This article is by Elizabeth Stockton and published by Recovery Connection
Throughout the history of humanity, mind-altering substances have been used in various forms in nearly every known culture. And wherever drugs or alcohol could be found, so could problems of individuals falling prey to the pleasures of intoxication. Addiction is not a new or sudden problem in our society, and therefore, it comes with centuries of philosophers, sociologists, psychologists and doctors attempting to define it and to cure it. Our social perceptions of addiction often include remnants of these older definitions that manifest as stigmas and myths. It’s time to talk about some of the common misunderstandings surrounding addiction and to bring these perceptions into a modern, more accurate light.
Myth: Addiction is a choice
According to the Diagnostic and Statistical Manual of Mental Disorders, substance use disorders like drug addiction or alcoholism are specifically characterized by a lack of choice. Individuals who struggle with addiction are dealing with a compulsion: a subconscious drive to use drugs or alcohol despite the conscious knowledge that it is unhealthy or damaging. The compulsion comes from a chemical imbalance in the brain, the causes of which can vary — but which are also typically beyond the addicted individual’s control.
For example, studies suggest a genetic component to addiction. A family history of substance abuse can mean that one person’s brain is hard-wired to be more susceptible to addiction than others. Environment is another significant factor: uncontrollable experiences like childhood neglect or abuse, growing up around normalized substance use or trauma like combat or sexual assault can all lead to an increased risk of addiction. Finally, even in instances where an individual knowingly begins using addictive substances, addiction does not set in intentionally or immediately. As a drug or alcohol habit develops, the individual’s brain slowly changes to depend on the substance, which in turn causes the characteristic compulsion and takes away a person’s ability to choose when, how or whether they use drugs or alcohol.
Myth: Addiction only happens to certain types of people
Someone asks you to picture an “addict.” What image first comes to mind? Popular media may have shaped the type of person you associate with drug and alcohol abuse. Perhaps the individual you imagine is involved in criminal activity, grew up in a “bad” neighborhood or is socioeconomically disadvantaged. It’s important to be critical of these stereotypes, not only because they can lead to prejudice or stigmas but also because they are statistically untrue.
Each year, surveys from organizations like the Substance Abuse and Mental Health Services Administration show that addiction affects people of all walks of life. While we do know that certain groups may be more susceptible to particular substance use disorders, overall, there is no single type of person who is especially likely to be an “addict.” And, on an individual level, each person who struggles with addiction comes from a unique background with highly personal risk factors and stressors. From a young person developing a binge drinking problem in college to a single parent using alcohol to self-medicate for stress; from a teenager dealing drugs to provide for their family to a high-powered executive using cocaine to keep up with their work — people of all ages, genders, income levels, and geographic locations can be affected by addiction and substance abuse.
Myth: Once treated, addiction should be gone for good
The more we learn about addiction, the more we understand that it is a complex, chronic disease — one that requires lifelong care and management. While it was once believed that achieving physical sobriety could set an individual back on the right path, we now know that the psychological aspects of addiction hold the key to recovery. Treating the mind, however, is not as straightforward as healing the body. Today’s addiction professionals know that psychological stressors can emerge and trigger relapse even after years of successful sobriety. It’s essential to acknowledge that addiction does not have a one-time cure. This way, we can equip clients to better prevent and manage these stressors, rather than leaving them unprepared and feeling as though they have failed in recovery.
Many treatment centers are focusing on giving their clients relapse management tools on top of more traditional therapies. In addition, many centers are providing multiple levels of care — instead of ending treatment upon discharge from a residential program, clients can now participate in outpatient care, alumni programs and more to stay supported and connected to a recovery community over time. Individualized treatment is also on the rise, offering targeted care, especially for high-risk cases such as polysubstance abuse or co-occurring disorders.
Myth: Prescription drugs are less dangerous than illicit drugs
We trust doctors with our wellbeing, so it’s natural to assume prescription medications aren’t harmful. And in general, prescription drugs are safe — when they treat a legitimate health concern, when they are used according to your doctor’s instructions and when your doctor is aware of any changes in your medication schedule. These caveats are essential to understanding prescription drug addiction. Drugs like opioids (Vicodin, fentanyl), stimulants (Ritalin, Adderall) and benzodiazepines (Xanax, Valium) are powerful substances. They contain similar chemical compounds to street drugs, often at a “purer” concentration. When misused, they are at least as harmful as their illicit counterparts.
Prescription drug abuse is characterized by rapid tolerance, in which the individual requires higher doses to achieve the desired effect. Tolerance leads to dependence and addiction, and to a greater risk of overdose as individuals take increasingly larger and more dangerous doses. According to data from the National Institute on Drug Abuse, rates of fatal overdose have been significantly higher in recent years among prescription drug users than users of illicit drugs like heroin and cocaine. It has unfortunately taken statistics like these to increase public awareness of the dangers of prescription drug abuse; moving forward, it’s essential to take prescription drugs seriously and use them with caution.
Myth: Addiction treatment should “scare them straight.”
When you see treatment centers that promise a comfortable, relaxing rehab experience, you might wonder if these places will really make their clients take recovery seriously. It’s easy to write off this kind of treatment as too soft, and to feel as though addiction treatment should really make individuals understand the full extent of what they’ve “done wrong.” However, experts know that addiction is based on compulsion — addicted individuals will continue to use drugs or alcohol despite knowing the consequences. Fear-, shame- or consequence-based interventions are no longer considered an effective means of treatment among top recovery centers.
In fact, this kind of approach is counterproductive. Some research suggests that self-reported feelings of shame in recovery are linked to a higher likelihood of relapse and that internalizing blame or poor self-esteem likewise makes addiction more difficult to control. Instead, effective addiction treatment should be supportive, focused on empowerment and aimed at rebuilding essential relationships with loved ones. The age-old adage that change comes from within rings especially true in recovery: only when the individual wants to change and believes they can enact change, will they be able to overcome their addiction. Using fear tactics will only perpetuate the individual’s belief that they are not capable of achieving more.
In our modern age of rapidly shared information, it’s essential that the knowledge we learn and spread is accurate and up to date. When we fall into old stereotypes about addiction or make judgments about what it’s like to go through recovery, we make it more difficult for society as a whole to talk about addiction in a healthy, productive way. Myths like those discussed here perpetuate the problem of substance abuse and prevent individuals who are struggling with addiction from receiving the support and understanding they need to heal. But when we work together to learn the truth, we change the dialogue and make room for a broadly impactful shift in how we treat, and ultimately prevent, the disease of addiction.