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Addiction: Disease Or Choice-You Decide


DSM-5 Definition and criteria for addiction

DSM-5 Definition for addiction:

Substance abuse disorders are patterns of symptoms resulting from the use of a substance that you continue to take, despite experiencing problems as a result. ( March 21, 2020)

DSM-5 Criteria for addiction

The 4 criteria for addiction falls under four basic categories:

1. Impaired control

2. Physical dependence

3. Social problems

4. Risky use

DSM-5 Addiction

In the DSM-IV patients only needed one symptom present to be diagnosed with substance abuse.

The DSM-5 eliminated the physiological subtype and the diagnosis of psysiologicol subtype, and the diagnosis of polysubstance abuse.

In the DSM-5 criteria for intoxication, withdrawal, sub-substance medication-inducded disorders, and unspecified substance induced disorders where relevant.

Disease or choice

Many things can be classified as an addiction, food, sex, shopping, alcohol or drugs.

In this we will look at the last two, alcohol, and drugs, including perscription drugs.

I have had many heated discussions with others over whether addiction is a disease or is a choice. Personally I believe it is a combination of both.

None of the people you will read about in the stories here, woke up one day and said I want to be an addict when they woke up one day.

Some addicts will readily admit to being an addict but many will say " I can stop or leave it alone anytime I want too".

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In most cases they can't.

I believe it also has a disease component. Who in their right mind would continue to abuse a substance that is going to kill them, maybe not this time, but the next or the next.

The Covid19 pandemic has increased the overdose rate by 30% compared to 2019 according to

The availability of the drugs, the drugs pouring across the open borders,and lots of extra money from the government subsities, and the ability to stay home and not work allows for more opportunities to use, and in some cases for the last time.


Stories of addiction: Joseph

Now read the stories of two addicts , Joseph and Dyan.


Joseph was 13 years when he began drinking. His drug of choice was alcohol. He came from a family where drinking meant you were a man. His father was and alcoholic and his uncles and others always drank. he had constant run-ins with the law for DWI and fighting. He served 15 years in prison.

At 20 years of age he added pot and coke to his repotoire of addictive substances.

He married a woman 20 years his senior with 8 children. He always made it to work and supported his ready made family. Other than the arrests no one would ever have known. His addiction to alcohol grew. He was court ordered to rehab and lost his license to drive was suspended for life in Nebraska.

Joseph, after many failed rehabs began attending AA and now has 40 years clean, and sober. He is a retired over the road truck driver. His license was restored after his sponsor testified to 25 years of sobriety.

He is sharing his story as an inspiration to other addicts to show there is hope and change is possible.

He goes by the rule " One day at a time".

A huge congradtulations to JOSEPH !!


Stories of addiction: Dyan

Dyan started using at age 18. her drug of choice was cocaine and amphetamine ( crank / crystal).

She was a single mother of two young daughters. Unable to make ends meet and no husband, the waitress just didn't pay the bills.

She took a job as a dancer at a club in Mobile, Alabama. Part of the job was to sit with customers and let them buy you drinks. It is mostly impossible to drink 8-10 hours a day and dance on a 3-5 foot stage without falling off on your head.

One night she walked into the dressing room and aanother dancer was snorting something with a rolled up dollar bill, it was coke.

"You wont get drunk and you'll feel great" her co-worker said.

Dyan tried it and so began her desent into addiction. She moved around alot, Texas, Florida, Mississippi and Alabama. She always worked in the clubs, always depending on the drug to stay sober and have the energy for the long shifts.

It would be many years before she could look in the mirror and admit she was an addict.

As the years passed coke played a bigger and bigger part in her life. It became an every day thing in the 80's and 90's when it was popular, especially in Miami. She even had the little bottle with a spoon attached to the inside of the lid, that hung around your neck which was very popular back then. Doctors, lawyers , everyone who was anyone was doing it.

It didn't become a problem until she was 40. She began having chest pains. She was hospitalized 43 times in a year and 32 of those she tested postive for cocaine. The doctor told her " one day you will do this and drop dead, you have and enlarged heart and heart failure". She still didnt stop.

She married a good man in 2001 and had a period of 5 years of sobriety.

In 2020 she had a relapse. She is now in recovery for the past year but she still struggles.

NOTE: She moved to a rural area where she knows no one and away from old friends and hangouts. She is now a teacher.

One day at a time Dyan, Keep it simple.



So the question remains, disease or choice? i have to defer to my previous answer. I believe it is a combination of both.

So the next time someone says " that addict or that junkie" , remember that they are someones father, mother, son or daughter. and maybe God is not through with them yet.

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