“We may think there is willpower involved, but more likely… change is due to want power. Wanting the new addiction more than the old one. Wanting the new me in preference to the person I am now.”
~ George A. Sheehan
One of the unfortunate side effects of the rise of mental health issues in the United States is the concurrent rise of common misconceptions about substance abuse and addiction. There is no question that substance abuse and addiction can lead to a profound change in behavior and even mental processes. However, addiction may not always look exactly the same for every individual, in every case, and in every family. Everything from the representation of substance abuse and addiction in the media to a general lack of understanding of the issue in the general public have given rise to many different misconceptions about substance abuse and addiction.
These misconceptions range from what addiction looks like, to why addiction is an issue for many people, to what is required for effective treatment of substance abuse and addiction. No matter the specific area, misconceptions about this mental disorder can be damaging, both to those struggling with substance abuse and addiction and to those attempting to remedy it. With this in mind, here we address these misconceptions directly and present the reality to contrast the damaging effects of these misconceptions. While the ‘myths’ of substance abuse are not limited to those discussed here, the six specific misconceptions that we address include:
- Substance Abuse and addiction is a choice
- Addiction to prescription drugs is different than other forms of addiction
- Addiction is the result of a moral failure or personality flaw
- Substance abuse and addiction always take the same form
- Drug addiction is more dangerous than alcoholism
- Substance abuse treatment does not work because of relapse rates
Misconception #1: Substance Abuse and Addiction is a Choice
In exploring the various myths about drug abuse and addiction, one of the most common misconceptions that arises is that substance abuse, addiction and alcoholism are all personal choices. The reality is quite different from this unfortunate misconception. In fact, the initial use of drugs or alcohol may be a choice, but addiction itself is stronger than any personal choice or personality.
“A person starts out as a n occasional drug user, and that is a voluntary decision. But as time passes, something happens, and that person goes from being a voluntary drug user to being a compulsive drug user. Why? Because over time, continued use of addictive drugs changes your brain – at times in dramatic, toxic ways at others in more subtle ways, but virtually always in ways that result in compulsive and even uncontrollable drug use.”
~ Alan I. Leshner, National Institute on Drug Abuse
In other words, substance use changes the brain in a way that makes quitting the drug or alcohol use not so much a matter of strong willpower and more an issue of getting treatment and professional help as a means of recovery. After decades of research on the topic, the vast majority of addiction experts are convinced that addiction itself is not a choice – and that does not even delve into the issues of genetic predisposition, environmental influences, and socioeconomic factors.
Misconception #2: Addiction to Prescription Drugs is Different Than Other Forms of Addiction
Because prescription opioids are not only legal but also prescribed in increasingly common circumstances, many people may think of these prescription drugs as being exempt from the dangers of addiction. This could not be further from the truth. From serious painkillers like OxyContin and Percocet to seemingly innocuous benzodiazepines like Xanax, prescription medications should be treated with extreme caution, particularly for individuals who have a family history of addiction.
“Despite the fact that prescription drug abuse has reached epidemic proportions in the past decade, the use of ‘legal’ drugs to get high carries less stigma than the use of illicit drugs. There is a widespread misconception that they are safer than street drugs. They are not. When a person takes a prescription medication in a larger dose or more often than intended or for a condition they do not have, it affects the same areas of the brain as illicit drugs and poses the same risk of addiction.”
~ Dr. David Sack, Psychology Today
Parents and counselors alike tend to minimize the risk of prescription drugs in talking to young people about substance abuse and addiction. This is an extremely dangerous misconception, particularly with the opioid epidemic that has been on the rise in the United States in recent years. If you or someone you know are using a prescription medication in any other way than its prescribed use, it is time to reach out for help today.
