Speaking of addictions....
My dad was an alcoholic my entire life, except for 3 years. I never really knew him even though I was 26 when he died. Weird, right? I didn't harbor any ill will towards him, but it was honestly a relief when he died. Basically what killed him was rampantly uncontrolled type 2 diabetes. It'll wreck your body if you don't take care of it. Toxins build up, organs shut down, and it's just a matter of time.
Anyway, I say all that to say this...and I'm glad nobody has said it that I've seen. After I found him and got everything taken care of, phone calls made, authorities alerted, etc...we all met up next door at my grandma's. My aunt, who is a very well educated RN had the nerve to say he had "a terrible disease". I knew what she was talking about, but I said; "Well, yeah, diabetes IS terrible!". Of course she went off about addictions being a disease and how it makes you unable to control yourself and being dependent on a substance. My rebuttal.. yes, exactly, that's what an addiction is. Cancer is a disease. You CAN stop drinking and you CAN control that...you can't just decide to stop having cancer.
Anyway, I totally understand why some people do stuff. I've hard some extremely hard times myself, but I've never once thought drugs or drinking would make it better. I'm thankful for that. Some folks just don't have the will power or fortitude to resist things.
Matt's post above is pretty similar to my experience. Hell, I drink, but thankfully I can leave it alone and not even think about it.
I think a lot of it is habit, honestly. People in general are creatures of habit.