health issue to make progress in helping 40 million people with a substance use disorder worldwide.

Is addiction a moral failing?

Scientific research into the causes and drivers of addiction has been a great source of interest since the turn of the 20th century. Over these years, much has been learned as to what addiction is and what it isn’t.

Addiction does not happen because of a person’s moral weakness or a lack of willpower. For millions of people with a substance use disorder, they are not choosing to continue fueling the addiction, nor can they simply make a binary choice to quit.

One of the most significant claims to support the view of addiction as a health issue came in a 2016 report from former US Surgeon General Vivek Murthy, M.D. His report states “It’s time to change how we view addiction, not as a moral failing but as a chronic illness that must be treated with skill, urgency and compassion. The way we address this crisis is a test for America.”

His report came as a result of landmark research on how addiction alters the brain. The research carried out by the National Institute on Alcohol Abuse and Alcoholism found a staggering 21 million Americans suffering from a substance use disorder, surpassing the number of people diagnosed with all cancers combined. The findings illustrate the urgent need for a greater understanding of the biological effects of drug and alcohol addiction.

How drugs reinforce addictive behaviours in the brain

If a person sees an addiction as a moral failing, the suggestion is that they simply don’t have the willpower to regain control. After struggling with an addiction for years, a person’s brain will have undergone significant changes. Simply having enough willpower will not suffice and professional support is needed.

As we strive toward a collective understanding of addictions being a matter of biology, not a moral choice, we should delve into scientific research that backs the claim.

• Brain “hijacking” and the role of dopamine: Every addiction eventually “hijacks” the brain, changing its chemical makeup and the foundations of a person’s natural reward system. Our reward system is in place to deliver dopamine as a response to doing something naturally rewarding and conducive to our well-being. This could be as simple as eating the food we love, spending time with friends, or exercising. Prolonged substance use in addiction floods the brain with dopamine, with research suggesting that using a substance releases 2 to 10 times as much, compared to the activities we listed earlier. In this way, a person with an addiction may feel, or actually be, at the mercy of their mind, wherein the pleasure felt from naturally rewarding activities diminishes.
• Impairments in decision-making and self-control: Leading on from impairments in dopamine levels, a person’s drug addiction will also damage their ability to make rational decisions. Research illustrates how addictions alter the brain’s prefrontal cortex, the area responsible for impulse control and decision-making. If we consider these impairments as both a cause and a consequence of addiction, we can see how a vicious cycle takes hold. Even when a person knows that quitting is good for them, the decision to stop can slowly slip through their fingertips.
• Disrupted balance in the body and mind: Addictions disrupt the way your brain naturally balances and regulates your moods. In psychology, this balance is often called a state of “homeostasis,” which basically helps us to readjust when external events affect our well-being. Chronic over-stimulation of the brain, such as what happens in addiction, shifts the balance. Taking the substance generates pleasure and as frequency increases, the incredibly adaptive shifts to a new baseline of normalcy, called “allostasis.” In time, this means the brain will only feel “normal” when the substance is present, so a day without the substance feels completely abnormal and unnatural.

How we should reframe perceptions to help recovery

In order for us to better understand ways to help someone with an addiction, we should take steps that help raise awareness of addiction being a health issue.

Recognising addiction as a chronic condition, not a choice

Addictions can develop from a multitude of social, environmental and genetic factors. Coming from a community that has frequent drug use or having an addiction in the family can become a risk factor for developing a substance use disorder. In addition to environmental factors, a person’s genes can play a surprisingly large role. Research shows that as much as 50% of the likelihood of addiction-forming is determined by genetic factors. By being considerate of the factors that a person cannot control in addiction-forming, we may be able to develop new pre-emptive measures to support them.

Changing our language around addiction

Stigma is one of the biggest barriers to treatment for people in need of recovery. It is often the case that the language we use carries these stigmas and makes a person feel worse, even when we don’t realise it. If we practice using more forgiving language when talking about addiction, a person in need of help will feel more supported. Some of the ways we can reframe our language may include:

• Instead of describing abstinence as being “clean,” describe it as being “substance-free.”
• Instead of “addict, druggie, drug abuser or junkie” use  “person with a substance use disorder” or “patient with a SUD (if in a clinical setting)”
• Instead of “addicted to ___ (substance)” use “has a ____ use disorder.”

Language is an incredibly powerful tool that shapes how we view and interact with the world around us. When talking about addiction, using language that reflects the medical nature of the condition can help us empathise with those suffering.

Shifting from punishment to treatment

Many people still carry the idea that a person with an addiction should face some kind of “punishment,” rather than get the help they need. Sadly, this sentiment isn’t only held by people on the outside looking into an addicted person’s life. Many people caught in the clutches of a SUD internalise feelings of shame and self-blame, which can hold them back. Research shows that as few as 1 in 9 people suffering seek professional help. If we switch our perception to prioritise helping them rather than seeing punishment as the correct response, more people can feel supported in overcoming an alcohol or drug addiction.

Where can I find help with my addiction?

Breaking free from the grips of addiction can feel like the biggest challenge you ever face. Lasting recovery needs the right support, treatment and tools to help you rebuild your life. If you or someone you know needs support, we want you to know that we’re here for you.

At UKAT, we understand the complex nature of addiction and how it should be treated as a health issue. Our expert team delivers medical detox to help you manage physical and psychological withdrawal symptoms. We incorporate evidence-based therapies to reinforce mental resilience. Aftercare and ongoing support are in place to sustain your efforts and help you stay sober for life.

Please don’t feel like addiction is something you have to face alone. Reach out to us today to take the first step toward a healthier life, free from the confines of substance addiction.