Multiple Paths to and from Addiction

Run away from the person who says there is only one path to sobriety

Posted May 16, 2014

Richard Nixon launched what we now easily and habitually refer to as The War on Drugs, naming drug use as “public enemy number one” in 1970. A little more than ten years later, Ronald Reagan upped the rhetoric by declaring drug use as a “threat to national security.” Nancy Reagan took this message to elementary and secondary schools. In response to an elementary schoolgirl’s question about what to do if offered drugs, Nancy Reagan advised her to “Just Say No.”

The “Just say no” approach was codified in many ways, and became the underpinning of all sorts of educational programs about drugs. This “just say no” approach is the first cousin to abstinence only sex education. In each case, the burden is put on a young person to be able to exert near super-human powers of resistance to substances and behaviors that seem mighty tempting to that age group. Or to any age group really.

While I could write a piece on why this sort of educational approach is bound to fail, this isn’t my focus. Rather, I want to coopt the expression “Just say no,” and extend it to the view that there is only one way to recover. This seems a perversely appropriate cooptation.

Just say no to the view that there is only one right way to recover. Just say no to the belief that all people need to recover by the same means or method.

Some of us in moral philosophy debate whether it is part of human nature to project our beliefs and attitudes on to others or a matter of acquired habits. Regardless of the origin of this tendency, we all seem to do it. People in recovery or who work in the field are no different. Some people who have recovered by using a particular program or professionals may have the best intentions; they know how high the stakes are.  

Often their projections or exhortations to use a particular program rest on two problematic assumptions. The first is that their way is right/best. The second is that there are no other viable options. Combined, these two beliefs produce a companion belief that if a person fails with this method, she perhaps is not trying hard enough.

This belief assigns blame to the individual rather than exploring the possibility that this method may not be effective for this person with that addiction in this context. My italics are meant to emphasize that there are at least three different variables, each of which is extraordinarily complex.

Each person’s addiction has its own trajectory. This is not to say there are not commonalities to people’s addictions. The brains of people who share the same addiction may respond the same way. The advances in brain science have been illuminating for addiction. But even with these commonalities it is important to recognize there are important differences between people with the same addictions. People begin to use and abuse for particular reasons and these reasons may have a stranglehold on a person. Some people may have other physical or psychological co-occurring conditions.

Addictions vary dramatically in the sorts of pleasures or highs or other effects they produce. The brain responds differently to different substances and behaviors. The frenetic high that is produced by cocaine is different from the on-beyond mellow of heroin is different from the dissociative effects of other drugs. Different drugs affect different parts of one’s psyche as well as the body itself.  

The context in which one lives and is trying to be sober matter enormously. Some people will have access to first rate medical care. Others will not. Some will have access to medications that may relieve cravings (naltrexone and acamprosate) while others not and yet others want to avoid all drugs even if they might help. Some will have supportive friends and families while others will be undermined by people who are threatened by someone getting sober.

Given all these complexities, it is more prudent to multiply options for achieving sobriety than to limit them.  

If you are told by anyone (a physician, a brain scientist, a counselor, spiritual advisor, a member of a self-help group or blogger) that “you must recover this way,” I suggest that you just say no to that view.