More than 23 million Americans struggle with drug abuse that causes problems in their lives. (1) Despite the high number of people with a substance use disorder, most Americans don’t understand addiction. Myths about addiction abound, and misinformation is widespread. But understanding addiction is essential for knowing whether you or someone you love is addicted, how addiction is treated and what kind of help you need to end an addiction for the long-term.
We’ll take a look at the ten most common myths about addiction and separate fact from fiction so you can better help yourself or a loved one enter recovery.
Myth #1: Drug abuse, addiction and dependence are the same thing.
While the terms drug abuse, addiction and dependence are often used interchangeably, they’re not the same thing.
Drug abuse is the act of using drugs in a way that causes problems in your life. These often include:
Legal troubles, such as charges of drug possession or DUI
Financial problems stemming from spending money on drugs or alcohol, losing your job or paying legal fees
Physical or mental health problems
Problems with your relationships
Engaging in risky behaviors like unprotected sex or driving under the influence
Binge drinking is the most common form of drug abuse. All illegal drug use is considered abuse, since these drugs can lead to serious legal and health issues. Likewise, using prescription drugs in a way other than as prescribed is considered drug abuse. While drug abuse isn’t the same thing as addiction, abusing drugs and alcohol can lead to addiction.
Addiction is a disease that can result from changes in the way your brain operates when you abuse drugs or alcohol:
Drugs cause the reward center of the brain to release dopamine, the chemical that produces feelings of pleasure.
As dopamine floods the pleasure center of your brain, the memory center records a memory of the pleasure.
At the same time, the learning center creates a strong conditioned response to the stimuli around you. This causes you to associate the pleasure with certain people, places, activities or things. These are known as “triggers.”
Chronic, heavy drug abuse can cause the pleasure center of the brain to communicate with the prefrontal cortex, the brain center responsible for planning and executing tasks.
The prefrontal cortex may begin to associate liking drugs with wanting them. This results in powerful cravings that motivate you to seek out the pleasure of the drug at all costs. These cravings are produced by the same drive for survival that leads us to eat food and procreate.
Addiction is characterized by being unable to stop using drugs or alcohol despite the problems it causes. People who have an addiction use drugs or alcohol even though it leads to negative consequences like relationship, legal, financial and health problems.
Addiction is chronic, progressive and relapsing. This means that:
It can’t be cured, but it can be sent into lifetime remission.
It will almost always get worse without treatment.
It may recur if you use drugs or alcohol after a period of recovery.
Dependence is a physical reliance on drugs or alcohol. Heavy substance abuse causes your brain to change the way it functions chemically in order to compensate for the presence of the substance. These chemical changes lead to tolerance. This means that you need increasingly higher doses of the drug to get the same effects. At some point, brain function may shift so that it begins to operate more “normally” when the substance is present than when it’s not. Then, when you stop using, normal brain function rebounds. This causes withdrawal symptoms to set in. Withdrawal is the primary indication that you’ve developed a dependence on drugs or alcohol.
Myth #2: Addiction is a lifestyle choice.
Addiction is a chronic, progressive and relapsing disease of the brain. Like other chronic diseases such as diabetes and heart disease, lifestyle choices initially come into play; using drugs or alcohol is a choice, and using them heavily is also a choice.
Once an addiction develops as the result of brain changes, however, using drugs is no longer a matter of choice, but rather it becomes a compulsion. You may want to stop, and you may try to stop, but chances are, you’ll find you’re unable to quit for the long-term.
Addiction is a medical condition that requires appropriate treatment by professionals. The National Institute on Drug Abuse stresses that willpower and good intentions are rarely enough to send an addiction into remission for good. (2) Professional help is almost always needed.
Myth #3: It’s easy to spot someone with an addiction.
Popular culture and outdated attitudes about addiction would have us believe in the down-and-out “addict” living on the streets, alienated from family, involved in a life of crime and unable to hold down a job. But the truth is, anyone can develop an addiction, from the high school cheerleader to the PTA president, from the lawyer to the banker, from the surgeon to the police officer.
The 2013 National Survey on Drug Use and Health offers a glimpse into who is addicted in America:(3)
Young adults between 18 and 25 have the highest rate of addiction at 7.4 percent, but addiction also affects both older and younger people. Over three percent of youth aged 12 to 17 have a drug or alcohol addiction, and nearly two percent of adults over the age of 26 have a substance addiction.
Asians have the lowest rate of addiction at 4.6 percent, followed by blacks at 7.4 percent, whites at 8.4 percent and Hispanics at 8.6 percent.
In 2013, rates of addiction were 6.4 percent for high school graduates, 7.2 percent for college graduates, 7.3 percent for those who didn’t finish high school and 7.4 percent with people who had some college education but no degree.
More than half of those aged 18 and older who had an addiction were employed full time in 2013.
Rates of addiction for those 12 and older are similar for large and small metropolitan areas at over eight percent. Non-metropolitan areas have an addiction rate of 6.6 percent.
