12 Misconceptions about addiction

An addiction misconception is a false narrative held by individuals regarding the cause, development, and treatment of addictions. These are typically mere echoes of prejudices, false assumptions, misinformation one has received, and a lack of understanding of the disease.

Misconceptions about addiction contribute to addiction problems in several ways. First, they create stigma, leading individuals to feel shame and isolation, which discourage them from seeking help. Second, these false beliefs influence policy and treatment approaches, often resulting in ineffective solutions that do not address the root causes of addiction. Third, they lead to a lack of empathy and support from society, making it harder for those struggling with addiction to find the resources and understanding they need. Finally, misconceptions perpetuate a cycle of misinformation, making it difficult to implement and sustain effective prevention and treatment strategies. By addressing these misconceptions, a more supportive environment is fostered, which encourages recovery and reduces the overall impact of addiction.

The misconceptions about addiction are listed below.

• Addiction is a choice.
• People with addiction can just quit if they really want to.
• Once an addict, always an addict.
• Addiction only involves drugs and alcohol.
• Prescription drugs can’t be addictive if used as directed.
• Addiction only affects those experiencing emotional difficulties.
• It is easy to spot addiction.
• Addicts cannot function in society.
• Addicted people must hit rock bottom to start recovering from addiction.
• Addiction treatment is the same for everyone.
• Relapse means treatment has failed and treatment can’t start over.
• Rehabilitation doesn’t work.

1. Misconception: Addiction is a choice.

Truth: Drug use starts as a choice but evolves into a compulsive disorder where self-control is lost, marking the onset of addiction. Viewing addiction as simply a choice significantly exacerbates the condition. This perspective fosters stigma and shame, causing individuals to feel judged and isolated, which prevents them from seeking help. The lack of empathy and support from those around them further compounds the issue, discouraging individuals from pursuing treatment.

Additionally, this view leads to ineffective treatment approaches that rely on punishment rather than addressing the complex biological, psychological, and environmental factors involved in addiction. By oversimplifying addiction as a matter of personal choice, this perspective overlooks the intricate interplay of brain chemistry, genetics, and environmental influences, ultimately hindering effective intervention and recovery efforts.

This misconception of addiction as a choice or a medical condition has been a topic of debate. A significant portion of experts lean towards the latter view, as evidenced by the research article “Drug addiction: Is it a disease or is it based on choice?” authored by Marc N. and published in the Journal of the Experimental Analysis of Behavior in 2011. This article reviews Gene Heyman’s book, “Addiction: A Disorder of Choice”. Heyman presents a comprehensive analysis of various forms of evidence to substantiate his claim that choice underpins the development of addiction.

The research article“Addiction is a disease: We must change our attitudes toward addicts” authored by Matthew B. Stanbrook published in the Canadian Medical Association Journal in 2012, highlights the powerful influence of genetics, environment, and neurobiology. The article explains that addictive substances hijack the brain’s reward system, impair decision-making, and induce lasting changes in brain structure, challenging the misconception that addiction is a choice or moral failing.

Addiction is a chronic disease that affects the brain. Just as heart failure damages the heart, addiction harms the brain’s ability to function normally. This makes it difficult for people with addiction to control their drug use, even if they want to stop.

2. Misconception: People with addiction can just quit if they really want to.

Truth: Quitting is often more challenging than it appears. The misconception that individuals with addiction can quit if they truly want to leads to several harmful outcomes. It oversimplifies addiction by reducing it to a matter of willpower, ignoring the complex interplay of biological, psychological, and environmental factors involved. This view dismisses the need for comprehensive treatment and support, resulting in prolonged substance use and relapse as individuals struggle without adequate help. It shifts the blame to the individual, fostering self-blame and guilt, which discourage them from seeking professional help and perpetuate the cycle of addiction.

Furthermore, by minimizing the importance of professional treatment, therapy, and support services, this misconception leads to ineffective attempts to quit and an increased likelihood of relapse.

