As Clinical Director of a relatively large mental health conglomerate that specializes, to a large extent, in the treatment of addiction
, I am constantly amazed by the amount of misinformation currently in circulation regarding the causes, nature, consequences, and treatment of addictions. Furthermore, I am saddened by the effect that many of these myths have on the people who are dealing with addiction - primarily the fact that the instant these individuals admit that they have a problem, they are shamed and stigmatized on many levels by family, friends, employers, and society in general, which often delays or prevents them from seeking the help they so desperately need.
Adi Jaffe, a former methamphetamine addict and convicted drug dealer, now an addiction psychologist and researcher, has written on CNN about his own experience with prejudice against drug addicts:
I’m still required to finish three years of drug testing before I can earn a state psychology license-in spite of the fact that I’ve already received a PhD, been drug-free for 10 years, successfully completed a drug rehab program, and undergone three years of previous drug testing.
The fact that addicts risk not only familial and social degradation but legal restrictions on housing, driving, child custody, business and professional licensing, etc. may keep many “in the closet” with their problem, even when they know they have an issue and would like to address it. In fact, research conducted by Jaffe and several colleagues shows that stigma and shame are significant barriers to addicts initially seeking treatment. As such, many addicts keep things quiet for as long as possible - too ashamed and/or afraid of stigmatization to seek assistance - choosing instead to continue in their addiction until they experience negative consequences so significant that the people around them finally intervene and push them toward rehab and recovery. Interestingly, this same study finds that education about addiction, especially information that can be anonymously accessed through online sources, helps to reduce the shame/stigma barrier, increasing the likelihood of treatment.
Knowing this, I’d like to provide a bit of that education by addressing six of the most commonly repeated and damaging myths about addiction and recovery. Hopefully this information will help at least one or two addicts overcome their shame and fears about admitting to a problem and seeking help.
- Addicts Are Easy to Spot: When most people think about addiction, they picture grizzled men in dirty clothes who hang out under bridges sharing wine bottles and needles. In truth, only a small percentage of addicts fit this low-bottom stereotype. Most work very hard to keep up appearances-primarily because they don’t want others to know about and therefore attempt to curtail their addiction. The vast majority of addicts are “functional,” with jobs and loving families. This does not, however, mean they’re not emotionally isolated and miserable. It is unfortunate that belief in this Skid Row myth often causes doctors, therapists, and loved ones to delay interventions until addicts have “bottomed out” and it’s undeniably obvious that there is a serious issue. This waiting game is counterproductive. Severity of consequences is unrelated to success in recovery, and there is no need to put things off until a desperate moment. In fact, the earlier an intervention takes place, the better. For tips on initiating an intervention, click here.
- Addiction Requires a Substance: An increasing percentage of addicts aren’t hooked on a substance at all. Instead, they have a behavioral (or process) addiction, such as compulsive gambling, compulsive spending, or sexual addiction. This concept makes more sense when you understand the true nature of addiction: Addicts don’t use to feel better and have a good time (even though their use probably started out that way); instead, they use to escape from and/or to control what they are feeling. In short, they want to avoid emotional discomfort and the pain of underlying psychological disorders like depression, anxiety, and unresolved trauma. Substance addicts create the desired “neurochemical numbness” by ingesting various chemicals; behavioral addicts create the same exact neurochemical numbness by engaging in intensely stimulating (and therefore intensely distracting) activities. Brain imaging research actually proves this, showing that the brains of substance addicts and behavioral addicts “light up” in the same spots and to the same degree when presented with addictive stimuli (and the brains of non-addicts don’t).
- Prescription Drugs Are Not Addictive: The common perception is that alcohol and marijuana are the primary gateways to hardcore addiction. In days of yore that was likely true. In today’s world, however, prescription medications are the more common danger-particularly prescription opioids like OxyContin, Vicodin, Percocet, and Percodan; benzodiazepines like Valium and Xanax; sleep medications like Ambien and Lunesta; and stimulants like Adderall, Dexedrine, and Ritalin. Over-the-counter medications can also be abused, most notably cough medications like Robitussin-DM and Sudafed. For the most part, one of more of these drugs is available in the average household’s medicine cabinet, meaning they are accessible to anyone, including children and teens. And kids know how to misuse these drugs in ways that get them high-taking much more than the recommended dose, crushing pills and inhaling them (to get a “rush” that solid pills don’t provide), etc. Many young people are “garbage can” drug abusers, taking whatever prescription or OTC medications are available, sometimes coupling this with alcohol and/or illicit drug use. Because of the belief that prescription medications are not dangerous or addictive, their abuse is often minimized, not only by young people but by their parents, who may also be abusing these drugs.
