📰BIDDEFORD | Addiction Isn’t a Choice. Pretending You Understand It Is. | OPINION

How shame, misinformation, and online “experts” make a medical crisis worse—and what real compassion looks like.

By Sean Mckenna

Every so often on Facebook, someone feels spiritually summoned to explain addiction to the masses. These are usually the same folks who believe WebMD diagnoses can be cured by “rubbing a little dirt on it.”

And the most popular Facebook theory of all time?

“Addiction is just a choice.”

Now, don’t get me wrong— I once thought people chose their problems, too. Like when I chose to grow a rat tail in 7th grade. Or when I chose to trust the DMV’s “estimated wait time.” But addiction? That’s a little more complicated.

Addiction isn’t a choice. It’s a disease— a documented, measurable, brain-based disease.

If people could simply choose not to be addicted, trust me, they would. Nobody wakes up and says, “Today feels like a great day to smoke meth, run naked through traffic, and growl at strangers.”

Science— actual, boring, plain old science— shows that addiction rewires the brain’s reward system, impulse control, and decision-making. It’s like the brain rearranges the furniture in the middle of the night and now you keep stubbing your toe on its irrational decisions.

Addiction isn’t a moral issue.

It isn’t a personality flaw.

It isn’t a missing “willpower.”

It’s a neurochemical catastrophe.

And if addiction is a “choice,” then so is cancer when people choose to smoke cigarettes, Type 2 diabetes when people choose to overeat, and PTSD when people choose to join the military. We don’t call those choices— we call them what they are: diseases. 

Speaking of PTSD—roughly 65% of combat veterans with PTSD also develop a substance use disorder. Not because they “chose poorly.” Because trauma reshapes the brain, too.

The Myth

There’s this cartoon belief that addiction begins the moment someone tries a hard drug. Some people must picture fireworks go off, a villain theme song plays, and—bam—lifelong chaos.

In reality, most addictions begin with something painfully ordinary:

• a prescription after surgery

• a dental procedure

• chronic pain

• “Take one every 4–6 hours”—the four most dangerous words since “We need to talk.”

Over 75% of people who eventually use heroin first became addicted to prescription opioids— not back-alley deals, not moral failure, not “bad choices.” Just legally prescribed medicine.

And we know why—

In 2020, Pfizer paid $349 million to New York State for illegally marketing opioids and downplaying addiction risks.

In 2023, Pfizer and King Pharmaceuticals paid $389 million more for their role in aggressively promoting fentanyl products.

Pharmaceutical companies helped create this crisis. Regulators failed to respond. Healthcare providers prescribed opioids based on guidance that downplayed their dangers— some for financial kickbacks. Meanwhile, the same companies selling the pills were also profiting from the treatments used later to fix the damage.

So, if we’re looking to assign blame, start with the systems that built the epidemic—not the people who ended up suffering because of it.

Addiction Is Bigger Than Substances

Addiction isn’t limited to drugs. It’s the disease itself.

You can become addicted to:

food, gambling, pornography, sex, caffeine, nicotine, video games, shopping— even your cellphone.

It’s not the activity.

It’s the brain’s reaction to the activity.

And here’s something important:

Nobody recovers because they were shamed. People recover because they were helped.

Addiction is medical. Recovery is possible. Judgment is just a hobby some people enjoy far too much.

We don’t fix addiction by lecturing strangers on Facebook. We fix it with compassion, education, and occasionally reminding someone that Googling something before commenting is free.

If we understood addiction better, we'd judge people a whole lot less.

Why I Know This

This year, I celebrated 12 years in recovery from opioids and benzos. The same “loser” many of you would’ve chased out of a comment section with pitchforks and torches is now working in mental health and spending his free time helping others.

For over a decade, I’ve stood beside people fighting addiction, helped people experiencing homelessness find housing, and worked to strengthen my community. If even 10% of the people whom mock or vilify addicts put half of that energy into lifting someone up, our communities would be stronger, safer, and far more compassionate.

So who’s the real “villain” here?

The combat veteran–turned–Massachusetts State Trooper I helped get into detox after he became addicted to heroin when his prescribed opioids were abruptly cut off, 3 months after he broke his back after crashing in a high speed chase?

Or the people who refuse to acknowledge the overwhelming science that addiction is a disease— and instead cling to the comfortable myth that people wake up one day and decide, “You know what would really spice up my life? Meth under a bridge.”

Educate yourselves. And more importantly, do better. Those “zombies” you insult on the sidewalk aren’t monsters. They're someone's children. They’re human beings in pain. They need love and compassion—

not hate and judgment.