15 Common Misconceptions About Addiction

Despite a large body of scientific research, myths and misconceptions about addiction remain prevalent in today’s society, contributing to stigma, barriers to treatment, and higher health burdens. The following is a list of common misconceptions.

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15 COMMON MISCONCEPTIONS ABOUT ADDICTION

1. Misconception: Addiction is choice.

Fact: Addiction is widely recognized as a primary disorder of the brain. According to the American Society of Addiction Medicine, “Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.” Heavy and continuous use of drugs/alcohol damages the brain, increasing the likelihood of addiction.

Despite this, choice can play a role in long-term sobriety, similar to how lifestyle decisions (i.e. treating symptoms, exercising, eating well, etc.) play a role in the management of other chronic illnesses such as diabetes or heart disease.

2. Misconception: Addiction is a character flaw or weakness.

Fact: The idea that addiction is a moral failing is based on the moral model of addiction. The reality is that addiction has little to do with moral conviction; both inherently “good” and “bad” people are susceptible to developing a substance use disorder.

That being said, a person in active addiction may act in contrast to their values; but that doesn’t mean they’re morally flawed. The moralization of addiction and associated stigma only contribute to guilt, shame, and a decreased willingness to seek treatment.

3. Misconception: Addiction is the result of a lack of willpower (and if someone “wanted it enough,” they would quit).

Fact: Like other chronic illnesses, addiction cannot be “willed” away. Individuals with substance use disorders are not compromised in willpower or lacking in self-discipline.

“The mentality and behavior of drug addicts and alcoholics [are] wholly irrational until you understand that they are completely powerless over their addiction and unless they have structured help, they have no hope.”

Russell Brand

4. Misconception: Some people have “addictive personalities.”

Fact: The truth is that every personality “type” is prone to addiction; we’re all biologically wired for addiction since our thoughts/behaviors are influenced by the brain’s reward system. Risk factors, not personality traits, are linked to the development of a substance use disorders. Risk factors may include biological influences (including genetics and differences in brain receptors), environmental influences, age of first use, and method of use.

5. Misconception: Many people use trauma as an “excuse” for using drugs/alcohol.

Fact: There is a strong association between trauma and addiction, and research indicates that addiction is directly linked to childhood abuse and trauma. It may seem like an excuse, but substance use is oftentimes a means of survival and/or a way to cope with unthinkable atrocities.

6. Misconception: Relapse is part of the process.

Fact: While relapse is relatively common, it doesn’t have to be a part of recovery. There are many contributing factors, both biological and environmental (i.e. stressors), that increase the chances of relapse.

Successful relapse prevention plans involve the avoidance and/or management of risk factors. Also, the less severe the addiction, the more likely someone is to avoid relapse altogether.

7. Misconception: Abstinence is the only path to recovery.

Fact: Recovery is not one-size-fits-all. For some, abstinence may be the only acceptable route, but for others, a reduction in use or the use of a less harmful substance is the desired outcome.

8. Misconception: You have to attend 12-step meetings and work the steps to get sober.

Fact: While AA and NA are often part of sustained sobriety, they are not the only way to stop using drugs or alcohol. Alternative evidence-based treatments for addiction include cognitive behavioral therapy, medication, family therapy, and group therapy.

9. Misconception: You have to be “ready” to stop using in order for treatment to work.

Fact: Addiction is characterized by ambivalence (i.e. you want to get sober and at the same time, you want to get high). Motivation comes and goes. A person may enter treatment with no intention of quitting, and then undergo a significant transformation. Or, someone may feel 100% ready to stop only to later change their mind. Ambivalence is normal.

That being said, the consequences of addiction (or costs of using) are oftentimes what tip the motivational balance, leading to increased motivation.

“When you can stop, you don’t want to, and when you want to stop, you can’t.”

Luke Davies

10. Misconception: You have to want recovery for yourself before you can get sober.

Fact: External motivators (i.e. the threat of losing a job, divorce, legal consequences, etc.) frequently precipitate treatment, and motivation is then internalized during treatment.

Research indicates that success rates of mandated treatment are similar to voluntary treatment; moreover, mandatory treatment is associated with increased rates of completion.

11. Misconception: You have to hit “rock bottom” before you can recover.

Fact: Sustained sobriety can be attained without experiencing severe consequences. While the costs of using are often what motivates someone to get sober, there’s no rule that you have to “bottom out” first. This misconception can be deadly; you may die waiting (or death may be your “rock bottom”).

“Remember that just because you hit bottom doesn’t mean you have to stay there.”

Robert Downey, Jr.

12. Misconception: If you’re receiving medication-assisted treatment (MAT), you aren’t really sober.

Fact: MAT is a highly effective evidence-based treatment for opioid use disorder; it helps to sustain long-term recovery. There are also FDA-approved medications for the treatment of alcoholism. MATs effectively and safely relieve withdrawal symptoms and reduce psychological cravings.

13. Misconception: Needle exchange programs and safe injection sites enable continued use.

Fact: Harm reduction methods reduce HIV/HCV infections and decrease overdose deaths. According the the CDC, “the majority of syringe services programs (SSPs) offer referrals to medication-assisted treatment,  and new users of SSPs are five times more likely to enter drug treatment and three times more likely to stop using drugs than those who don’t use the programs.” SSPs are proven and effective, and aren’t linked to increased drug use or crime.

14. Misconception: Narcan enables continued use.

Fact: Narcan (an opioid reversal medication) enables life. It gives someone a chance for recovery.

15. Misconception: “Once an addict, always an addict.”

Fact: Having a substance use disorder increases your chances of becoming addicted to other substances, but the belief that you’ll forever be an “addict” can be counterproductive or harmful. People grow and change, and may stop viewing themselves as “addicts” when they leave the lifestyle behind.

The belief that “once an addict, always an addict” also depends on the recovery model you subscribe to; for example, AA/NA principles support the idea of the “lifelong addict,” but those who believe in other models may prefer to call themselves “ex-addicts” or simply say, “I don’t drink.”

“Though no one can go back and make a brand new start, anyone can start from now and make a brand new ending.”

Carl Bard

Cassie Jewell, M.Ed., LPC, LSATP