Why Addiction Is Not a Choice and How to Stage an Intervention

Catherine, Princess of Wales, launched the Taking Action on Addiction campaign with a passionate and heartfelt speech. One of the things she said that really stood out to me was, “No one chooses to become an addict”. Because that is such a hard part of the addiction for many people to understand. After all, if you are addicted to alcohol, drugs, gambling, or anything else, surely you chose to do it in the first place. 

I hope this post will help explain why addiction is not a choice so that if you feel shame about your addiction, you can reach out for the help you need. And if you are concerned about someone struggling with addiction, you can understand a little more about why they did not choose to become an addict. Attitudes are slowly shifting, and hopefully, Catherine, the Princess of Wales’, message of support will play a part in changing the view so often held about addicts. 

Addiction and the Brain

Addiction is defined as not having control over doing or taking something harmful and causing negative consequences. This could be alcohol, drugs, or an activity such as gambling. Furthermore, addiction is recognized as a brain disease because the structure and functions of the brain of an addict are different from the brain of someone without addiction. 

If you are not keen on reading, this video about addiction and the brain explains how addiction changes the brain structure and how it processes information. 

If you prefer to read, here is a brief explanation of the changes that happen to the brain of an addict. Your brain is your “navigation system” similar to a GPS you use to get instructions on how to find somewhere you want to get to. Through our senses (namely sight, smell, touch, taste, and hearing), the brain processes information and sends messages to the reward circuit also called the brain reward system. The reward circuit then releases a neurotransmitter called dopamine to indicate when a specific behaviour needs remembering.

When we engage in behaviour that brings us pleasure, the brain releases a surge of dopamine. This happens when you eat and drink or participate in activities that make you feel good, referred to as natural reinforcers. The problem is addictive substances cause a much larger surge of dopamine to be released. 

For example, when you take an addictive drug for the first time, the reward circuit receives a much larger burst of dopamine than a naturally pleasurable activity or behaviour. With repeated use, the brain adapts to reduce the dopamine receptors available in the reward circuit, reducing the dopamine released from natural reinforcers. Over time an addict needs the substance or activity to feel any pleasure. Additionally, addictive substances alter the brain’s actual structure, taking away your ability to make conscious choices about substance abuse. 

To support brain functions, including memory and our ability to learn, the brain links this surge of dopamine with the behaviour and how we felt (our emotions). Think about ways you try to trigger a really good memory. You might have a souvenir you look at, a particular food you eat, or a smell associated with it. These external cues trigger the memory. This is why even after months or years after beating an addiction, an addict can relapse when external signals trigger the brain to remember the activity associated with them.  

How to Stage an Intervention

If you are concerned about someone you care about, staging an intervention could save their life. An intervention requires careful planning and typically involves family or friends. Group dynamics play an important part in an intervention, and while staging an intervention alone can work, it is the last option. 

Four Steps for an Intervention

An intervention is never going to be easy, but following these four steps may increase the potential for its success.

1. Get everyone together. When you have established who will be involved with the intervention, get together to make a plan. Decide who will speak first and what part you will each play during the intervention. It can also be helpful to write on cards things you want to say to help you to remember and stick to what has been agreed. By doing this, you reduce the potential you will become angry or upset.
2. Focus on the facts. An intervention is a stressful and emotional thing to do and will not work if the person feels like they are being attacked. Focusing on the facts helps to lessen strong emotions. Explain specific times when behavior caused by their addiction has resulted in issues.

For example, you could say, “When you came home late on DATE, I was worried because I didn’t know if you were safe” or “When you drank alcohol at TIME and PLACE, you drove home, and I am scared you will be in a car accident or go to jail if you are pulled over”.

3. Have information about addiction treatment options. Providing solutions is key to the success of an intervention. Having all the options and information is essential to reaching an agreement about the type of treatment the person will commit to. If you cannot find a residential rehab centre with same-day admission or they will have outpatient treatment, make sure it is arranged as quickly as possible.
4. Decide the next steps. If possible, ensure the person is not left alone until they can start addiction treatment. If you cannot arrange this, set up times for regular video calls throughout the day. It is also critical to have someone they can call if they are struggling day or night.

What to Do If an Addict Refuses Help

An intervention may fail, and it can be challenging to know what to do next. It is often very scary to ask a loved one to move out or limit a friendship to daytime meetings in a public space, but an addict will only get help if there are consequences for their addiction. Don’t confuse this with delivering an ultimatum. You are simply refusing to enable their addiction. 

Addiction Helplines

FRANK — 0300 1236600 

Open 24 hours a day, seven days a week.

FRANK can help you to locate free drug treatment services in England.

Narcotics Anonymous — 0300 999 1212 

Open 10 am to midnight, seven days a week.

They provide support on the telephone and hold in-person meetings in the UK and Channel Islands.

DrugFam — 0300 888 3853

Open 9 am to 9 pm, seven days a week.

They provide support on the telephone and hold weekly online groups most days of the week for family and friends impacted by someone else’s addiction.