Abstract
The paper describes different attitudes towards the problem of drug addiction as a consequence of an individual’s personal choices. The paper presents two perspectives: one advocating for autonomy, and another opposing it. It is pointing out that personal freedoms are violated during addiction and that one cannot fully judge the autonomy of drug use. Conclusions are drawn about what causes the understanding of the complex problem of drug addiction.
Introduction
Drug addiction is a complex problem that affects different sectors of society and has a detrimental impact on human functioning. Among the debated issues is the main one: whether drug addiction is a personal choice or a coincidence of circumstances and a forced choice. One side argues that taking drugs is an individual’s choice, while the other side argues that the environment influences this decision. Although various factors may lead to a person’s desire to take drugs, drug addiction as a chronic disease cannot be an individual choice.
Literature Review
Attention to drug addiction as a problem has emerged because of the many deleterious effects on health. However, if this is pretty clear, the factor of autonomy and autonomous decision-making has gained traction relatively recently. Bergamin et al (2022) point out that autonomy cannot describe a patient with addiction. In contrast, Seiler et al. (2022) tend to believe that responsibility comes regardless of autonomy. From this point of view, it is challenging to interpret addiction as an autonomous disease due to external factors or as a consequence of one’s own choices.
Brief History
Addiction has been around for quite some time and is now recognized in many standards and guidelines. The definition of substance use disorders as mental disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is a significant step forward in our knowledge of addiction (Vandaele & Ahmed, 2021). Problems with substance abuse have led to a growing body of research focusing on how to alleviate the plight of people who take drugs and what prevention programs can reduce the desire to take drugs.
Pro-Side
The external environment is a source of factors that contribute to the development of drug abuse. Biological and genetic characteristics of an individual form vulnerabilities; thus, the urge to take drugs cannot be stopped completely (Pickard, 2020). Heather et al (2018) indicate that combined factors (biological, psychological, and social) underpin strategies for working with people with an addiction and demonstrate success through reinforcement. Individuality and motivation may be lost due to drug use; thus, there is no rational core to the choices.
Neurobiological and chemical changes in the brain can lead to a reduced sense of responsibility and an altered personality, making it difficult to fully comprehend the consequences of the choice as a whole (Pickard, 2020). An integrated approach is seen as the main approach in assessing the extent of drug addiction and finding ways to overcome it.
Against-Side
Conscientiousness is the main factor that leads to drug taking. Seiler et al. (2022) note that individual freedom and responsibility for one’s decisions may not correlate, so that taking drugs is not perceived as an action with consequences. Instead, the choice to take drugs is a consequence of behavioral choices and human rights, where restricting this freedom is ethically wrong.
A rational view suggests that addiction, as a consequence of a personal zone of responsibility, is a more solvable problem than when recognizing a lack of choice (Vandale & Ahmed, 2021). Accepting responsibility for one’s choices is the primary strategy for working with addiction to help solve the problem (Pickard, 2020). The motivation factor is the most significant in accepting that addiction is a personal choice of the individual.
Opinion
By assuming that drug addiction is a consequence of personal choice, society shifts the blame for use onto the individual. In this position, social and biological factors are not taken into account. This means that society does not seek to help the person with the disease because the cost of their mistake affects them directly. Based on this, it is possible to establish the influence of the guilt factor in opposing drug addiction and finding solutions for its treatment.
As long as drug addiction is accepted as a personal choice, society does not want to solve the problem. This leads to the complication of the individual’s attitude towards their problem and worsens the course of the disease. This means that the pressure of guilt and lack of social support forces the person to put down and forget their identity because of their drug use experience. Based on this, it is rational to consider all factors, not just personality factors, that contribute to the progression of the disease.
Rationalized approaches based on a combination of biological and genetic factors are best suited to conceptualize addiction. Vandaele & Daeppen (2022) identify that preclinical prevention and understanding of the neurochemical nature of addiction facilitates future treatment. This means that only understanding the complexity of the motivation factor in addiction and the patient’s lack of absolute freedom will lead to the best outcome. Consequently, the factor of personal choice as the primary catalyst of addiction cannot be interpreted as correct.
Conclusion
Attitudes to the problem of drug addiction are diverse. Still, only an understanding of biology and genetics allows us to conclude that drug addiction is not the fault of the individual. Making personal choices under the influence of narcotic drugs is impossible. Although the patient may take responsibility for their actions, this does not describe autonomy as an ethical category. Thus, drug dependence should be understood as a consequence of biological, genetic, and neurophysiological factors that contribute to involvement in drug addiction and make it difficult to recover from it.
References
Bergamin, J., Luigjes, J., Kiverstein, J., Bockting, C. L., & Denys, D. (2022). Defining autonomy in psychiatry. Frontiers in Psychiatry, 13.
Heather, N., Best, D, Kawalek, A, Field, M., Lewis, M., Rotgers, F., Wiers, F. & Heim, D. (2018). Challenging the brain disease model of addiction: European launch of the addiction theory network. Addiction Research & Theory, 26(4), 249-255.
Pickard, H. (2020). What we’re not talking about when we talk about addiction. Hastings Center Report, 50(4), 37-46.
Seiler, J. L., Cosme, C. V., Sherathiya, V. N., Schaid, M. D., Bianco, J. M., Bridgemohan, A. S., & Lerner, T. N. (2022). Dopamine signaling in the dorsomedial striatum promotes compulsive behavior. Current Biology, 32(5), 1175-1188.
Vandaele, Y., & Ahmed, S. H. (2021). Habit, choice, and addiction. Neuropsychopharmacology, 46(4), 689-698.
Vandaele, Y., & Daeppen, J. B. (2022). From concepts to treatment: A dialog between a preclinical researcher and a clinician in addiction medicine. Translational Psychiatry, 12(1), 401.