It’s More Than Just A “Choice”

Approaching a stoplight, you see a homeless man standing on the corner where you are about to make a left turn. He is holding a piece of cardboard that says, “Homeless. No food. No money. Anything helps.” You cannot help it, your mind instantly goes to the assumption that the five dollars you could give him sitting in your wallet will go straight to the liquor store because the man MUST be an alcoholic. Although it’s understandable why some people might assume this, the effects of such assumptions are completely unfair. The stigmas that arise from these assumptions are unfair to the person and do nothing to help them get back on their feet.

I have often wondered why diseases that involve, for example, the heart or the lungs seem to be “socially acceptable”. Is this because, historically, there has been a more biological, medical explanation for such diseases? Sometimes, I feel that this is the case. It seems that when society has a scientific explanation for a disease or disorder, we are more willing to accept and understand what the person is going through. For example, society is more willing to accept someone who has coronary artery disease or emphysema because we recognize that these diseases are out of the person’s control, that it is not their CHOICE to have intense chest pains or a chronic cough. More recently in our history, disorders of the brain are also becoming more accepted and understood by the public, such as bipolar disorder or schizophrenia. Instead of believing that the person is simply “moody”, or “crazy”, we understand that their brains do not function as the “normal” person’s does. This means that society is more willing to understand their condition and exerts effort to help the person maintain a normal lifestyle through therapies and/or medications.

Unfortunately, this is not yet the case for addictive disorders such as alcoholism. Society places a great stigma on those who are addicted to drugs and/or alcohol, which does nothing to help the person or the country as a whole. We are quick to associate alcoholism with bad choices and irresponsibility. “Why can’t they control their drinking? I can..” are questions that may often be raised when encountering someone who has a history of alcoholism. What society does not understand is that, just as coronary artery disease and bipolar are diseases that can be “explained” scientifically  (although much is still unknown about the diseases), so too are addictive disorders. Genetics and environment have an affect on the body and on a person’s susceptibility to become addicted to drugs and/or alcohol. Too often we assume that it is simply a matter of choice for a person to quit abusing drugs or alcohol, but we forget that far more is occurring within that person than we could ever understand without experiencing the addiction ourselves.

Not only does science explain why addicts experience an almost unbearable withdrawal from substances when they try to quit or refrain from using, but science can also point to childhood experiences and environments that increase a person’s likelihood of experiencing addictive substances and their susceptibility to addiction. When we understand that addiction is more than just a “bad choice”, we are more willing to understand and be empathetic towards a person’s state of wellbeing rather than climbing aboard our high horse and passing judgments on them.

This week in class we reviewed a scholarly literature review that looked into the chemical and biological mechanisms that played a role in a person’s susceptibility to alcoholism as well as the dysfunctional mechanisms that exist in the disorder. Alcoholism is so much more than simply a “bad choice”. Yes, it IS a person’s choice to take a sip of alcohol, but it is naïve to believe that this is the only piece of the story. Just as we accept those with other diseases, we must also accept those who have addictions, as neither the person or the country move forward until we do.