Addiction and Choice: What Truly Causes Addiction?

There are so many misconceptions surrounding addiction that it can sometimes be easy to make incorrect assumptions about the people who struggle with it. Falling into this trap is only intensified by people’s inexperience with the causes of addiction and the corresponding inability to understand that no one chooses this kind of life.

The reasons people become addicted to certain substances are as varied as the people themselves. Some common threads do tie them together, however, and knowing these will serve you well in helping to fight the scourge of addiction.



The first misconception about addiction is that experimentation with a drug is a consciously made choice, and therefore the cycle of addiction that can sometimes follow is due to the user’s decision to experiment. The fallacy in this assumption comes when the curtain is pulled back just a little bit. Choosing to use a substance and “choosing” to be addicted to that substance are two separate things. After all, even the most non-addictive personalities can fall prey to the issues that led to experimentation in the first place. These include peer pressure, recreation, trauma and more.


Peer Pressure and Recreational Use

By the time we reach adulthood, many of our routines are already established. During our most impressionable period—adolescence—substance abuse can rise to the forefront thanks to social factors such as peer pressure and a desire to fit in.

Many teenagers are exposed to marijuana, alcohol, and other drugs at a young age, which tends to normalize those substances and create an environment where recreational use is accepted. Substance use at such an early age can cause kids to use them to self-medicate as a way of combatting the emotional rollercoaster of puberty and the wildly fluctuating hormones that accompany it. As preventable as the first use of a substance is, addiction can be swift and substance use can very quickly become substance abuse, thus affecting everyday life.



Teenagers aren’t the only ones who may use substances as a method of self-medication. Experiencing a trauma or dealing with chronic pain or emotional disorders can cause people of any age to self-medicate with drugs and alcohol. Relying on substances to help cope with mental or physical issues can easily cause people to slip into an addiction cycle, regardless of whether they’re under the care of a physician or not.



Opioid abuse has been a tense topic of discussion for family, friends, clinicians, and health care providers for more than a decade. What began in the 1990s as an easy way for doctors to relieve the chronic pain of their terminal patients has quickly devolved into an addiction crisis that continues to leave experts searching for answers. With more than 115 people dying every day in the United States from opioids, the crises has now reached epidemic proportions.

As opioid addiction has soared in the United States, and the costs of prescription opioids have continued to rise, many patients have found a cheaper way to combat the pain of their illnesses as well as their intense cravings: heroin. According to one study, nearly 80% of people who use heroin used prescription opioids first.



For many people, genetics and environment play a large role in the struggle with substance use disorder. The risk of heritability varies by substance, age, race, sex and developmental stage.

Caused in part by their genetic predisposition, people react differently to different substances. Someone who is predisposed to alcoholism, for example, may become addicted on their first use, yet someone else may have no craving or strong desire for alcohol even after several uses. Not knowing how certain substances will affect people due to their genetic makeup plays a role in who ends up struggling with substance abuse and who doesn’t.

This genetic uncertainty doesn’t just limit itself to substances, either. Studies indicate that genetics may play a role across the entire addictive spectrum, from drug and alcohol abuse to gambling addictions to eating disorders.

Regardless of how addictive behavior starts, be it genetics, environment, or self-medication, it’s important to remember that most addicts don’t descend into addiction with a conscious desire to do so. People often react angrily to the “choices” an addict makes to obtain the addictive substance or to engage in the addictive behavior, not realizing that their motives are driven by a dependence that has spiraled out of their control.

If you or someone you know is struggling with addiction, please reach out to us today. We offer intensive outpatient counseling sessions as well as residential therapy, and we would love to help you or a loved one on your journey to recovery.

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