The misconception that people with addiction can just quit if they really want to, implying that addiction is simply a matter of personal willpower. It suggests that the primary barrier to overcoming addiction is a lack of desire or commitment, rather than acknowledging the complex interplay of factors that contribute to the condition. This is incorrect because according to a study titled“Ordinary people associate addiction with loss of free will” authored by Andrew J. Vonasch et al. published in the journal Addictive Behaviors Reports in 2017, ordinary people think addiction is linked to a loss of personal control. The research suggests that self-discipline is essential for success, and a lack of it increases the risk of addiction. People who think they control their own actions are better equipped to resist addictive behaviors. Conversely, those who doubt their ability to make choices or consider fate determines their actions are more likely to struggle with addiction.

3. Misconception: Once an addict, always an addict.

Truth: This misconception significantly undermines recovery efforts. By reinforcing a fixed mindset, this notion leads individuals to feel powerless and destined to fail, despite their attempts to overcome addiction. This sense of inevitability abstains from taking help and making meaningful changes in life. Additionally, if individuals are convinced they cannot change, they are more likely to relapse, feeling that recovery is an unattainable goal. This mindset leads to lack of motivation and self-efficacy, causing people to accept their addiction as a permanent condition rather than pursuing recovery as a viable possibility.

Once an addict, always an addict is a misconception that implies the permanent and unchangeable nature of addiction. People with addiction consider recovery as a battle without end.

The outdated misconception that addiction is a permanent condition is being disproved by modern research. The National Institute on Drug Abuse’s publication titled, “Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition)” revised in January 2018 confirms that lasting recovery from substance abuse is achievable for many individuals. It emphasizes that recovery is a long-term journey often involving multiple treatment phases and potential setbacks, much like managing other chronic conditions. These findings reinforce that addiction does not have to be a permanent state and that with the right interventions, individuals achieve and maintain a healthy, addiction-free life.

4. Misconception: Addiction only involves drugs and alcohol.

Truth: The misconception that addiction only involves drugs and alcohol supports addiction by maintaining a narrow focus that overlooks other potentially addictive behaviors. This limited perspective causes individuals to disregard or minimize the seriousness of non-substance-related addictions, leading to a lack of awareness and appropriate treatment for these conditions. Additionally, this view stigmatizes those with behavioral addictions, implying that their struggles are less valid or severe compared to drug addiction, which discourages them from seeking help. Moreover, concentrating exclusively on drugs and alcohol addiction results in underestimating the risks associated with other addictive behaviors, preventing individuals from recognizing and addressing the harmful impact these behaviors have on their lives.

The misconception that addiction only involves drugs and alcohol, which confines the concept of addiction to substances like drugs and alcohol, ignoring the reality that addiction involves various behaviors and activities. While substance abuse, such as alcohol and drug use, is a common form of addiction, it’s not the only one. Addiction is a complex brain disease that involves a compulsive pattern of behavior, regardless of the substance or activity involved.

Addiction encompasses a broad range of conditions, including both substance-related and behavioral disorders. Conditions such as gambling disorder, internet addiction, and binge eating disorder are recognized as serious and impactful.

5. Misconception: Prescription drugs can’t be addictive if used as directed.

Truth: Contrary to the commonly-held belief that prescription drugs are inherently safe, these medications pose serious risks when misused or even used as directed. This is due to the fact that these medications still include potent ingredients that have the potential to gravely affect the body and brain. The risk of developing an addiction to prescription medicines is constant, and many of them have major negative effects. They ought to only be taken under the guidance of a qualified medical expert, never by anyone else or without adhering to the authorized dosage. A prescription from a doctor doesn’t guarantee complete safety. A study “Prescription Drug Use and Misuse in the United States:Results from the 2015 National Survey on Drug Use and Health” authored by Arthur Hughes et al. published in the National Survey on Drug Use and Health (NSDUH), Substance Abuse and Mental Health Services Administration (SAMHSA) in 2016, revealed a startling number of Americans misusing prescription drugs. Despite the common misconception that these medications are safe when used as directed, nearly 19 million people misused prescription psychotherapeutic drugs that year.