A number of industries carry a risk of substance abuse and addiction, including high-stress jobs and those that involve a lot of trauma, such as military personnel, EMTs and police officers. Addiction to Adderall and Ritalin isn’t uncommon in high schools and colleges across America, where these drugs are falsely rumored to improve academic and athletic performance. Older Americans who experience profound loss, declining health or isolation in retirement are also at risk for developing an addiction.
Myth #4: People don’t seek help for an addiction until they hit rock bottom.
Many people with an addiction seek treatment long before they hit “rock bottom.” They get help for a number of reasons:
They feel ill, or the addiction is causing health problems.
They tire of the constant search for drugs.
They fear losing their job due to their drug abuse.
They want to improve their relationships.
They want to be more productive.
They want an improved sense of well-being.
They become pregnant.
They’re ordered to participate in treatment by the courts.
They agree to treatment when pressured by family members.
Still, only around 11 percent of those who need help for an addiction seek it. Some of the reasons why people avoid treatment include:
Being in denial that there’s a problem.
Not feeling ready to stop using.
Fear of losing their job.
Fear of what others will think.
Fear of what life will be like without drugs or alcohol.
Fear of losing the friends they use with.
Fear of losing a significant other who still uses.
Fear that treatment won’t work for them.
The cost of treatment.
Myth #5: You have to want to recover in order for treatment to work.
Treatment doesn’t have to be voluntary to work. (4) People who are ordered by the court to get treatment, or those who are reluctantly led into treatment by family members, often go on to live happy, drug-free lives.
Motivational interviewing is a common and effective therapy used in treatment to help those who don’t necessarily want to recover find their own motivations and reasons for wanting to quit. Then, as they begin working through a variety of issues in group, individual and family therapy, they learn astonishing things about themselves. Changes begin to occur from the inside out.
In treatment, you will:
Identify your inherent strengths and values.
Identify false or outdated beliefs about yourself, your addiction and the way you see the world.
Identify self-destructive thought and behavior patterns and develop healthier ways of thinking and behaving.
Identify your triggers and high-risk situations and develop a toolkit of skills and strategies to help you cope with them.
Learn how to cope with cravings.
Work through the issues that underlie the addiction, such as chronic stress, a history of trauma, an underlying mental illness or family dysfunction.
Work to repair damaged relationships and learn how to develop and nurture healthy relationships.
Address any legal or financial issues or medical problems that need to be resolved in order to reduce stress and improve well-being.
Find purpose and meaning in life.
Improve your self-awareness, self-confidence and self-esteem.
Learn how to have fun and enjoy yourself without drugs or alcohol.
A high-quality treatment program helps you reach into all corners of your life to improve it on all levels.
Myth #6: Addiction treatment is the same for everyone.
The Substance Abuse and Mental Health Services Administration stresses that there is no single pathway to recovery.(5) Recovery is a process of change that can occur through many avenues, including therapy, medication, peer and family support, self-care, and mindfulness. Recovery is built on your inherent talents, strengths, values, coping abilities, and resources.
A high-quality treatment program will offer a holistic approach to treatment that addresses issues of body, mind and spirit for whole-person healing. Your treatment plan will be developed based on your specific needs, issues and preferences.
A combination of traditional and alternative therapies are used to provide a variety of approaches to solving a range of problems. The most common traditional therapies used in treatment include:
Cognitive-behavioral therapy, which helps you examine your thought and behavior patterns.
Family therapy, which helps restore function to the family system.
Psychoeducational workshops, which help you better understand addiction and recovery.
Pharmacotherapy, or the use of medication, which can help reduce cravings or treat a co-occurring mental illness.
Support groups, which offer peer support, improve personal accountability and help you work through a variety of issues with others going through a similar situation.
Common complementary therapies used in treatment include:
Art therapy, which helps you work through difficult emotions and experiences.
Acupuncture or massage, which helps reduce stress and alleviate cravings.
Yoga or meditation, which improves mindfulness and increases mental and physical strength, balance and flexibility.
Biofeedback, which helps you reduce your body’s stress response on the spot through deep breathing and visualization exercises.
Outdoor therapy, which builds self-confidence and self-awareness, increases trust and improves communication skills.
Not every therapy works optimally for every individual, so a holistic approach to treatment ensures a better outcome.
Myth #7: Treatment doesn’t work most of the time.
Contrary to a large body research proving otherwise, many people believe that treatment doesn’t really work or won’t work for them. The truth is, most people who get professional help for an addiction are able to enter recovery for the long-term.
Studies show that for most people who engage with it, treatment:(6)
Reduces drug and alcohol use
Reduces domestic violence
Reduces risky behaviors
Improves employment status
Improves educational status
Improves interpersonal relationships
Improves mental health
Improves physical health
Staying in treatment for an adequate amount of time and fully engaging with your treatment plan are the two most important factors for successful treatment outcomes. Participating in treatment for fewer than 90 days is of limited effectiveness. (7)
Myth #8: Relapse after rehab means that treatment didn’t work.
