Addiction

Uncovering Its Misconception

“Bound as I was, not with another man’s irons, but by my own iron will. My will the enemy held, and thence had made a chain for me, and bound me. For of a froward will, was lust made; and a lust served, became custom; and custom not registered became necessityBy which links, as it were, joined together (whence I called it a chain) a hard bondage held me enthralled.” —Augustine, Confessions, Book 8


Most doctors and psychologists today would say that addiction is a disease. They would say that addiction is “a disease that involves changes to an individuals’ brain,”[1] or that addiction is “a brain disease that is manifested by compulsive substance use despite harmful consequences.”[2] The keywords in both quotations related to the definition of addiction as a disease are “changes to [the] brain” and “compulsive.” That is, according to the National Institute on Drug Abuse (NADI), because “compulsive” substance use occurs, which naturally leads to neurological and anatomical changes in the brain (actual physical brain matter),[3] addiction is therefore a disease. This is a circular cylcle; while the “compulsive” behavior triggers neurological and anatomical changes in the brain (i.e., the disease), the opposite is also true: the disease triggers the “compulsive” behavior.

Therefore, the argument runs as such: because anatomical changes occur in the brain as a result of compulsive behavior (and vise-versa), “addiction” ensues. This argument is contingent upon the word “compulsive.” According to Merriam-Webster’s online dictionary, “compulsion” is “an irresistible persistent impulse to perform an act.”[4] Granted, addicts do feel like their behavior is “irresistible,” as Ed Welch helpfully points out,

Addicts feel as if they are trapped out of control … They feel like they can’t let go, clinging even when the addictive behavior yields very few pleasures and a great deal of pain. They fee like they are in bondage. Addicts feel … enslaved, stuck, and without hope for freedom or escape. Something or someone other than the living God controls them, and the controlling object tells them how to live, think, and feel.”[5]

But is this so-called “compulsive” behavior really compulsive? Is it really “irresistible?” And therefore, is such “addiction” really addiction? To answer these questions, we need to see what actually happens to the brain when such “compulsive” behavior occurs. 

The Nature of Addiction

Excessive drug use and some behaviors like gambling and pornographic viewing can affect the brain’s “‘reward circuit’ by flooding it with the chemical messenger dopamine”[6] “This reward system controls the body’s ability to feel pleasure and motivates a person to repeat behaviors needed to thrive.”[7] This then can “overstimulate” these reward circuits. As a result, an “intensely pleasurable ‘high’” follows.[8] With habitual use, the brain adjusts to the overproduction of dopamine by making less dopamine OR “reducing the ability of cells in the reward circuit to respond to it” [a.k.a. “tolerance”].[9] As a result, addicts then tend to use more to attain a “high” comparable to that when they first used. Extended periods of use can lead to long term affects on one's learning, judgment, decision-making, stress, memory, and especially behavior.[10]

However, “despite being aware of these harmful outcomes, many people who [continue in addictive behavior] continue to [behave as such], which is the nature of addiction.”[11] 

Reworded, NADI’s definition in the previous sentence reads like this: The nature of addiction is the persistence of a particular behavior despite self-harm. Most agree that this is the case. I do. But most also believe that nobody in their right mind would voluntarily choose self-harm. The implication from this belief is that addicts are in an involuntary state when they choose to behave in an addictive manner. Therefore, the majority of scientists believe that because addiction is “a medical condition that actually erodes a person’s capacity to act freely in their own best interests,”[12] addiction is a disease. Nobody in their right might would harm themselves. Therefore, the addict is not in a rational frame of mind, but in an irrational, uncontrollable state.

