Is addiction an illness or a choice? This question has been fiercely debated over the years. Proponents for the disease concept of addiction say there are clear physiological differences between addicts and non-addicts – including greater levels of impulsivity, over which addicts have little control. Others dismiss the idea that addiction is an illness – they claim that addicts always act of their own free will, including when they make impulsive decisions. New research published in March 2019 sheds some light on this question.
Researchers from Cambridge University’s Department of Psychiatry and Aarhus University in Denmark have found that young people at risk of addiction show marked differences in a key brain region. The study showed there is “a strong association between increased behavioural impulsivity in young adults and abnormalities in nerve cells in the putamen, a key brain region involved in addictive disorders.” 
In terms of addiction, the putamen is significant because it sends dopamine signals to other parts of the brain. Dopamine is a neurotransmitter that has a number of functions including its role in pleasure and reward, as well as effects on mood, attention and cognitive ability. The putamen also plays a role in mediating impulsivity.
Ask Yourself Тhese 25 Questions about Impulsivity and Addiction
Do you have concerns about your level of impulsivity, particularly when you drink, take drugs or get caught up in an addictive process? Answer yes or no to each of these 25 questions in our impulsivity test. You can also take more time with each question if you want – identifying any relevant examples from your life.
1. When using or acting out in your addiction, do you often do things that are out of character or shock other people?
2. Do you often set out to use for a certain amount of time, only to prolong the session on a whim?
3. Do you make snap decisions in your addiction, with little or no thought of the consequences?
4. The morning after, do you wonder how certain things happened – for example losing a lot of money at the bookies or drinking until 4am?
5. Do you regret hasty decisions you have made, including whilst using or acting out addictively?
6. Do you often say things to other people, which later make you feel ashamed (whether or not you’ve been using)?
7. Are you known as a risk taker by your friends and family?
8. Do people worry about your safety?
9. Do unusual or bad things seem to happen to you, more than to other people you know?
10. Have you ever made fast decisions to escape a painful reality – such as quitting a job impulsively because of tensions with your boss?
11. Do you feel impulsivity is a force beyond your control – particularly when you’re using substances or engaged in an addictive process?
12. Do your thoughts race, including just prior to using or acting out addictively?
13. Are you bored easily? Is boredom a trigger for your addictive habits?
14. Do your moods often flare – such as being quick to temper or upset very easily? Does this happen if something unexpected gets in the way of your addiction?
15. Do you often spend more money than you intended, to prolong or enhance an addictive hit?
16. Do you try to talk yourself out of doing things – only to find yourself doing the very thing you wanted to avoid?
17. Do you not think much, if at all, of the future – especially when using or acting out?
18. Do you find it hard to sit still or wait for long periods – such as during family meals, on long car journeys or queuing up?
19. Do conversations about future planning annoy you – for example, talking to your partner about household finances, pension planning or wills?
20. Have you ever moved area because you felt very unhappy or in need of a change, only to find yourself quickly feeling dissatisfied again?
21. Is it hard to concentrate when other people speak? Do your thoughts drift while they’re talking?
22. Do you interrupt people a lot in conversation?
23. Do you impose periods of tight restriction on yourself, to try to control your impulsivity and addiction? Does that approach work?
24. Do you walk towards dangerous situations, rather than stepping back – for example, if you see people fighting in the street?
25. Do you take a particular sense of pride in being known as impulsive? Does your addiction fuel the unpredictability?
If you relate, please get in touch with UKAT for an addictions assessment and treatment options. It’s confidential and non-judgmental. Family and friends are also welcome to get in touch about a loved one’s addiction.