While relapse was once regarded as a catastrophe, it’s now considered to be a normal part of recovery. Just as it takes time to develop an addiction and the unhealthy thought and behavior patterns it produces, it takes time to learn healthy ways of thinking and behaving. It takes time to develop healthy lifestyle habits. It takes time to assemble the skills and strategies needed to prevent a relapse.
According to the National Institute on Drug Abuse, relapse rates for addiction are similar to those of other chronic diseases like diabetes and heart disease. Around 40 to 60 percent of people will relapse once in recovery. (8) But this doesn’t mean that treatment failed or that all is lost. In fact, relapse is largely regarded as an opportunity to determine what went wrong and develop the skills to correct it and prevent it from occurring again.
How you approach a relapse is extremely important. (9) Those who are filled with guilt, shame, hopelessness and self-hatred following a relapse are slower to get back on the road to recovery. They may abandon the idea of sobriety altogether. But those who approach a relapse with a positive attitude and work to develop the skills they’re missing are more likely to get back to recovery very quickly—and more motivated than ever to stay on track.
Myth #9: Life in recovery is dull.
One of the biggest fears people have when they consider getting help for an addiction is that life will be a drag without drugs or alcohol. For so long, substances provided comfort or staved off boredom, made socializing easier or helped ease the pain of loss or trauma. You may wonder how you’ll ever have fun or get excited about anything again without the help of your substance of choice.
The fact is, treatment is deeply focused on helping you find purpose, meaning and joy in a sober life. After all, the best relapse prevention tool is a life you actually enjoy without drugs or alcohol. You’ll spend a lot of time in treatment thinking about what you want the future to look like and setting actionable goals to get you there. You’ll work through your beliefs about happiness, and you’ll redefine fun. You’ll identify your strengths and values, your talents and passions. You’ll cultivate these and build a new life around them.
Treatment is anything but dull, and life after treatment will be what you make it. In treatment, you’ll develop an arsenal of the skills, strategies and resources you need. Your new ways of thinking about work, relationships, fun and meaning in life will help propel you toward authentic happiness.
Myth #10: After treatment, you’re left on your own in recovery.
You may wonder what will become of you once treatment is complete. Will you be sent off on your own to fend for yourself as you put everything you’ve learned into practice?
Not at all. An essential component of any high-quality treatment plan is aftercare. Aftercare is an individualized plan that helps you get through the early weeks and months of solo recovery. Your aftercare plan will likely include ongoing therapy and participation in a support group. Other components will be added based on your individual needs and challenges. These may include:
A sober living community to help ease your transition back into regular life
Vocational rehabilitation to help you find and maintain employment
Educational assistance for continuing your education
Legal assistance for ongoing legal problems
Ongoing monitoring of any co-occurring mental illnesses and the medications used to treat them
Help finding safe housing
Relapse prevention programming, including activities that promote developing healthy relationships and having fun
Contingency management programs that offer tangible rewards like cash or vouchers for attending meetings, meeting personal goals and staying sober
A case manager will be assigned to oversee your aftercare plan and make changes to it based on emerging needs. As you progress through recovery and no longer need certain supports, they’ll be dropped from the plan.
Accurate Information is Everything
If you or a loved one is addicted to drugs or alcohol, learning everything you can about addiction is important. This includes understanding how it develops, its common underlying issues, how it’s treated and how it can relapse. Once addiction is demystified, it’s easier to see a path forward, and it’s easier to hold on to hope for a better future.
Hope is the foundation of recovery. Hope is the belief that a better future is possible. If you’re thinking about exploring a future free of addiction, we can help.
(1) 10 Percent of US Adults Have Drug Use Disorder at Some Point in Their Lives. (2015, November 18). Retrieved from https://www.nih.gov/news-events/news-releases/10-percent-us-adults-have-drug-use-disorder-some-point-their-lives
(2) Understanding Drug Use and Addiction. (2016, August). Retrieved from https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction
(3) Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings. (2014, September). Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUHresultsPDFWHTML2013/Web/NSDUHresults2013.pdf
(4) Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition): Principles of Effective Treatment. (2012, December 1). Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment
(5) Recovery and Recovery Support. (2015, October 5). Retrieved from https://www.samhsa.gov/recovery
(6) McCaffrey, B. R. (1996, March). Treatment Protocol Effectiveness Study. Retrieved from https://www.ncjrs.gov/ondcppubs/publications/treat/trmtprot.html
(7) Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition): How Long Does Drug Addiction Treatment Usually Last? (2012, December 1). Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-long-does-drug-addiction-treatment
(8) Drugs, Brains, and Behavior: The Science of Addiction. (2014, July 1). Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
(9) Melemis, S.M. Relapse Prevention and the Five Rules of Recovery. (2015, September). Yale Journal of Biology and Medicine, 88(3), 325-332. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553654/