Biology versus Choice: Is a simple explanation of addiction enough?

At the recent Addictions conference, held in D.C. and sponsored by Elsevier, a well known academic publishing house, I got myself into one of those long debates with a fellow addiction researcher. The question we were debating was whether addiction is primarily biological or if it is mostly a matter of personal choice. We ran through research evidence, the notion of stigma, and more, making us late for the afternoon session of talks – but it was worth it.

My take on it was that one can’t separate biology from choice, a point I have made over and over (see my choice Vs. control talk), and that ignoring the biology of addiction is therefore impossible. My opponent across the stage (or lunch table as it were) was Christopher Russell, a graduate student at the University of Strathclyde in the United Kingdom who is a bigger believer in the choice view of addiction, along with people like Dr. Bruce Alexander of Rat Park fame and Dr. Gene Heyman who wrote “Addiction is a disorder of choice.”

I like good debates and at as far as I understand it Christopher and I ended-up agreeing that as usual neither biology, nor choice, do a good enough job of explaining a complex disorder like substance abuse and addiction. I’ve been making that point for a while, so I’m pretty comfortable with the final conclusion – Biology, environment, and choice (cravings) all factor into addiction as I understand it. Without understanding the machinery and how genetics and behavior affect it, I think the rest of the discussion is moot, but it is pretty much as pointless without addressing environmental influences and the role of choice.

I liked debating with Christopher so much that we’re going to be bringing him on a writer on A3. He’ll help us keep on top of the most recent addiction research and news while bringing in another voice on the topic that I think will help move our discussion forward. So please help me welcome Christoper Russell from the U.K., and look ahead for his contribution as well as a likely ongoing debate about the importance of biology versus personal choice.

7 Replies to “Biology versus Choice: Is a simple explanation of addiction enough?”

  1. Just for sake of non professional and non addict point of view……
    We parents don’t like any of the options. If it is genetics, we blame ourselves, If it choice, we blame ourselves for doing something in the upbringing that encourages bad choices. Environment, well there we are again!
    And this is why we have many more “sick” family members than we have addicts and alcoholics.

    1. Thank you for providing input we don’t normally get here Denise. Firstly, parents need to understand that genetics extend beyond their control and that we’re now realizing that there are aspects of genetic code that are not transmitted from parents and affect the way our body behaves (look up epigenetics). Secondly, while learning does affect a lot about what choices individuals make, it’s often their interpretation of learned experiences that guides that process, so all parents ever really can do is provide the best environment for good learning to take place. I do understand why playing the blame game is attractive – it’s easy to understand and seems very logical – however, in the big picture, there is rarely a single source to blame for any of this.

  2. I’m speaking as an addict in recovery. I believe it is biological and then we choose to give into our cravings when the occasion arises. I know I have a disease/illness and it is my responsibility to get help.

    1. Clarissa, what do you think plays into your ability to choose? Is it the environment (stress, availability, and more), your biological makeup (genetic impulsivity, risk-taking and such), the coping mechanisms you’ve learned, or a combination of all or some of these?

  3. I think it’s due to the way we’re wired – so it’s biological. But not in the way most people think. Our bodies doesn’t tell us to get addicted to substances. It tells us to pursue pleasure, but society supplies us with dangerous substances that fulfills this pleasure, we end up addicted. In the old caveman days, we didn’t have this surplus of drugs, alcohol, substances, porn, etc. It’s a result of biology + society.

    1. Great observation Henway, though i think the fact that only some people get addicted means that it’s likely more than just those two factors – otherwise everyone would be compulsive about their consumption of these substances. That’s where I think biology, peer and family influence, and other factors come in.

  4. As stated addiction is far too complex to isolate a single causal factor.

    This is the reason why many treatment facilities do not overly encourage alcoholics to look for reasons for their addiction. Of primary importance is dealing with the alcoholism.

    If the individual then wants to explore possible causes for their addiction (be they environmental, genetic, society etc. etc.)then all well and good.

    The problem with searching for reasons for our addiction(s) is that when we believe we have found them we tend to enter the blame game. Which can remove personal responsibility (i.e. choice)from the equation.

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