No one chooses to be an addict. Addiction is a painful, relentless, life-destroying force. The idea that anyone would make a conscious decision to live life that way — constantly in search of the next fix and an unattainable high — is absurd. Calling it a disease always feels limiting to me: “Disease” implies that there’s a cure. No one who picks up a cigarette or a bottle or a needle thinks that this will become the thing they can’t control. Addiction builds and it takes hold of you so suddenly you don’t notice it happening. By the time you realize how deep in it you are, you’re already stepping it up to harder drugs and dreading the agony of withdrawal. No one chooses to relinquish control.
No one chooses to stay an addict either, because once you’re an addict, you don’t have that kind of choice. Getting treatment isn’t a choice so much as a battle for survival, and it’s always easier said than done. A stint in rehab teaches you coping skills, but it doesn’t make the cravings go away. The program works, but you have to work it, and that takes a kind of strength many of us don’t have. Sobriety doesn’t fix the emptiness that until that point you’ve been self-medicating. It’s a coping mechanism for a world that is scary and fucked, for brains that are scary and fucked. No one chooses to need drugs to feel whole — or just to feel normal.
And no one chooses to die. Even those who take their own lives are fighting against depression so severe that suicide feels like the only option, and no one chooses that unbearable misery. Death is fucking infuriating, which is why we’re so eager to assign blame. To an outsider, death by overdose looks selfish: You chose to get high, you got careless, you died and left your family and loved ones behind to deal with your absence. But selfishness suggests free will, and addiction robs you of that. No one chooses to give it up willingly, and once it’s gone, it’s a fucking endless struggle to get it back.