When “Choice” Becomes a Loaded Word

For many it’s just easier and more comfortable to view addiction as a choice. If they’re convinced that someone chooses to derail their lives and plunge deeper and deeper into drug and alcohol dependency on a daily basis, it’s easier to cut them off without having to contemplate the excruciating and complex pain they’re experiencing. If they tell themselves that “it’s their choice” to spend all their money on their addiction, isolate themselves from their friends and family and gradually destroy their quality of life, it’s easier to write them off without having to think about what brought them there.

Despite piles of medical and scientific evidence to the contrary, many still believe that chemical dependency extends only as far as the “choices” of the user. This perception has allowed the stigma of addiction to infiltrate society further and significantly impact patient access to treatment. There is evidence of this phenomenon in the insurance industry as well as the clinical landscape. The recovery community is full of stories about patients that had to “fail first” in a program that was clearly inadequate to address their care needs before their insurance providers allowed them to enter another, more targeted program. While these decisions are clearly motivated by cost, they are also part and parcel of a culture that still seems to downplay the serious medical nature of addiction.

As hard as it is to face addiction-related discrimination in lifestyle areas like housing, employment and others, it’s even harder to thrive in recovery and survive on a daily basis with this strong, albeit dwindling stigma. While the addiction treatment community has made significant strides in representing chemical dependency as the medical condition that it is, it may be a while before actual substantive policy reflects this shifting perception. In the meantime, we can learn to overcome stigma by being living examples of recovery each day. We don’t have to, nor should we be, held hostage by the opinions of others.