The Disease of Addiction

Facts & Myths

Myth – Drug addiction is voluntary behavior

FACT
Not every doctor or program may be the right fit for someone seeking treatment. For many, finding an approach that is personally effective for treating their addiction can mean trying out several different doctors and/or treatment centers before a perfect "match" is found between patient and program.

Myth – More than anything else, drug addiction is a character flaw

FACT
Drug addiction is a brain disease. Every type of drug of abuse has its own individual mechanism for changing how the brain functions.  But regardless of which drug a person is addicted to, many of the effects it has on the brain are similar: they range from changes in the molecules and cells that make up the brain, to mood changes, to changes in memory processes and in such motor skills as walking and talking. And these changes have a huge influence on all aspects of a person's behavior. The drug becomes the single most powerful motivator in a drug abuser's existence. He or she will do almost anything for the drug. This comes about because drug use has changed the individual's brain and its functioning in critical ways.

Myth – You have to want drug treatment for it to be effective

FACT
Virtually no one wants drug treatment. Two of the primary reasons people seek drug treatment are because court ordered them to do so, or because loved ones urged them to seek treatment. Many scientific studies have shown convincingly that those who enter drug treatment programs in which they face "high pressure" to confront and attempt to surmount their treatment, regardless of the reason they sought treatment in the first place.

Myth – Treatment for drug addiction should be a one-shot deal

FACT
Like many other illnesses, drug addiction typically is a chronic disorder. To be sure, some people can quit drug use "cold turkey" or they can quit after receiving one treatment just one time at a rehabilitation facility. But most of those who abuse drugs require longer-term treatment and, in many instances, repeated treatments.

Myth – People don't need treatment. They can stop using drugs if they really want to

FACT
It is extremely difficult for people addicted to drugs to achieve and maintain long-term abstinence. Research shows long-term drug use actually changes a person's brain function, causing them to crave the drug even more, making it increasingly difficult for the person to quit. Especially for adolescents, intervening and stopping substance abuse early is important, as children become addicted to drugs much faster than adults and risk greater physical, mental and psychological harm from illicit drug use.

Myth – Treatment just doesn't work

FACT
Treatment can help people. Studies show drug treatment reduces drug use by 40 to 60 percent and can significantly decrease criminal activity during and after treatment. There is also evidence that drug addiction treatment reduces the risk of HIV infection (intravenous-drug users who enter and stay in treatment are up to six times less likely to become infected with HIV than other users) and improves the prospects for employment, with gains of up to 40 percent after treatment.

Myth – Nobody will voluntarily seek treatment until they hit "rock bottom"

FACT
There are many things that can motivate a person to enter and complete substance abuse treatment before they hit 'rock bottom'. Pressure from family members and employers, as well as personal recognition that they have a problem, can be powerful motivating factors for individuals to seek treatment. For teens, parents and school administrators are often driving forces in getting them into treatment once problems at home or in school develop but before situations become dire. Seventeen percent of adolescents entering treatment in 1999 were self-or individual referrals, while 11 percent were referred through school.

Myth – You can't force someone into treatment

FACT
Treatment does not have to be voluntary. People coerced into treatment by the legal system can be just as successful as those who enter treatment voluntarily. Sometimes they do better, as they are more likely to remain in treatment longer and to complete the program. In 1999, over half of adolescents admitted into treatment were directed to do so by the criminal justice system.

Myth – There should be a standard treatment program for everyone

FACT
One treatment method is not necessarily appropriate for everyone. The best programs develop an individual treatment plan based on a thorough assessment of the individual's problems. These plans may combine a variety of of methods tailored to address each person's specific needs and may include behavioral therapy (such as counseling, cognitive therapy or psychotherapy), medications, or a combination. Referrals to other medical, psychological, and social services may also be crucial components of treatment for many people. Furthermore, treatment for teens varies depending on the child's age, maturity and family/peer environment, and relies more heavily than adult treatment on family involvement during the recovery process. "(They) must be approached differently than adults because of their unique developmental issues, differences in their values and belief systems, and environmental considerations (e.g., strong peer influences).

Myth – If you've tried one doctor or treatment program, you've tried them all

FACT
Not every doctor or program may be the right fit for someone seeking treatment. For many, finding an approach that is personally effective for treating their addiction can mean trying out several different doctors and/or treatment centers before a perfect "match" is found between patient and program.

Myth – People can successfully finish drug abuse treatment in a couple of weeks if they're truly motivated

FACT
Research indicates a minimum of 90 days of treatment for residential and outpatient drug-free programs, and 21 days for short-term inpatient programs to have an effect. To maintain the treatment effect, follow up supervision and support are essential. In all recovery programs the best predictor of success is the length of treatment. Patients who remain at least a year are more than twice as likely to remain drug free, and a recent study showed adolescents who met or exceeded the minimum treatment time were over one and a half times more likely to abstain from drug and alcohol use. However, completing a treatment program is merely the first step in struggle for recovery that can extend throughout a person's entire lifetime.

Myth – People who continue to abuse drugs after treatment are hopeless

FACT
Drug addiction is a chronic disorder; occasional relapse does not mean failure. Psychological stress from work and family problems, social cues (i.e. meeting individuals from one's drug-using past), or their environment (i.e. encountering stress, objects, or even smells associated with drug use) can easily trigger a relapse. Addicts are most vulnerable to drug use during the few months immediately following their release from treatment. Children are especially at risk for relapse when forced to return to family and environmental situations that initially led them to abuse substances. Recovery is a long process and frequently requires multiple treatment attempts before complete and consistent sobriety can be achieved.

SOURCES (unless otherwise noted): Principles of Drug Addiction Treatment: A Research-Based Guide. (October 1999). National Institute on Drug Abuse, National Institute of Health; Alan I. Leshner, Ph.D., former Director of the National Institute on Drug Abuse (2001).