Addiction is a decision

I sit and I listen. I sit and I think. I don't ask any questions and I don't say a word. I would like to stand up and scream bullshit this is all fucking bullshit, but I don't do it. I don't believe that addiction is a disease. Cancer is a disease. It takes over the body and destroys it. Alzheimer's is a disease. It takes over the body and the mind and it ruins them. Parkinson's is a disease. It takes over the body and the mind and makes them shake and it wrecks them. Addiction is not a disease. Not even close. Diseases are destructive Medical conditions that human beings do not control. They do not choose when to have them, they do not choose when to get rid of them. They do not choose the type of the disease they would like or in what form it is delivered, they do not choose how much of it they would like or at what time they would like it. A disease is a Medical condition that must be dealt with using Medical technology. It cannot be dealt with using a Group or a set of Steps. It cannot be dealt by talking about it. It cannot be dealt with by having Family Members attend three-day seminars about it or by reading books with blue covers or saying prayers about serenity.
Although genetics and a genetic link may be undeniable, everything about us is genetic, and everything about our physical selves is predetermined by a genetic link. If an individual is fat but wants to be thin, it is not a genetic disease. If someone is stupid, but wants to be smart, it is not a genetic disease. If a drunk is a drunk, but doesn't want to be a drunk anymore, it is not a genetic disease. Addiction is a decision. An individual wants something, whatever that something is, and makes a decision to get it. Once they have it, they make a decision to take it. If they take it too often, that process of decision making gets out of control, and if it gets too far out of control, it becomes an addiction. At that point the decision is a difficult one to make, but it is still a decision. Do I or don't I? Am I going to take or am I not going to take? Am I going to be a pathetic dumbshit Addict and continue to waste my life or am I going to say no and try to stay sober and be a decent Person. It is a decision. Each and every time. A decision. String enough of these decisions together and you set a course and you set a standard of living. Addict or human. Genetics do not make that call. They are just an excuse. They allow People to say it wasn't my fault I am genetically predisposed. It wasn't my fault I was preprogrammed from day one. It wasn't my fault I didn't have any say in the matter. Bullshit. Fuck that bullshit. There is always a decision. Take responsibility for it. Addict or human. It's a fucking decision. Each and every time.
James Frey: A Million Little Pieces

This is the way I see it: Addiction is both, a decision and a disease. Sure enough: to drink or not to drink is a decision. Yet once the alcoholic has started to drink, the alcohol takes over, and from that moment onwards the alcohol is in charge and decides: drinking has turned into a disease, whether in a medical sense or not is beside the point for the alcoholic is surely dis-eased. What for me is important in this excerpt is the emphasis on personal responsibility - I completely share it.