I think for myself it is the symptom of a mental illness. Alcohol, pot, opioids, Xanax, provide some relief from overwhelming feelings of inadequacy, loneliness and despair. So, it is not a free choice, but still it is a choice, to choose relief from pain & distress. I’m managing my addiction at the present time. Therapy has helped reveal to myself the early childhood trauma that I suffered. I have expressed my anger, shame, helplessness... mainly anger, toward my father & mother, which has given me an intellectual awareness of why I choose to self-medicate. The pain persists, and the medications work well enough to keep using them. Shoot, I’m closing in on 70yo, and if I was psychologically healthy my life would be very satisfying, even fulfilling. I’m struggling, but I deepdown inside inside Ihave hope. Comfortably numb feels ok for me. GDB