The misconception that prescription drugs can’t be addictive if used as directed implies that these medications are inherently safe from addiction when taken according to a doctor’s instructions, suggesting that the risk of addiction only arises from misuse or abuse. However, this belief is flawed, as prolonged use of prescription medications lead to the development of tolerance in the body, necessitating higher doses to achieve the same effect. This phenomenon, known as drug tolerance, is typical of many commonly abused substances, including nicotine and alcohol. Other addictive prescription drugs include opioids like hydrocodone and oxycodone, sleep aiding medicines such as zolpidem, and stimulants like methylphenidate found in Ritalin. Prescription drug addiction is challenging to recognize, affecting individuals across a wide range of demographics, including both men and women, younger and older adults, and people from various socioeconomic backgrounds.

A report titled “Drug Abuse Warning Network, 2011: National Estimates of Drug-Related Emergency Department Visits” published by the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA) in 2013, revealed 1.2 million of emergency room visits related to nonmedical use of prescription drugs, over-the-counter drugs, or other types of medications in 2011. The report indicates that 46% of these cases involved pain relievers, with 29% specifically related to narcotic pain relievers. Emergency room visits related to prescription drug misuse saw an increase of more than 132% between 2004 and 2011. Visits specifically involving opioids rose by around 183% during the same period.

Therefore, the misconception that prescription drugs cannot be addictive if used as directed is misleading. Prescription medications, particularly opioids, benzodiazepines, and certain stimulants, have a well-documented risk of addiction even when used according to medical guidelines.

6. Misconception: Addiction only affects those experiencing emotional difficulties.

Truth: Attributing addiction primarily to emotional difficulties supports addiction by fostering stigma and misunderstanding. This view stigmatized individuals, portraying their struggles as personal weaknesses rather than recognizing addiction as a complex condition influenced by multiple factors. Such stigma discourages people from seeking help, as they feel their issues are perceived as personal failings. Additionally, this belief leads to an oversimplified understanding of addiction, neglecting critical factors like genetics, social environment, and biological predispositions. As a result, treatment approaches become inadequate if they fail to address the full range of contributing factors. Furthermore, focusing solely on emotional problems in prevention efforts overlooks other significant strategies that address genetic, environmental, and behavioral risk factors. This narrow focus potentially misses key opportunities for intervention and support.

Addiction only affects those experiencing emotional difficulties is a misconception, suggesting that addiction is solely a result of emotional or psychological problems, implying that only individuals with significant emotional struggles are susceptible to addiction. It overlooks the complex interplay of various factors that contribute to addiction. This is misleading as addiction is a multifaceted condition influenced by various factors beyond emotional struggles. While emotional difficulties contribute, addiction involves genetic predisposition, biological factors, environmental influences, and behavioral patterns. The study titled“The Genetic Basis of Addictive Disorders” authored by Francesca Ducci and David Goldman published in the journal The Psychiatric Clinics of North America in 2012, indicates that genes influence each stage of addiction, from initiation to the development of the disorder. The study emphasizes that addiction is the result of interactions between genetic factors and environmental influences, underscoring the complexity of addiction beyond just emotional difficulties.

7. Misconception: It is easy to spot addiction.

Truth: The assumption that addiction is readily identifiable has detrimental consequences. It leads to the lack of recognition of less apparent forms of addiction, resulting in delayed diagnosis and treatment. This misconception fosters a narrow focus on stereotypical signs of addiction such as weight loss, disheveled appearance, slurred speech, financial and health issues, often overlooking individuals who exhibit more subtle symptoms like mood swings, irritability, absenteeism from office, school or social events.

It is easy to spot addiction, suggesting that addiction is always visible and easily identifiable by their actions, appearance, or lifestyle choices. This misconception leads to the notion that if someone does not display these apparent signs, they are not struggling with addiction or do not need help. This simplistic view fails to account for the wide range of addiction manifestations that are well-hidden, thus overlooking individuals who need support. This is mistaken as it fails to account for the fact that identifying addiction is challenging, especially when individuals are in denial. Denial acts as a psychological defense mechanism that distorts reality, making it difficult for individuals to accept the truth of their addiction. To shield themselves from the emotional distress of acknowledging their condition, they use various defense mechanisms, such as suppressing memories of substance use, rationalizing their behavior, or shifting blame onto external factors or others.

