15 Common Misconceptions About Addiction

Misconceptions about addiction are prevalent in today’s society and contribute to stigma. This is a list of 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.


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

misconceptions about addiction

Interview: Substance Abuse Counseling

An interview with JS, a substance abuse counselor who works with people from all walks of life.

JS is a certified substance abuse counselor who works at a residential treatment center in northern Virginia. The following article is about his work, thoughts on relapse, what it’s like to lose a client, stigma, and valuable advice for anyone considering a career in addiction counseling.


Interview: “They Are Just People”

JS works at an intermediate-length residential center for adults with substance use and mental health disorders. The clients live in shared dorms and adhere to a daily schedule that includes counseling, psychoeducation, groups, 12-step meetings, and medication therapy.

Once a client successfully completes the inpatient portion of treatment, they transition to “re-entry.” In re-entry, clients reside in sober living homes and receive continuing care services. They are able to look for employment, start working, and “re-enter” the larger community. JS provides counseling and support services for this component.

Inspired to help

JS has personal experience with addiction. “I am a person in recovery… About a decade ago I found myself in a very dark place and had to get help… I met a substance abuse counselor [who] changed my life. He educated me, engaged me, and challenged me. He was instrumental in turning my life around.”

With his counselor’s encouragement and support, JS made the decision to get back on track. He realized that he wanted to help others who struggled. “My own experiences with addiction allow me to have an incredibly deep empathy for the clients I serve and the fulfillment I receive in return is unreal.”

“Addiction does not discriminate”

JS works with people from all walks of life. He’s worked with individuals who are homeless to young fathers to successful businessmen; from people in their teens to adults in their late 80’s. “There is no age, sex, gender, race, sexual orientation, religion, occupation, or economic class that is safe from addiction.”

As for the substances abused, the list is never ending, but JS regularly sees people addicted to alcohol, opiates (including heroin), cocaine, methamphetamine, and PCP. Many of the clients he counsels also have mental illness such as depression, anxiety, or bipolar disorder.

No typical days

According to JS, “typical” days don’t exist where he works. “There is no way to describe a typical day in this field. One day I could be [providing therapy] and another day could involve a trip to the emergency room or helping out with chores… I never know what to expect and I never get bored.”

Effective treatment planning is important for substance abuse counselors; JS meets with his clients to develop an individualized service plan. Clients come up with their own goals, and JS supplies interventions to help them achieve their goals over the next couple of months.

According to JS, client goals vary, ranging from attending 12-meetings to obtaining a driver’s license to enrolling in school; basically, a goal can be any life skill a person may need for success. Corresponding interventions could include providing bus tokens to get to AA meetings, linking to driving school, and helping to fill out college applications and apply for financial aid.

JS explained that adults who have been incarcerated or dealing drugs for a living miss out on major milestones such as learning to drive, attending college, renting an apartment, etc. Furthermore, basic skills that many of us take for granted, such as filling out an online form or depositing a check can be overwhelming for someone newly in recovery who never learned how.

JS meets with his clients at least once per week for therapy sessions. I asked what comes up in a typical session and his response was “anything and everything.” Sessions may involve reviewing goals, learning coping skills, poop jokes (his clients are all men), or processing childhood trauma.

Substance abuse and relapse

“Not good” was JS’s response when I asked what the success rate was for someone who completes re-entry. He explained that this is a reflection of the general rates of recovery in substance abuse, which are low. “It can be disheartening, working with someone for months and when they leave, they relapse in less than a week.”

JS explained that while relapse is a deterrent to the field for some counselors, he sees it differently. “For me, it will never be a deterrent. My battle with addiction was not easy, nor was it accomplished in a single attempt. Relapse is a part of my story. I would not be here if people gave up or lost hope that I could get better. For that, I will never give up or lose hope that my clients can recover, no matter how many times they relapse.”

For JS, losing a client, not relapse, is the hardest part of the job. “I’ve worked with many clients who didn’t make it. I’ve lost clients to overdose, suicide, and homicide. It never gets easier.”

JS grieves for his lost clients. “I find myself wading through the stages of grief until I reach some level of acceptance.”

What everyone needs to know about substance abuse

“The people I work with are just people. They are your sister, your cousin, your neighbor, or the guy in line at the grocery store. They are people with families, jobs, hobbies, and dreams.”

JS discussed ignorance and stigma; he shared that individuals with substance use disorders are often subjected to mistreatment, even from professionals in the field. “There are substance abuse counselors who perpetuate harmful addiction myths, once widely accepted as fact, but discredited by the scientific community decades ago.”

JS shared examples of common myths:

  • “All addicts are liars.”
  • “Addicts are lazy and selfish.”
  • “It’s not a disease, it’s a choice.”

“The lack of compassion when it comes to substance abuse is mindboggling and painful to encounter. Often, it stems from a lack of understanding or knowledge about substance abuse and those with substance use disorders. They are just people who are struggling with something far beyond their control. And those in treatment? They are just people trying to get better. And in case I didn’t make it clear; they are just people.”

