Substance Abuse, Choice or Disease?

Substance Abuse can Happen to Anyone, but Why?

Science. The human brain is programmed to do things that feel good. This makes sense. We all flock to satisfaction to some extent. But we also all know someone who cannot break free from substance abuse and we all ask ourselves why?  

According to, an initiative to create a healthier 2020 defines substance abuse as, “A set of related conditions associated with the consumption of mind- and behavior-altering substances that have negative behavioral and health outcomes.” 

Substance abuse happens when we begin using “mind- and behavior-altering substances” and as a result, lose enjoyment in things we often found pleasure because our brain only craves this substance. Addictive drugs tap into our brain’s reward system and floods it with dopamine, which triggers extreme pleasure. The flooding of these receptors prevents other things from hitting them and these other things, that once brought us immense joy, just do not seem as important to our brains; things like food, family, and fun activities. Over time, this “feel good” effect even from the substance wears off and our brain thinks we need more and more. With prolonged use, changes in other brain chemical systems begin to occur and can hurt the substance abuser’s:

  • Judgement

  • Decision Making

  • Memory

  • Ability to Learn

Another key problem is the simple fact that 95 percent of people with substance abuse issues are not aware that it is a problem. Those who are aware of their substance abuse problems have a hard time getting proper help and often fall back into substance abuse patterns. 

Is it a Choice or a Disease?
People have long argued over whether substance abuse is a genetic disease or a matter of choice. Recent research has developed evidence-based strategies and improvements in brain-imaging technologies and medications for treatment, which have shifted the perspective on substance abuse in the research community., suggests, “There is now a deeper understanding of substance abuse as a disorder that develops in adolescence and, for some individuals, will develop into a chronic illness that will require lifelong monitoring and care.”

Why Does it Matter?

Substance abuse impacts more than just the individuals who are abusing substances. Families and communities take the social, emotional, and financial brunt, which results in more problems. These problems include, but are not limited to:

  • Teenage pregnancy

  • Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)

  • Other sexually transmitted diseases (STDs)

  • Domestic violence

  • Child abuse

  • Motor vehicle crashes

  • Physical fights

  • Crime

  • Homicide

  • Suicide

Adolescent and Military Substance Abuse, On the Rise

Certain populations of people have increased risks of substance abuse, but for different reasons. Nonmedical use of prescription pain relievers like Vicodin and Oxycontin have been steadily on the rise and is a big part of the ‘opioid crisis’. There are believed to be two main reasons for this: 

  1. Availability of prescription drugs from the home medicine cabinet, internet, and doctors. 

  2. Many adolescents believe prescription drugs are safer than getting them off the street.  

Military operations can cause mental health strain for military families and personnel. Close to ten percent of people with a substance abuse disorder are veterans. 

What Then? Evaluations.
Emphasizing evaluation expands evidence-based practices for substance abuse treatment. Getting a substance abuse evaluation can help you, but also the greater good. Take this online evaluation tool to see if you may need to contact a substance abuse provider like Stepping Stones of Lincoln, Nebraska: You may be surprised by the results and whether or not you are at risk. The tricky part of substance abuse is that some people can abuse the same substances as someone else, at the same frequency, and not become addicted. But, it isn’t worth the risk to try and find out. 

If you or a loved one are at risk, experiencing problems as a result of substance abuse, or you feel like you don't enjoy the things you once loved, call us at Stepping Stones in Lincoln, Nebraska at 402-483-4571 for a more in depth substance abuse evaluation and get back your ability to enjoy life.


Christine Weeks