Recovery is a choice. Most people need treatment to help arrest there addiction, lots of help. Some choose that help and others don't, i'm not alway sure why. I will tell you this, it does not always have to do with how "bad" their addiction was or how much drugs or alcohol people used, at some point they just make that decision and accept the help they need, aa calls it a "spiritual awakening", its why I do this.
Still with me? Addiction fits the model of other chronic diseases, genes play a role, but so does choice. When people are in the midist of their addiction, they are not choosing to do what they are doing, their neurocircuitry is abnormal and drives their motivation. Their drug of choice is literally more important than anything else, food, family, sex, anything. Their reward center has been highjacked.
Lets continue. Diabetes, obesity is a risk for that, is obesity a choice or disease. Some people choose to eat too much, some people have a food addiction. Though genetics can also play a large role in obesity, some people will have a different metabolic rate, abnormal amount of hormones or neurotransmitters that drive their obesity. They were raised in a family that rewarded with food, is that a choice for them.
Lets compare first? Is type 2 diabetes a disease or choice. Clearly there is a strong genetic component to this disease, yet not everyone with the genes gets it, lifestyle is very important as well, proper diet, weight management, regular exercies, these are choices right? Then if diagnosed some people follow therapy and some don't and suffer the consequences, loss of vision, limb loss, heart disease, to be continued.
Mostly disease. The nimh has published a standard describing the abnormal neural networks involved in alcohol& drug addiction. The apa has published data depicting 90% of alcoholics as untreated adhd patients. The majority of addicted patients are self medicating themselves into a dismal drug downward spiral. Recovery involves determining the cause & treatment of the addiction. Very few people are just addicts.
Both. Addiction is defined as the compulsive use of and preoccupation with a substance despite damaging effects. We understand compulsive behavior as an abnormal state. The addict doesn't feel he has a choice even though an observer may believe otherwise. Initial use is a choice, obsessive use a disease.
It depends. "disease" is a conceptual model that has been very beneficial for the relief of suffering caused by chemical dependency. Obsessive attachment to "the disease" can limit the extent of recovery. Recovery is the development and strengthening of behaviors that offer a choice to the suffering of cd. We can't excise memories of prior behaviors (drug use) that temporarily changed unpleasant feelings.