By Karen James, LCSW-C, Manager, Adult Therapy Services
Both Myth and Science offer explanations of our world and our experiences in it. In ancient cultures, myths were invented stories created to explain otherwise inexplicable events and occurrences. Humans always want to know why. Listen to any three-year-old —or perhaps to adult conversations where we each explain it all to each other (sometimes called monologues!). We want to know WHY and we want to KNOW why. Sometimes our desire to KNOW leads us to accept beliefs which should be better examined.
Myths and misunderstandings about substance abuse and addiction too often cause harm to those facing such issues—whether one is affected directly by addiction itself, or loving someone who deals with addiction. Their hope for recovery and sobriety can be stolen from them by these biases and prejudices. Certainly many beliefs cut them off from others and leave them isolated and alone in their struggle.
The science of addiction has made great strides in recent years, but have we kept up? What are some of these myths about addiction? What is their harmful impact? What is the rational, scientific “take” on some of these myths?
MYTH: Addiction is a failure of will-power.
HARM: Addicts may be chastised by themselves or others as weak. They may try to keep using only will-power to recover, but will-power does not work on diseases.
SCIENCE: Addiction is now understood to have real physiological impact on the brain, actually changing how it operates. Addiction processes take place in a part of the brain that is not under conscious control (the mesolimbic dopamine system). Recovery demands consistent hard work, and the process of reaching it is worthy of respect.
MYTH: Addicts are different from us. They are (choose your pejorative) crazy, low-class, stupid, lazy, even bad people.
HARM: Risky behavior may be tolerated and early addiction signs missed because “that doesn’t happen to people like us.” Also, believing prejudices or bigotries about oneself or one’s group does not empower a person to change course.
SCIENCE: Addicts may have a genetic predisposition, but they are the same as everyone else. Addicts come from every class, ethnicity, religion, or other category you can describe. Addiction is now understood to be a brain disease. Different effects may be caused by different substances, but the resulting anatomical, electrical and chemical changes within the brain are the same. Molecules and cells actually change with continued use.
The good news? With sustained effort and hard work, they can change back to better functioning brains.
MYTH: People choose to become addicts.
HARM: “How can she be so incredibly selfish?” “How can I ever forgive myself for what I have done?” “Why does my child hate me so much to cause all this pain?” Harsh judgments are made about addicts, and this does not encourage recovery. Hopelessness feeds the disease and causes more pain for families.
SCIENCE: People may choose to experiment with drugs or alcohol. For some, however, there is an invisible line between recreation and addiction. Usually that line is only detectable in hindsight. After it is crossed, substance use is no longer under an individual’s conscious control. The changes in the brain have taken over and deeply affect a person’s decision-making processes. Choice is no longer an operative concept. Treatment helps people deal with cravings while making the changes in cognition and behavior that re-create the brain and re-establish a life.
MYTH: Relapses and repeated attempts at rehabilitation show that there is no hope for recovery.
HARM: Stealing hope again — and not accurate. This myth may cause families and friends to pull away when they are most needed.
SCIENCE: The Big Book from Alcoholics Anonymous is a good source here, calling addiction “a cunning and baffling disease.” Science would call it a chronic disease with relapse rates similar to those for other chronic illnesses, such as hypertension, diabetes, and asthma. Relapse can be expected, but so can a return to sobriety. It is more helpful to understand the vulnerabilities and triggers that were part of the relapse, and to use this event as a way to learn more. Different people may need different approaches to fit their issues. Many people go through several rehabilitation programs. The idea is never to give up.
If you or someone close to you is struggling with addiction, think about your assumptions. If we can sort out the myths from the science, we will create a more supportive emotional and intellectual environment for real recovery. And we will do no harm.
By Karen James, LCSW-C, Manager, Adult Therapy Services, Jewish Community Services, Baltimore, MD
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