While the term addiction might conjure up stereotypical images of certain demographics or substances, addiction, and substance use don’t discriminate against age, gender, or social class and could involve substances such as illicit drugs, prescription pills, alcohol, and gambling.
Not all addictions look the same. For some people, addiction and substance use can be a quiet struggle experienced in isolation; while for others, it might be a battle that includes intervention, detox, or adhering to a strict treatment program.
In order to better understand how people are affected by addiction & substance use, and how to treat addiction, we want to dispel some common myths and misconceptions surrounding the topic.
1. Addiction and Substance Use Are the Same Thing
The terms ‘substance use’ and ‘addiction’ are often used interchangeably, but there are some key differences. A substance disorder is primarily defined by how someone voluntarily uses alcohol or drugs, while addiction is categorized by withdrawal symptoms, compromised brain functions, and a person’s inability to control their impulses to use substances.
Scientists believe the compulsive and destructive behaviors that come about in addiction disorders are due to physical changes in areas of the brain that are critical for decision-making, memory, learning, and behavior control.
According to the National Institute on Drug Abuse (NIDA), “Addiction is defined as a relapsing, chronic brain disease that is characterized by compulsive drug-seeking use, despite harmful consequences. It is considered a brain disease because drugs change the brain; they change its structure and how it works. These brain changes can be long lasting and can lead to many harmful and often self-destructive behaviors.”
Some scientists and health professionals argue that the difference between substance use and addiction is that substance use alters the brain only briefly, while an addiction alters the brain to a point where it becomes a mental health issue.
Dr. Gabor Maté, addiction expert, speaker, and best-selling author, argues that it’s not drugs themselves that change brain chemistry and create addiction; it’s trauma or the experience of loss, however minute over the course of our lives, that causes the brain neuropathways to alter and predispose someone to develop addictive habits. He points to how addictive tendencies govern the most basic and life-sustaining needs and functions, such as incentive and motivation, physical and emotional pain relief, the regulation of stress, and the capacity to feel and receive love. Furthermore, Mate believes that addiction should be treated with compassion. Click here to view Dr. Gabor Mate’s video, What is addiction? where he elaborates on this.
“Choices do not happen without a brain – it is the mechanism of choice. The quality of a person’s choices depends on the health of that mechanism. Even if taking a drug for the first time is a free choice, the progression of brain changes that occur after that involves the weakening of circuits in the prefrontal cortex and elsewhere that are necessary for exerting self-control and resisting the temptations of drug use. Once addiction takes hold, there is greatly diminished capacity, on one’s own, to stop using.”- Dr. Nora Volkow, writing for the National Institute on Drug Abuse
2. Addiction to prescription medications is less harmful than other substances
Pain relievers, tranquilizers, stimulants, and sedatives can be beneficial when used according to medical guidelines. However, misuse of these substances often occurs as people seek pleasure or stress relief. This misuse alters the brain’s reward circuit, contributing to substance use disorder and making it difficult to control behavioral impulses.
While prescription drugs are largely perceived as ‘safe’ because they are dispensed by a doctor, their effects can be just as harmful, if not more dangerous, than illegal drugs. If you look at opioids such as heroin and oxycodone, for example, they have the same addictive properties and effects, but one is accessible over the counter.
Opioid addiction often starts with prescription medications like oxycodone, which interacts with opioid receptors in the brain to alleviate pain and produce feelings of euphoria. Due to its highly addictive nature, misuse can quickly lead to an opioid use disorder, contributing to the growing opioid crisis. Even after treatment, the likelihood of relapse is high, as the changes to the brain’s reward circuit make it challenging to maintain long-term abstinence.
In fact, the current opioid crisis in America highlights prescription drug addiction as the fastest-growing form of addiction in the world, due in part to its widespread availability and the public’s misconceptions about prescription pills.
3. The answer to addiction is quitting cold turkey
Quitting addictive substances suddenly can be dangerous, even life-threatening for an addict due to severe withdrawal symptoms, including being sick and other physical symptoms, that can harm the brain and body. Due to this, many people use to avoid withdrawal symptoms.
For addiction recovery, rather than quitting cold turkey, NIDA suggests that addiction treatment medications should be paired with behavioral therapy rather than relying solely on willpower. That’s because addiction can change the brain’s chemistry, making it hard to quit even if you want to.
Treatment often includes behavioral therapy to help people develop healthier ways to cope with stress and emotional pain, which are common reasons for using drugs or alcohol in the first place. These coping skills can make a big difference in achieving long-term recovery and reducing relapse rates.
4. Addiction is a sign of weakness
Many factors play into the development of an addiction, including psychological conditions beyond an individual’s control or choice, such as anxiety or depression; family history of addiction; life stress; peer pressure from friends; and/or a dependence brought on by prescribed medications for an injury/condition. However, Dr. Maté argues that addiction is often the result of a lack of nurturing during childhood, trauma, and/or the experience of loss.
Despite the difference of opinion, addiction is nonetheless categorized as a mental illness that affects memory, decision-making, and judgment, meaning a person suffering from addiction may no longer have the psychological mechanisms necessary to carry out acts of willpower.
Addiction is a widespread issue in the United States, affecting approximately 20.4 million adults with a substance use disorder, according to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) most recent data. Unfortunately, negative attitudes and stigmas surrounding addiction often act as barriers to seeking help, delaying critical care and support for those struggling. Substance use treatment centers play a vital role in changing this narrative by offering evidence-based treatment options that combine medication-assisted treatment, therapy, and oftentimes peer support. These organizations not only provide immediate relief from the grips of addiction but also pave the way for long-term recovery, equipping individuals with the tools and coping skills needed to lead a healthier, fulfilling life. By addressing the misconceptions and stigmas around addiction, we can facilitate more effective care and encourage those affected to take the first step toward recovery.