Well my thoughts are that saying an addict "can't help it," or "did or didn't choose it" is sort of more complicated than one might think. It really doesn't help that many "synthetic opiates" were put on the market with claims of ZERO addiction potential when that was not in fact true.
Many, many (surprisingly many) chronic pain patients end up in Methadone or other maintenance programs, you'd be shocked at the numbers honestly. They sort of "max out" their opiate tolerance and get funneled there.
As far as addiction being a choice, a lifestyle choice or anything else, well, sometimes that really depends on genetics and/or environment I mean a baby born addicted already has a brain "primed" for whatever substance so to speak. This in no way implies that every substance-addicted baby becomes addicted in later life, that is also not true.
However saying an addict has "ho choices" to stop is also arguably not true. I think the multitude of folks who do halt an addiction show this statement to be somewhat false. You may well have to suffer a certain amount of misery first, but it is arguably and fully 100% possible. Plenty of addicts die addicted before they can get there, though.
This is why harm reduction works actually, though, I think. If you are getting your (whatever insert substance) off the street, where quality control is poor, it may be cut with horrible things, it's not inexpensive, and an addict is forced to do more and more illegal things to obtain their substance, well, there isn't a lot of time or energy left in order to sort of focus on "what do I want my life to be besides obtaining "substance X." When harm reduction programs are combined with other supportive treatment well, an addict stands a much better chance of having some time to think about changing things, a lot of the health risks are reduced and being told that harm reduction or abstinence is even an option, well, that can be useful also. Absolutely every country that has adopted harm reduction and legalization has found this statistic to be true.
But one can also be amazed concerning that "precipitating event" that causes abstinence to happen, it can be really not if/when you'd expect..
I've seen prison detoxes and they make my toes curl because it's so incredibly inhumane. It kind o makes me want to use and I've been sober a long, long time. It's not an experience that tends to make a person go, "Wow, substances are really ruining my life I should use this opportunity to QUIT to be frank." Not to say it doesn't happen but were I to be detoxing in prison off (insert whatever substance) well, my thoughts would likely turn to "What thing am I going to do first once I get out of here."
But I do think it's important to not "cheapen" the value of someone deciding to stop abusing a whatever substance, including tobacco, it happens every day. I've used and halted a few things in my day and they say your last addiction is your hardest, well some folks say that, and I've got to give tobacco the win on that one. It was the one thing I KNEW I could never give up.
It's nice to be wrong.
Anna