The disease model of addiction:

Bickel (2019) discusses the consequential and rewarding attributes that are associated with addiction, and how the frequency of these behaviors lead to deterioration overtime. The disease model consists of a cyclic process of Binge/Intoxication – where excessive consumption of the substance leads to perceived level of rewards – withdrawal/Negative Affect – the absence of substance leads to negative physical and emotional symptoms – and preoccupation/anticipation – where and when the next moment of consumption will begin again. All three of these factors involve different parts of the brain, all affecting and reacting differently with each intake (Butler Center for Research, 2021)

How substance use changes the brain:

Baranger et al (2023) discuss how substance abuse, particularly alcohol addiction, limits the quantity of grey matter in the brain. The neurotoxic properties of alcohol consumption leads to the thinning of the cortex and affects overall reasoning, cognitive function and behaviours. As mentioned above, due to the misguided, rewarding aspects of intoxication, the neural circuitry perceives and craves gratification through these acts and therefore, requires constant attention to attain the same level of sustenance.

Is substance use a choice?

Addiction has been categorised as a chronic brain disease, not only does it affect physical domains, but the addiction cycle feeds every unhealthy behaviour that is caused by consumption as a whole. Genetic predispositions can be a highly determining factor for addicts
and can also subject them to mannerisms that lead to substance abuse disorders.

Are people with addiction responsible for their actions?

Due to aspects of shame, deteriorated or non-existent locus of control (the ability to control our behaviours regardless of external factors) rationalisation and pressures by familial ties and parasocial domains, people with addiction no longer feel that they can control the situation, rather – the situation, or the substance, controls them. Their moral responsibility is overlooked because of how much it lacks. Addiction is a progressive disease that affects all aspects of functioning, internally and externally and until these behaviours and thoughts associated to these behaviours can be modified, refined and managed, all domains of human reasoning, functioning and living will remain untamed and will lead towards self destructive tendencies that affect and manipulate the environment around them.