"Addiction does not define who I am...."

Addiction is a disease.

Yes it is.

     Saying that does not mean that one is not taking away personal responsibility- we can't break down anything into simple black or white- addiction is no different. There is our responsibility and there is what is inside us. There is environmental and there is biological.

Consider:

Heart disease- We eat right and exercise after the fact, admitting that we should have done so all along while people around us empathize and say they should do the same and how difficult it can be, trading tips...but not shaming. 

Diabetes- rarely do we say "...maybe you should have laid off the sugar fattypants...".

Asthma- "Well you dumb f&ck, why did you stay in the house when you were 7 if your parents were smoking? You should have gone out into the fresh air! And for gods sake, stop running around! You'll have an asthma attack  and that will be your own fault." 

Now those in the "addiction is choice" camp are saying- NOT THE SAME. 

YOU decided to take a drink or try that drug.
YOU decided to keep doing it even knowing it was bad / illegal.
YOU decided to keep going as the world fell apart around you.
YOU were selfish.
YOU didn't care.

     Picking up a drink or a cigarette, buying a scratch ticket, going to the casino, online shopping, sex, marijuana, food....all things that can become addictive start like anything else- we try it. Food is a necessity, alcohol can be pleasant and fun, scratch tickets are a guilty little pleasure, no harm, you can't win if you don't play, thousands go to the casinos daily, shopping gets us the things we need, sex...well....
point being that these things are fairly normal but not for everyone. And you don't know if you could become addicted before doing any of the "optional" items like scratch tickets. You might know of a family member who had their own issues and that maybe it would be higher risk for you but you don't KNOW. Because we don't know yet! Science hasn't quite figured that one out. 

     But what about things like cocaine, heroin, meth...you KNOW those are bad for you and illegal!
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     Yes, you have a point. And in those cases, there are times when it is not purposeful such as a person getting opioids from their doctor legitimately and then become addicted or there are times it is purposeful but is secondary to something else....maybe inhibitions are down because of alcohol use, maybe a person has gone through some kind of trauma and the pain of that experience is so big that taking drugs is the best way they know how to deal with it- maybe it is peer pressure "to be cool"- which is a sad social commentary to my thinking as I clearly remember times in my life when I wanted desperately to belong, feeling so out of it and bad about myself that I would have done almost anything to fit in- to have friends. I'm not saying these are good reasons or bad reasons- they are reasons that are understandable. 
     By the time things start getting bad, you are already hooked. Your brain has already undergone changes that LITERALLY alter your ability to think, plan, and do anything "normal".

     The key in the image is "brain response". Your brain is changing to adapt to that drug or alcohol or thing that is creating pleasure (this could be food, shopping, or gambling like stated above). Your judgement is impaired...meaning you aren't able to make decisions as well as you used to and impulses are harder to control. Your brain literally changes. 

Actual structural changes. The healthy brain has the wrinkles and lines we see on drawings and so on. The addicted brain is dented and riddled with what almost looks like potholes. 

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  To look at it another way, below is brain scans that show areas where the brain is lit up, active, and areas where it is not working normally. 

     These scans are for slightly different things and I use them here to illustrate the changes based on different substances: nicotine, alcohol, food, and cocaine. Other drugs also impact the brain in similar ways. An internet search pulls up images of methamphetamines, heroin, marijuana- anything you can think of.
     Typically we think of cancers of the lung, throat, and breathing diseases when talking about smoking risks. In the infograph, you can see that the brain is impacted as well. The blue areas are low function areas. The non smoker brain is crackling with energy, yellows, greens, red- the smoker brain has more dark areas and the colorful areas are not as bright and pronounced.  You can see similar light changes in the other substance brains- areas that aren't as bright or active, more blue areas showing low activity, and more black areas- no activity. 
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     What does this all mean? It means that an argument can be made for anyone struggling with addiction STARTING their addiction with some purpose. And the majority of people with addiction I work with take responsibility for that...and usually more, taking responsibility for the part that happens when the brain damage has already begun and the ability to make logical and reasonable choice is gone. It means that the person who still eats sugary foods after a diabetes diagnosis, or fast food after a cardiac incident, is either equally at fault OR we can have an equal amount of compassion. 
    Most of us know the struggle of trying to avoid chips and desserts, of trying to get in some exercise, get to the gym so maybe we find it easier to have compassion for those things. Imagine if we could have similar compassion for every disease, every issue- even "invisible" illnesses like addiction. Compassion doesn't mean absolving someone of responsibility but it does mean that instead of screaming in someone's face that THEY are bad or THEY created this problem and THEY don't deserve kindness, you can notice that someone is trying to change that- to change their lives, to change THEIR BRAIN. (and the good thing is that our brains are remarkably pliant throughout our lives- it might be harder later in life but we CAN heal our brains). Maybe instead of people slinking into buildings without a sign, that everyone KNOWS is a methadone clinic, we simply let them live their life and notice how amazing it is that they have decided to do anything and everything to be BETTER. Maybe instead of "anonymous" meetings, we can have a world where someone can just as easily say "drug addiction" as "heart attack" and elicit the same compassionate response and helpful (or maybe not so helpful) hints, tips, and support instead of a sour slightly disgusted look. 

     Bottom line is that we all need to work on having compassion for others whether we understand or not. Compassion and support- relationships- caring- this is crucial medicine for addiction. AA has steps and meetings but also is CONNECTION and relationships for those struggling and that is a big part of the healing process. 

     Many people may still be convinced that addiction is not a disease as surely as I am convinced it is- but the true plea to this post and to everyone out there is that regardless of what you believe- compassion and kindness go a long way- for everyone and costs us nothing except the chance to make someone else's life a little bit better. 

“I BELIEVE COMPASSION TO BE ONE OF THE FEW THINGS WE CAN PRACTICE THAT WILL BRING IMMEDIATE AND LONG-TERM HAPPINESS TO OUR LIVES. I’M NOT TALKING ABOUT THE SHORT-TERM GRATIFICATION OF PLEASURES LIKE SEX, DRUGS OR GAMBLING (THOUGH I’M NOT KNOCKING THEM), BUT SOMETHING THAT WILL BRING TRUE AND LASTING HAPPINESS. THE KIND THAT STICKS.” The Dalai Lama