Is this true? Is addiction an “involuntary” disease just because various types of habitual behavior have radical, devastating effects on the brain, leading some people to persist in particular behavior despite self-destructive outcomes? If so, this has radical social implications. If so, then we should, as some secular sources do, list “addiction” alongside Alzheimer’s, hypertension, asthma, arthritis, etc. In fact, in order to remain consistent, we should deem it morally wrong to charge addicts for their destructive behavior (e.g., drunk driving) because the law is simply punishing somebody who quite literally “cannot help themselves.” Furthermore, it would only be consistent to offer addicts insurance plans that match those “for traditional chronic diseases such as cancer, arthritis, etc.”[13]

But if not, and if addiction isn’t a disease, then the implication is that voluntary behavior can at times be self-destructive.[14] 

An Scientist and a Calvinist Walk into a Bar: Addiction Is a Choice

Gene Heyman, Senior Lecturer at Boston College and Associate Professor at Harvard University, in his book Addiction: A Disorder of Choice, distinguishes between two general categories of behavior: involuntary and voluntary.[15] Involuntary activities are those such as reflexes, blinking, and breathing, which are predetermined in every person. Voluntary activities are learned behaviors such as winking and holding your breath, which could be predisposed in some people. Regarding the latter, Dr. Heyman argues, “we inherit genes; we do not inherit behaviors.”[16] Therefore, he would say that addiction is a behavior. But even more, he would argue that addiction is also a choice.

For instance, what are the factors (either losses or benefits) that influence an addict to voluntarily stop behaving a particular way? Main factors include what the family thinks, loss of a job, finances, and religious beliefs. And regarding the effect one’s behavior has one the anatomical structure of the brain, Dr. Heyman concludes that everything changes the brain, not just drugs or alcohol. Thus, to define “addiction” as a disease because “compulsive” behavior alters brain matter is fallacious because everything alters physical brain matter (e.g., daily choices, where we live, who are parents are, who we marry, having kids, etc.). Granted, though this is true, certain experiences seems to affect the brain more than others (especially pornographic viewing).

But the important question is this: are the brain changes (due to a particular addictive behavior) residual? That is, do the brain changes persist in a way that prevents the individual from responding to the consequence of his behavior (which is what the majority of scientists believe)? The only way to know this is to look at one’s behavior. And surprisingly, Dr. Heyman’s research indicates that most addicts do eventually cease their addictive behavior. Therefore, addiction is a choice not a disease. 

Not surprisingly, Dr. Heyman’s finding align with biblical principles. Along similar lines as Dr. Heyman, John Piper believes that if the stakes are high enough (i.e., high in value) and sure enough (i.e., positive likelihood), then one can and will resist a given behavioral temptation.[17] That is, the “addict” is not decisively controlled by a disease—an involuntary, irresistible urge. The addict is decisively controlled by what he believes. In the words of Dr. Heyman, “Individuals always choose the better option.”[18]

You Are Not Addicted Like the World Defines “Addicted”

Certainly, one may be an addict. I do not deny that addiction is real. But addiction is not real in the way the majority of scientists believe. When we persist in a particular behavior despite adverse consequences, we might be addicted. If so, then we must seek radical accountability. We are spirit-body creatures, and what we do affects our souls and vise-versa. This is especially the case in pornographic viewing and masturbation. Therefore, we should not take lightly “guilty pleasures” or “occasional” binges of video games and Netflix. What we do really does affect our brains, making it more difficult—but not impossible—to resist future temptations. Though this in itself does not constitute a disease, it only shows that we are more vulnerable than we think. Therefore, “addiction” to a degree is a relative term. Some people do actually have their brains altered because of persistent, self-destructive behaviors. Some people do actually feel as if they’re being controlled by something other than themselves. This is true. I would call this addiction.

Above, I reworded the NADI definition to read like this: The nature of addiction is the persistence of a particular behavior despite self-harm. I still agree with this definition, but I believe it isn’t precise enough. I define addiction as follows: Addiction is the persistence of a particular choice despite adverse consequences. By changing “particular behavior” to “choice,” I emphasize the addict’s voluntary action. This (1) uncovers the misconception of addiction as a disease, which defers to involuntary behavior; (2) aligns closer to biblical principles regarding self-control and moral standards; (3) removes one’s identity from the connotations of irrevocability, compulsivity, and irresistibility within the term “addict”; and (4) instills real hope for real change in the addict.