Misconception #3: Substance Abuse is the Result of a Moral Failure or Personality Flaw
Related to thinking of addiction as a choice, many people may think of substance abuse as having to do with the personality or morality of the individual struggling with the issue. Again, nothing could be further from the truth. The reality is that a variety of psychological and social factors work against individuals to create the apparent necessity of substance abuse in the short-term and the struggle of addiction in the long-term. Some of these factors include:
- Addiction as a mental disorder: As we mentioned above, addiction has been shown time and again to be a mental disorder on par with depression or anxiety. For those with the disorder, there is very little that they can do for themselves outside of seeking out the professional help and support of loved ones that they need to recover. Even this initial step can be quite difficult given the relative strength of addiction caused by substance abuse.
- Environmental factors: From growing up in a dysfunctional home to being surrounded by a unique type of peer pressure, one’s environment can heavily influence the likelihood of substance abuse. Clearly, these environmental factors are outside the control of any single individual.
- Genetic influences: Addiction is a family disease in more ways than one. If your family has a history of addiction or substance abuse, you are much more likely to deal with similar struggles. Again, this is outside of individualized control, and shows that substance abuse is far from the result of any kind of moral failure or flaw in personality.
- Developmental factors: Turning to substance abuse, which can directly result in addiction, can often be the result of other psychological influences. These influences include everything from suffering from another mental health disorder (such as ADHD or PTSD) or struggling with anxiety or depression, particularly from a young age.
Misconception #5: Substance Abuse and Addiction Always Look the Same
Most people have a preconceived notion of what substance abuse looks like, and how addiction takes shape in individual lives. The reality is that there are as many different experiences of addiction as there are people, and many people can abuse substances without making it apparent to those around them. Not every drug addict can be found on a street corner or in a motel, and not every alcoholic shows up to work drunk. That said, there are certain signs of addiction to look for. Despite the differences in how addiction takes shape in individual lives, it is almost always associated with at least several of the following symptoms of substance abuse:
- A sudden or gradual change in relationships
- Decreased performance either at work or at school
- Marked changes in energy levels and sleep patterns
- Avoidance of social situations and certain relationships
- Legal or financial troubles as a result of substance use
- Multiple attempts to quit using the drug or drinking alcohol, without success
- An increase in tolerance for the substance
- Withdrawal symptoms after a period of not using the substance
Misconception #6: Drug Addiction is More Dangerous Than Alcoholism
Many people tend to think of alcohol as being completely safe, and not having an addictive nature at all. This is beyond a dangerous misconception. Make no mistake: alcohol is a drug. Just because it is a more socially acceptable drug does not mean that it cannot have the same detrimental impact when casual drinking turns into addiction. Hard drugs like heroin or crystal meth may have a worse reputation because of their addictive and dangerous nature, but alcohol can be just as dangerous if it goes unchecked. In fact, many more people die from alcohol-related issues than from drug overdose in the United States.
The threat of alcoholism becomes even more dangerous with this misconception, since it allows people to continue to abuse alcohol while being in denial about their own addiction. To avoid this danger, alcohol should be understood in the same way as any other drug.
Misconception #7: Substance Abuse Treatment Does Not Work
Finally, some people may think of substance abuse and addiction treatment as inefficient or entirely dysfunctional, given the high rates of relapse associated with addiction. This is a crucial misconception to address directly, since misunderstanding addiction can undermine recovery in the long run.
“In addition to contributing to the stigma of addiction and deterring people from seeking treatment, research shows that shame is a strong predictor of relapse. Still, the media perpetuates the myth that there is a right way and a wrong way to recover, and that treatment that is luxurious or comfortable is inherently bad. The myths about addiction are damaging not only to addicts and their families but to all of us. By understanding addiction as a brain disease and allowing people to recover in the way that works best for them, we can make significant strides in addressing the nation’s leading public health problem.”
~ Dr. David Sack, Psychology Today
In fact, addiction treatment (either through inpatient drug rehab or a form of intensive outpatient treatment) is one of the best ways to overcome substance abuse and get set up for dealing with addiction in the long run. Relapse is a very real possibility, but this speaks to the detrimental power of addiction rather than to the inadequacy of treatment for it. With the right approach, addiction treatment can be the key to recovery.
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