- Addiction is a Choice: This myth implies that addicts just like to party, or they’re weak-willed, or they’re just inherently bad and immoral people. These beliefs lead to a great deal of social and even legal prejudice-both of which can prevent addicts from “coming clean” and seeking treatment. And yes, addicts do tend to behave in ways that reinforce these negative perceptions. That said, addiction is not a choice, and addicts are neither weak-willed nor inherently bad. Certainly in the beginning people do choose to drink or use drugs or gamble or chase sexual fantasies or whatever, but not because they want to be addicted. Addiction is a chronic, debilitating disease, and people don’t want it any more than they want diabetes or cancer. Instead, people initially experiment with addictive substances and behaviors as a form of recreation, and the vast majority don’t progress beyond this social enjoyment stage. However, as discussed above, some people are predisposed toward addiction through genetics and/or environment. These unfortunate individuals sometimes learn they can self-soothe emotional discomfort-stress, depression, loneliness, anxiety, boredom, and the like-by numbing out with a substance or an intense behavior. Over time, this escapist coping mechanism can rewire the brain-primarily areas in charge of mood, memory, and decision-making-and the initial desire for an addictive substance/activity becomes a need. At that point, users lose control over their ability to not use, and their ability to stop using once they’ve started, no matter the negative consequences they may experience. This “lack of choice” is the primary element that defines addiction.
- Addiction is Entirely Genetic: There is a belief that addiction is driven entirely by genetics. This belief causes some people to simply give up, believing they are doomed from the start, and others to throw caution to the wind, thinking they don’t have the addiction gene and can therefore do whatever they want. This myth is actually grounded in fact, as dozens of studies show a link between genetics and addiction. However, research also shows that genes are not the only factor, and that environmental influences play an equally significant role. Furthermore, genetics can be easily overridden by environment. For instance, abused and/or neglected children are incredibly at-risk for addiction regardless of genetics. In truth, the majority of people who do (or don’t) become addicts are brought down by (or manage to overcome) a combination of risk factors, so the risk for addiction is less an argument about nature versus nurture and more an examination of how the two factors come together to influence a particular person.
- Drug Addiction Fries Your Brain: Perhaps you remember the late-1980s fried egg commercial telling viewers, “This is your brain on drugs.” The ad, sponsored by the Partnership for a Drug-Free America, was effective in terms of making at least a few people think twice about trying illicit drugs. Unfortunately, it also gave the impression that people hooked on drugs automatically and permanently become useless zombies. This created a societal perception of addicts and recovering addicts as damaged goods, setting the stage for unnecessary and misguided discrimination by employers, insurers, health care providers, the legal system, and others. In reality, although addictions do “rewire” addicts’ brains in harmful ways, this damage is typically undone or circumvented with a period of continued sobriety. In fact, the brains of most recovering addicts return to baseline within six to eighteen months, depending on genetic makeup and addiction history, as long as the addict stays clean and sober.
The good news is that despite the many myths about addiction, many addicts have sought treatment and established long-term sobriety and recovery, living healthier, happier, and more productive lives. The bad news is that many more addicts are shamed and stigmatized into silence and continued addiction. The simple truth is addiction is a chronic, progressive, and potentially fatal yet treatable disease, much like heart disease, diabetes, and cancer. In other words, addicts are not bad people, they are sick people. And they deserve empathetic and supportive treatment just like any other sick person. Hopefully, as the above myths are systematically debunked, an increasing percentage of addicted individuals will seek out the assistance and recovery they desperately need.
Robert Weiss LCSW, CSAT-S is Senior Vice President of Clinical Development with Elements Behavioral Health. He has developed clinical programs for The Ranch outside Nashville and The Sexual Recovery Institute in Los Angeles.A licensed UCLA MSW graduate and personal trainee of Dr. Patrick Carnes, Mr. Weiss is author of Cruise Control: Understanding Sex Addiction in Gay Men and Sex Addiction 101: A Basic Guide to Healing from Sex, Porn, and Love Addiction,and co-author with Dr. Jennifer Schneider of both Untangling the Web: Sex, Porn, and Fantasy Obsession in the Internet Age and Closer Together, Further Apart: The Effect of Technology and the Internet on Parenting, Work, and Relationships, along with numerous peer-reviewed articles and chapters. For more information for Rob on Facebook and Twitter.