But by believing that addiction is foremost a disease, one detaches morality from behavior. However, diseases like down-syndrome or liver cancer are in no capacity connected with morality—but alcoholism is, opioid addiction is, sexual addiction is. When an addict kills a person while driving intoxicated, our government rightly prosecutes the addict. Why is this just? Because the person’s addictive behavior is not separate from moral judgments. Such a belief creates a false dichotomy. 

You Always Choose What You Believe Is Best

People “always choose the better option.”[19] And yet, at the same time, “the heart is deceitful above all things” (Jer 17:9). Therefore, people are easily duped. We see this in the serpent’s crafty deception of Adam and Eve in Genesis 3. They chose what they perceived to be the better option: taking the fruit because of its looks, its nutrition, and wisdom-imparting qualities. Though this seemed to be the best choice, it certainly wasn’t—and they knew it! They knew God told them not to eat of that tree or else they would die, but they ate anyway. Thus, their ruin was a direct result of their choosing—or as Piper argues, it was a direct result of what they believed. They believed a lie and not the truth; they were deceived not only by Satan, but by what they desired. They chose. We choose. Addicts choose, though for them it is immensely more difficult—though not impossible—to choose rightly because of anatomical changes in the brain.

There's Always Hope

If you're an addict, you are not addicted in the majority sense of “addiction.” You can resist temptation. As hard as it may seem, you have it in you to resist because God’s Holy Spirit resides in you. Do you believe that? If all humans (nonbelievers included) have the willpower to resist addictive behaviors, how much so you who have an eternal well spring of power in you? And not only that, you have other Christians—in whom resides the same well spring of power—to walk with you. Confess your struggles openly, don’t deny the truth of your weakness and neediness, and cry out to God for help. This will look different for everyone, especially those addicted to drugs and alcohol; they might need intense medical attention, for example. But nonetheless, your addiction isn’t an “addiction”—that is, it isn’t a disease that defines you. In spite of all of the horrifying effects addictive behaviors have on the brain, addiction is ultimately a succession of persistent choices (beliefs). Therefore, you have the capacity for choosing rightly. You have the capacity to see the greater pleasure that comes from self-control and resistance. Deep down in oneself, and in severe cases with the right kind of medical or psychological help, such self-control is available for every addict. Therefore, there’s hope for sobriety. There’s always hope. You have a body and brain capable of embracing such hope, and you have a God who has promised you unshakable hope over and above the clutches of addiction.




[1] Levounis, Petros, Erin Zerbo, Rashi Aggarwai, eds., Pocket Guide to Addiction Assessment and Treatment (Arlington, VA: American Psychiatric Association, 2016), 3.

[2] American Psychiatric Assosiation: http://www.apa.org/topics/addi....

[3] National Institute on Drug Abuse, “Understanding Drug Use and Addiction,” (2016): https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction.

[4] Merriam-Webster, https://www.merriam-webster.com/dictionary/compulsion.

[5] Edward T. Welch, Addictions: A Banquet in the Grave (Greensboro, NC: New Growth Press, 2011), 11 (emphasis mine).

[6] National Institute on Drug Abuse, “Understanding Drug Use and Addiction,” (2016): https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction.

[7] Ibid.

[8] Ibid.

[9] Ibid.

[10] Ibid.

[11] Ibid.

[12] Levounis, et al, Pocket Guide, 5.

[13] Ibid., 90.

[14] Gene M. Heyman, Addiction: A Disorder of Choice (London: Harvard University Press, 2009), 104.

[15] Ibid., 102–112.

[16] Ibid., 93.

[17] DesiringGod, https://www.desiringgod.org/me....

[18] Heyman, Addiction, 119.

[19] Ibid.