Substance Abuse: Choice or disease?

Currently, I am taking a graduate course called Substance Abuse Counseling. Today we were asked to write a discussion post taking a stance on whether substance abuse is a choice or a disease. Although smoking crack, shooting heroin, snorting lines of coke or drinking liquor by the liter all sound much different than an eating disorder, to our brain they are much the same. An addiction, an addiction that grows from the time of initial use. There are all kinds of deeply-rooted emotional, personal and/or societal reasons one chooses to start abusing a substance. 
Although I think this may stir up some controversy, I believe that eating disorders are not much different... ultimately a choice. Below is my discussion post that defends my opinion:


   I believe that anyone who initially chooses to pick up a cigarette, a pipe, a joint, a bottle of beer, a shot glass, a needle, et cetera does so by matter of 50:50 choice. Its a rather simple choice if you think about the easy hand to mouth, or similar, movement they all involve. Either you say yes and grab the substance or, you don't. Yes or No. Accept or decline. All are a choice on a dangerously polar scale.

   Once a person says yes and accepts a substance, this is where disease grows. We all are likely to know that some substances are more addicting than others due to their chemical make-ups. Because of this variance in addiction qualities, some substances are easier to say yes to only once or twice and then, never again. Others, not so much. 

   When the more addicting substances are involved, disease grows quickly and inevitably. In order to rid yourself of the more addictive substance driven diseases, detox may be required. Once detox is completed in success, this leaves the substance abuser with another choice: to pick it up again or not. This is where the disease gets more complicated.

   Because of the reward center in our brains, some people may have a genetic disposition to crave and continue to seek, not the drug but, the previously experienced "high". Can't forget about one's environment... if a drug user or abuser is located in an environment where substances are prevalent, they may be left with more of the same use-or-not-to-use choices than those who are in cleaner environments. Because of our brain's stronger recollection of the pro's rather than the con's of previous substance use, the brain will urge a person to give in and just say yes again. 

   By no means whatsoever am I saying this yes or no question is an easy 50:50 choice. No. However, ultimately, it is still what it always was, a choice. 

As a recovering disordered eater, I will tell you that my substance abuse was NOT easy to say no to. However, I always had a choice. My acceptance of that fact, that it is MY CHOICE, has been one of my biggest saving graces. It never had to be catastrophic, I just had to make a different choice. Although my brain and mind might have urged me to binge and/or purge, it has always been my right and my ability to say yes or to say no, no more.

Gratefully, I can now say I have learned and adjusted and accepted... I choose no.