Is addiction a choice or a disease?

Addiction is recognized as a chronic brain disease by major medical organizations. While the initial decision to use a substance may be voluntary, repeated use causes brain changes that impair self-control and drive compulsive use.

Can addiction be cured?

Addiction is a chronic condition that can be effectively managed but not always cured. Like other chronic diseases such as diabetes, it requires ongoing management, and relapse does not mean treatment has failed.

What is the most effective treatment for addiction?

The most effective approach combines medication-assisted treatment with behavioral therapies tailored to the individual. Treatment should address the whole person, including co-occurring mental health conditions and social needs.

Mental HealthICD-10: F19Over 20 million Americans have a substance use disorder; about 10% of adults experience it in their lifetime

Substance Use Disorder

Also known as: Addiction, Drug addiction, Substance abuse

Substance use disorder is a chronic brain condition characterized by the compulsive use of substances such as alcohol, drugs, or medications despite harmful consequences. It involves changes in brain circuits related to reward, stress, and self-control that can persist long after substance use stops. Recovery is achievable through a combination of behavioral therapies, medications, and ongoing support.

Symptoms

Inability to control or stop substance use despite wanting to

Craving or strong urge to use the substance

Continued use despite negative effects on health, relationships, or work

Needing more of the substance to achieve the same effect (tolerance)

Withdrawal symptoms when not using the substance

Spending significant time obtaining, using, or recovering from the substance

Neglecting responsibilities and social activities

Using substances in risky situations

Causes

Changes in brain reward circuitry from repeated substance exposure
Genetic vulnerability accounting for 40-60% of risk
Environmental factors including peer pressure and early exposure
Mental health conditions contributing to self-medication
Chronic stress and trauma

Risk Factors

Family history of addiction
Mental health disorders such as depression, anxiety, or PTSD
Early age of first substance use
Lack of social support or family involvement
Peer pressure and environmental exposure
History of childhood trauma or adverse experiences

Diagnosis

Clinical interview using DSM-5 criteria for severity classification
Screening tools such as CAGE, AUDIT, or DAST questionnaires
Urine or blood drug screening
Assessment of co-occurring mental health disorders

Treatment

Behavioral therapies including CBT and motivational interviewing
Medication-assisted treatment such as methadone, buprenorphine, or naltrexone for opioid use disorder
Medically supervised detoxification
Residential or outpatient rehabilitation programs
12-step programs and peer support groups
Treatment of co-occurring mental health conditions

Prevention

Education about risks of substance use, especially for adolescents
Early intervention for mental health issues
Building strong family bonds and social support
Community-based prevention programs

When to See a Doctor

Inability to stop using a substance despite wanting to
Substance use causing problems at work, school, or in relationships
Physical withdrawal symptoms when stopping use
Feeling that you need to use more of a substance to get the same effect

Frequently Asked Questions

Related Conditions

Depression

Mental Health

Anxiety Disorders

Mental Health

Post-Traumatic Stress Disorder

Mental Health

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