For example, society often paints a distorted picture of alcoholism, perpetuating stereotypes that hinder diagnosis and treatment. Contrary to popular misconception, alcoholics are not confined to a single mold. The image of a homeless, unemployed individual struggling with chronic alcohol abuse is a harmful oversimplification. High-functioning alcoholics, those who seemingly manage their lives despite excessive drinking, challenge these stereotypes. The research article “Subtypes of Alcohol Dependence in a Nationally Representative Sample” authored by Howard B. Moss et al. published in the journal Drug and Alcohol Dependence in 2007, indicates that the majority of alcoholics do not fit the profile of the stereotypical, “low-bottom” drinker. This misconception contributes to underdiagnosis and delayed intervention.

8. Misconception: Addicts cannot function in society.

Truth: This misconception that addicts cannot function in society reinforce stigma and discrimination, making individuals less likely to seek help for their addiction due to fear of being perceived as incapable or worthless. This stigma discourages them from accessing treatment or support, as they are reluctant to admit their struggles if they consider that they are judged as unable to contribute to society. Additionally, this misconception leads to a narrow focus on the most visible, severe cases of addiction, while overlooking those who manage to hide their issues or maintain their responsibilities.

Addicts cannot function in society, suggesting that addiction renders individuals incapable of performing everyday tasks or maintaining responsibilities. It assumes that addiction always leads to dysfunction and social withdrawal. This is flawed because it does not consider that many individuals with addiction continue to function effectively in their personal and professional lives, maintaining jobs, family relationships, and social connections despite their struggles.

Functional addicts, who outwardly appear normal, are adept at hiding their problems to avoid reputational or career damage. They achieve professional success and maintain active social lives while concealing their addiction from even close friends and family. The study titled“Researchers Identify Alcoholism Subtypes” published by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in 2007 found that 19.5% of U.S. alcoholics, typically middle-aged, well-educated, and with stable families, jobs, and good income, are highly functional and well-established.

9. Misconception: Addicted people must hit rock bottom to start recovering from addiction.

Truth: Believing that hitting rock bottom is a prerequisite for recovery delay intervention and treatment. This mindset causes people to avoid seeking help until they experience severe negative consequences, exacerbating the damage done by addiction. It leads to a fatal attitude where individuals wait for a dramatic crisis to trigger their desire for change, potentially leading to worsening health, strained relationships, and increased risk of overdose or other severe outcomes. Moreover, it discourages early intervention efforts by suggesting that recovery is only possible after reaching an extreme low point.

Addicted people must hit rock bottom to start recovering from addiction, suggesting that individuals with addiction cannot begin the recovery process until they reach a point of extreme crisis or total collapse. The research article “Identifying ‘Hitting Bottom’ among Individuals with Alcohol Problems: Development and Evaluation of the Noteworthy Aspects of Drinking Important to Recovery (NADIR)” by Megan Kirouac and Katie Witkiewitz, published in the journal Substance Use and Misuse in 2017, explores the concept of “hitting bottom.” This idea, which has been discussed for over 50 years, was first introduced in a 1965 paper on alcohol addiction, suggesting that individuals need to “hit rock bottom” before they change. The endorsement of this concept has been linked to treatment entry and improved treatment adherence.

The concept of a universal “rock bottom” is misleading, as personal experiences and tolerance levels vary greatly. While some individuals face a dramatic crisis that prompts them to seek help, others proactively address their addiction before reaching such extreme conditions. It is crucial to recognize that experiences with addiction are highly individual, and what one person considers “rock bottom” differs from another’s experience. Factors like co-occurring mental health conditions and personal circumstances influence this pivotal moment. Ultimately, the desire for change, whether spurred by a crisis or a proactive decision, drives the process of seeking help and embarking on the path to recovery.

10. Misconception: Addiction treatment is the same for everyone.

Truth: A one-size-fits-all approach to addiction treatment is ineffective and counterproductive. Ignoring individual differences undermines treatment success by failing to address specific challenges and strengths. Generic programs often lack the tools necessary to prevent relapse, contributing to higher rates of treatment failure. Moreover, the perception of a standardized approach reinforces harmful stereotypes, deterring individuals from seeking help. Ultimately, a lack of personalization compromises treatment efficacy, leading to prolonged recovery and increased costs.

