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Although addicted people, like other sick people, are not responsible for their diseases, they are fully responsible for their behaviors during every stage of the disease. The addicted person’s disease is a heightened vulnerability to drug-induced rewarding experiences, which has both biological and environmental elements. Addicts’ behaviors, including their use of alcohol and other drugs, is entirely their responsibility, as is their use, or nonuse, of various recovery options, including the totally free and widely available 12-Step programs, such as Alcoholics Anonymous and Narcotics Anonymous.

People with diabetes are not responsible for their disease, but they are responsible for their behaviors, including how they manage their illness. Adherence to proper diet and wise use of medicines are the personal responsibility of each diabetic person. The consequences of failure to care for the disease of diabetes mellitus are often added suffering and early death. The same is true for addiction. Denial and wishful thinking are deadly threats to people with all kinds of diseases. Addicted people, like people with diabetes, are responsible for the management of their diseases. As with addiction, genetics and behavior before the onset of the disease sometimes play important parts in the experience of the disease of diabetes.

- excerpt from The Selfish Brain: Learning from Addiction (1997) – Robert L. DuPont, M.D.