The Dangers of Neglecting Addiction Treatment: How the View of Addiction as a Choice Fuels Institutionalization

In recent years, the topic of addiction has gained attention across [social] media, healthcare systems, and policy debates. However, a dangerous societal fallacy endures: many still view addiction as a personal choice rather than a complex, chronic, and progressive disease. This misconception not only delays or prevents appropriate treatment but also contributes to an alarming trend—individuals with addiction are more often institutionalized than treated with evidence-based care. This blog explores the dangers of untreated addiction, how viewing addiction as a choice perpetuates stigma, and the growing acceptance of institutionalization as an answer to addiction.

The Dangers of Untreated Addiction

Addiction is a chronic and progressive illness that affects brain function and behavior (National Institute on Drug Abuse [NIDA], 2020). Left untreated, it has severe physiological, mental, and social consequences. Despite growing awareness, many people do not receive adequate care due to shame, lack of access, and misconceptions. The dangers of untreated addiction include:

            1.         Health Deterioration: Substance use disorders (SUDs) can lead to permanent damage to vital organs, such as the liver, heart, and brain, as well as increased risk of infectious diseases like HIV and hepatitis. The Centers for Disease Control and Prevention (CDC, 2020) reports that opioid addiction has singlehandedly contributed to alarming rising rates of infectious diseases and deaths related to overdose.

            2.         Mental Health Decline: Untreated addiction often co-occurs with mental health disorders, creating a vicious cycle. Substance abuse can exacerbate anxiety, depression, and other psychiatric conditions (NIDA, 2020).

            3.         Increased Risk of Overdose: Without treatment, individuals are at an increased probability of overdose, especially with the abundance of synthetic opioids such as fentanyl. Overdose deaths in the U.S. have surged in recent years, highlighting the urgent need for accessible treatment (CDC, 2020).

Addiction as a Choice: The Consequences of a Misguided Perspective

Despite scientific data, addiction continues to be viewed by many as a personal choice or a lack of moral compass. This standpoint has deep origins in public beliefs about personal accountability and self-control. However, research has shown that addiction is not simply a matter of determination; it is a medical condition that fundamentally modifies brain chemistry (American Psychiatric Association, 2021).

This perspective leads to several harmful outcomes:

            1.         Stigma and Shame: Viewing addiction as a moral malfunction creates stigma, which can discourage individuals from pursuing help. Stigma surrounds people with addiction, who may feel judged, misunderstood, and isolated. According to the World Health Organization (2021), stigma is one of the chief reasons people with substance use disorders delay or evade treatment.

            2.         Criminalization Over Treatment: Societies that view addiction as a choice tend to criminalize substance use rather than treat it as the public health issue that it is. The effect: addicts are more likely to be incarcerated than rehabilitated. This approach leads to a cycle of incarceration (i.e., recidivism) without addressing the origin of addiction (Hart et al., 2017).

            3.         Reduced Support for Treatment: Public opinion can, and does, influence policy. When addiction is viewed as a personal choice, there is less public support for treatment programs and harm reduction efforts. People may view these programs as uneconomical or undeserved, diminishing both the accessibility and quality of care for those in need (Volkow, 2020).

Institutionalization as an Accepted Norm

When addiction is perceived as a personal choice rather than a medical disease, the response often shifts toward containment and control. As a result, institutionalization—whether through prisons, mental health facilities, or punitive rehab centers—has become a generally accepted solution for managing addiction. This practice can be detrimental for numerous reasons.

            1.         Failure to Address Root Causes: Institutionalization often places concentration on containment rather than healing. Incarceration or long-term stays in non-therapeutic milieus fail to tackle the underlying psychological and social factors causal to addiction (Hart et al., 2017).

            2.         Increased Trauma: Being institutionalized in prison or other retributory environments can cause or exacerbate [existing ]trauma, which is often a foundation to addiction. Rather than treating addiction, institutionalization can deteriorate mental health and contribute to increased rates of relapse upon release (Volkow, 2020).

            3.         Revolving Door of Incarceration: Many individuals with addiction end up in a cycle of repeated institutionalization. Without access to comprehensive care, they are more likely to relapse, reoffend, and be re-incarcerated. This perpetuates the perception that addicts are “choosing” their lifestyle, when in reality, they are trapped in a system that fails to provide adequate care (Hart et al., 2017).

Breaking the Cycle: Addiction Treatment as a Public Health Priority

To address the addiction crisis, we must transform how society views and responds to addiction. Treating addiction as a chronic disease requires a shift in public insight and policy, moving away from punishing measures and toward health-centered solutions.

            1.         Public Education and Awareness: Education campaigns can help shift societal opinions on addiction, framing it as a medical issue rather than a moral inadequacy. Studies show that when people understand addiction as a disease, they are more likely to encourage treatment and harm reduction initiatives (Hart et al., 2017).

            2.         Increased Access to Evidence-Based Treatment: Government bodies must invest in addiction treatment groundwork, including medication-assisted treatment (MAT), counseling, and community support. Expanding access to these services can prevent institutionalization and assist people in recovering in environments that are conducive to healing (Volkow, 2020).

            3.         Decriminalization and Diversion Programs: Decriminalizing drug use and prioritizing diversion programs can help decrease incarceration rates and link individuals to the treatment they need. Countries that have embraced these methods have seen enhanced results in public health and safety (Hart et al., 2017).

Conclusion

 The risks of untreated addiction are profound, touching not only the individuals struggling with it but their families and communities as well. Viewing addiction as a choice rather than a medical condition leads to dangerous social effects, including stigma, criminalization, and the acceptance of institutionalization as an answer. To combat the addiction crisis, society must move toward a more empathetic, health-centered approach, providing treatment and support rather than punishment.

References

 American Psychiatric Association. (2021). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.

 Centers for Disease Control and Prevention. (2020). Understanding the epidemic: Drug overdose deaths. https://www.cdc.gov/drugoverdose/epidemic/index.html

Hart, C. L., Ksir, C., & Ray, O. (2017). Drugs, society, and human behavior (17th ed.). McGraw-Hill.

 National Institute on Drug Abuse. (2020). The science of drug use and addiction: The basics. https://nida.nih.gov/publications/media-guide/science-drug-use-addiction-basics

 Volkow, N. D. (2020). Stigma and the toll of addiction. New England Journal of Medicine, 382(14), 1289-1290. https://doi.org/10.1056/NEJMp1917360

 World Health Organization. (2021). Substance abuse: Stigma and discrimination. https://www.who.int/initiatives/substance-abuse