This misconception is misleading because it assumes a one-size-fits-all approach to addiction treatment, where all individuals receive the same type of intervention without considering their unique needs and circumstances. This view overlooks the fact that addiction is a complex and multifaceted disorder that varies from person to person.

The assertion that addiction treatment is identical for everyone is fundamentally flawed and hinders recovery. Addiction is a complex disease shaped by various factors including genetics, and environment. Additionally, factors such as the onset, type, duration, and severity of the addiction, as well as co-occurring mental health issues and personal life circumstances, all influence treatment needs and responses.

The study “Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention” by Nora D. Volkow and Carlos Blanco, published in the World psychiatry: Official Journal of the World Psychiatric Association (WPA) in 2023, emphasizes the need for personalized treatment plans for substance use disorders. Treatment intensity needs to align with the severity of the addiction and any co-occurring mental or physical health conditions. A Chronic Care Model, which adapts treatment over time, is recommended. This model suggests that substance use disorders (SUD) treatment needs to be tailored to the individual’s evolving needs, with the intensity of interventions adjusted according to the severity of the disorder.

Additionally, it advocates for the integrated treatment of co-occurring psychiatric and physical conditions, recognizing that effective management of SUDs involves addressing all aspects of a person’s health. The study further advocates for a shift away from punitive measures, such as incarceration, towards therapeutic approaches. This change not only reduces costs but improves outcomes in terms of substance use and overall mortality.

11. Misconception: Relapse means treatment has failed and treatment can’t start over.

Truth: Viewing relapse as a definitive failure has devastating consequences for individuals struggling with addiction. This misconception fosters feelings of shame and discouragement, often leading to treatment abandonment. It creates a barrier to continuous care, as individuals are reluctant to re-engage in treatment after setbacks. Consequently, the perception of relapse as a catastrophic event increases the likelihood of prolonged substance use and hinders the recovery process.

The misconception that relapse means treatment has failed and treatment can’t start over, stems from the misconception that recovery is a linear process. This perspective views relapse as an indication that the entire treatment effort was ineffective, rather than acknowledging that recovery often involves setbacks and requires ongoing effort and adaptation.

The research article “Relapse Prevention and the Five Rules of Recovery” by Steven M. Melemis, published in The Yale Journal of Biology and Medicine in 2015, underscores that recovery is a gradual process that begins weeks or even months before an individual resumes substance use. Melemis identifies three stages of relapse: emotional, mental, and physical. Understanding these stages helps to recognize that relapse is not a failure of treatment but rather a signal to address underlying issues and adjust the recovery plan.

12. Misconception: Rehabilitation doesn’t work.

Truth: The misconception that rehabilitation doesn’t work reinforces addiction in multiple ways. It discourages individuals from seeking or continuing treatment, thus perpetuating their addiction and obstructing the path to recovery. Additionally, it undermines trust in treatment programs and support systems, weakening the community and social support necessary for effective recovery.

Rehabilitation doesn’t work stems from the misconception that addiction treatment is ineffective or fails to produce lasting results. This view often emerges from observing high relapse rates or hearing anecdotal stories of unsuccessful treatment experiences, leading to the assumption that rehabilitation as a whole is ineffective.

This misconception is not correct, as rehabilitation has proven to be an effective tool in overcoming addiction, especially when tailored to individual needs and complemented by ongoing support. While some individuals voluntarily seek treatment, others enter rehab under pressure from legal, familial, or professional circumstances. According to chapter 5 titled “Specialized Substance Abuse Treatment Programs” in the Treatment Improvement Protocol (TIP) Series, No. 24 published by the Substance Abuse and Mental Health Services Administration (U.S.) in 1997, effective rehab treatment is linked to active participation. The chapter outlines that prolonged abstinence and extended treatment durations improve recovery rates. It was found that nearly 90% of individuals who remain abstinent for two years stay drug and alcohol-free after ten years. Individuals with fewer psychological or social issues and continued involvement in aftercare or self-help groups have a higher chance of sustained recovery.