ADDICTION NOT TOTALLY MATTER OF CHOICE

Dear Editor:

Many professionals agree that alcoholism and other kinds of drug abuse
can be related to a person's genetics. The neuro-chemical reactions
that occur when Person A ingests a narcotic may differ from Person B's
experience. The intensity of the chemical dependence that results
depends upon the substance and the person ingesting the substance.

Thus, someone whose family has dealt with alcoholism in the past is
more likely to have difficulties with alcohol consumption if they
choose to drink. This is not merely a sociological phenomenon. Some of
how that person experiences "alcohol" is dependent upon a person's
genes. One point I must emphasize is that human beings may be
predisposed towards one addiction or another.

Now, as many addicts in recovery will tell others, they have to take
responsibility for their actions and make wise choices concerning
their lifestyle. These people know that they made unwise choices,
therefore it seems unnecessary to remind them that choice is
important. We all, as Mr. Phinney said, should take responsibility for
our lifestyle choices. However, to ignore a person's biology in this
discussion is to oversimplify the matter.

A person with cancer will often get the disease regardless of their
healthy lifestyles. Sure, risks for cancer can be cut significantly
for many people if certain lifestyle choices are made. However, a
person's genes cannot be overlooked. Some people are more likely to
get certain kinds of cancer than other people. It is not an even
playing field. It is a disease that oftentimes strikes down many good
and otherwise healthy people.

I think a person's genes play a role. As it relates to the consumption
of alcohol, if I drink a beer, it will be a different experience for
me than it will be for someone whose biology spells out
"alcoholic."

Moreover, a person's genes can influence almost everything about a
person. Obesity is also sometimes encouraged by a person's genes,
although for most of us our lifestyle choices could control that
problem. However, no one can tell me that the skinny guy who can eat
anything he wants is on the same playing field as the obese guy who
can just look at the pizza and gain five pounds (relax, it's a hyperbole).

At any rate, I have heard physicians refer to obesity as a
"disease," and I think that they are ahead of Mr. Phinney or myself
in terms of being able to tell what is and what is not a "disease."
Once again, this is an example of how our biology can affect how we
experience a choice we have made.

My point is that we live lives defined by both our choices and our
environment (genetics included). I think that by telling recovering
addicts that their problem is one of purely making bad choices, we
trivialize their struggles in the most callous way. If a person in
recovery tells me they have a disease, I will not quibble over
semantics. I believe that they understand more about what it's like to
wrestle with substance abuse than I do. I have never met a person who
is in recovery that has tried to deflect the responsibility of their
choices into their genetics. They understand choice better than most.
Even so, genetics play a part as well as other factors. How we react
to substances and stimuli varies from person to person. This is true
from bee stings to heroin.

In closing, I affirm Mr. Phinney's call to responsibility. However,
can we say with much certainly that a person's biology has nothing to
do with the effect of our choices? Until we know for sure, I am
willing to give most recovering addicts the benefit of the doubt.
After all, despite prior choices and their present biology, they chose
to go to recovery.

Will Elliot

Maryville, TN 37804