Advice for new substance abuse counselors

“Be willing to learn. The field of addiction treatment is constantly changing. Standard practices from 20 years ago are now ineffective and outdated. If you want to do this work, be open to learning the newest treatment models, medications, and research on addiction. This field is not static, and we do our clients a major disservice when we quit learning.”

As a last piece of advice, JS suggested self-care for substance abuse counselors as a way to combat burnout. “Identify ways to decompress. This job is not easy. Some of the people you help will die. Compassion fatigue is a real thing and you must take care of yourself to care for others.”


“They are just people.”

JS

substance abuse

40 Worst Comments About Mental Illness on Quora

What questions are people asking about mental health? Quora posts indicate that misconceptions and myths related to mental illness and addiction prevail. Read the top 40 most unsettling questions on Quora.com.

I turned to Quora (an online platform for asking questions) to see what people today are asking about mental illness. What I found ranged from thought-provoking to comical to disturbing, illustrating how common misconceptions are. Here are some of the worst comments and questions I came across:

woman sleeping
Photo by Ivan Oboleninov on Pexels.com

40 Worst Comments & Disturbing Posts About Mental Illness (on Quora)

1. “Is mental illness really an illness?”

2. “Is mental illness catchable?”

3. “Do people with mental disorders have friends?”

4. “Are people who self-harm just looking for attention?”

5. “Is drug addiction really just a lack of willpower?”

6. “Can a person be intelligent and a drug addict?”

7. “Should drug addicts be left to die?”

8. “Why can’t drug addicts just stop? What compels a person to continue with a destructive behavior despite the obvious problems their behavior causes?” (Note: Addiction is a brain disease, which is why someone struggling with substance abuse can’t “just stop.”)

9. “Why should one feel sorry or sympathetic for drug addicts, given most of them chose this life?”

10. “Instead of ‘rescuing’ drug addicts who have overdosed, wouldn’t society as a whole benefit from just letting nature take its course?” (If that was the case, shouldn’t we then withhold all types of medical treatment and preventative or life-saving measures… to allow nature to take its course?)

11. “Is there any country in the world that won in the war against drugs by killing the users or the drug addicts?”

12. “Why should we lament drug addicted celebrities dying of drug-related causes? It’s their fault for starting a drug habit.”

13. “Why save drug addicts from overdosing? From my experience they were problems for their families, a drain on society from their teen years, and won’t get better once addicted.” (All diseases are a drain on society to an extent; that doesn’t mean lives aren’t worth saving.)

14. “How do you differentiate between drug addicts and real homeless people when giving money?” (You don’t; find other ways to help.)

15. “What are the best ways to punish an alcoholic?”

16. “Don’t you think it’s time we stop spreading the myth that alcoholism is a disease? You can’t catch it from anyone. One chooses to drink alcohol.”

17. “Why do people who are oppressed/abused never defend themselves and have pride?”

18. “Why don’t I have empathy for people who end up in abusive or unhealthy relationships? I feel that they deserve it for being such a poor judge of character.”

19. “Why do most women put up with domestic violence?” (Most women?? “Put up”??)

20. “Are schizophrenics aware they’re crazy?”

21. “Are schizophrenic people allowed to drive?”

22. “Do people who become schizophrenic become that way because they are morally conflicted?”

23. “Are schizophrenics able to learn?”

24. “Can a schizophrenic be coherent enough to answer a question like ‘What is life like with schizophrenia?’ on Quora?”

25. “Can one ‘catch’ schizophrenia by hanging out too long with schizophrenics?”

26. “Can schizophrenics have normal sex?” (Yes, or kinky, whichever they prefer)

27. “Why do people ignore the positive impact spanking has on raising children?” (See #28)

28. “Is being spoiled as a child a cause of mental illness such as depression?” (No, but spanking is linked to mental disorders and addiction in adulthood.)

29. “Should mentally ill people be allowed to reproduce?”

30. “Should people with mental illness be allowed to vote?”

31. “Are we breeding weakness into the gene pool by treating and allowing people with physical and mental illnesses to procreate?”

32. “Why are we allowing mental illnesses of sexual orientation disturbance and gender identity disorder that were changed for political reasons, to be accepted like race?”

33. “Why do some people with mental illness refuse to work and live off the government when they are perfectly capable of working?”

34. “Why are mentally disturbed women allowed to have children?”

35. “I feel no sympathy for the homeless because I feel like it is their own fault. Are there examples of seemingly “normal” and respectable people becoming homeless?”

36. “How is poverty not a choice? At what point does an individual stop blaming their parents/society/the government and take responsibility for their own life?” (White privilege at its finest)

37. “Why are mental disorders so common nowadays? Is it just an “excuse” to do bad or selfish things?”

38. “Are most ‘crazy’ people really just suffering from a low IQ?”

39. “Why do some people have sympathy for those who commit suicide? It is very cowardly and selfish to take your life.”

40. “Is suicide part of the world’s survival of the fittest theory?”


worst comments

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