The nature of addiction


in Geek stuff, Politics, Psychology, Science

Over on XUP’s blog, there is an interesting discussion on addiction. It is certainly a difficult topic on which to get good information: the academic literature is complicated and conflicting.

Perhaps it is a topic about which our understanding will improve considerably as we delve deeper into cognitive and behavioural psychology, as well as into the relationships between complex dynamic systems like genetics and cognition.

On this site, I have repeatedly argued that the best public policy approach to addictive drugs is legalization, regulation, and the treatment of addiction as a medical problem. Bad as it is to be addicted to legal drugs, at least those thus afflicted don’t need to worry about being poisoned or surprised by a major change in the concentration of active ingredients, since those drugs are manufactured by reputable companies and regulated. Those people also don’t need to worry about the pitfalls of production and supply chains that are dominated by organized criminal groups. Paradoxically, addicts may have the most to gain from drug legalization.

In addition, society at large doesn’t need to worry about the violent and harmful side-effects that arise from that criminal economy. The links between drug criminalization, organized crime, and political corruption are both self-evident and demonstrated by numerous historical examples, from alcohol prohibition in the United States to the largely pointless attempts to stamp out poppy growing in Afghanistan now.

Perhaps an important corollary to the legalize, regulate, and treat approach is to hold producers responsible to some extent for the inevitable addictions to their products that will exist in society. They could, for instance, be required to pay part of the cost for treatment, counseling, and rehabilitation programs.

{ 39 comments… read them below or add one }

. May 21, 2010 at 10:46 am

Ottawa From the Down Side Up

An active drug user in the Ottawa Community, Junkie_Monkey has spent the last six years as a street-involved youth. This blog will range from stories unrelated to drug use, to real & graphic stories of drug use. I hope to give you a look at the streets thru the eyes of a drug user.

XUP May 21, 2010 at 12:41 pm

I totally agree. From what I’ve read, law enforcement pretty much agrees with this viewpoint, too. It seems to be only politicians (and those who have been scared enough by politicians) who are in favour of this never-ending, futile, incredibly expensive “war on drugs.”

Milan May 21, 2010 at 1:50 pm
Matt May 21, 2010 at 4:39 pm

I can’t agree with you more. I haven’t seen any evidence that the baseline level of addiction would rise with legalization (of course, regulation would still be necessary).

Someone like myself is unlike to say “now that heroin is legal, I think I’ll try a bit.” Addiction is unfortunate, but it will always be a problem for a subset of the population. Why flush money down the toilet fighting it?

R.K. May 21, 2010 at 4:50 pm

Where people are allowed to use drugs is also a significant policy area.

Alcohol – for example – we allow in all sorts of pleasant places. Sports games, nightclubs, opera houses, etc. All this is a kind of implicit endorsement.

Smokers are increasingly banished outside, and even pushed farther and farther from doors and windows.

One way to deal with the risk of more people wanting to try ‘hard’ drugs if they are legalized would be to restrict them to uncool settings. Let people try heroin if they want to, but only in some ugly government-run clinic.

oleh May 22, 2010 at 8:44 pm

“Perhaps an important corollary to the legalize, regulate, and treat approach is to hold producers responsible to some extent for the inevitable addictions to their products that will exist in society. They could, for instance, be required to pay part of the cost for treatment, counseling, and rehabilitation programs.”

I agree.

I wonder if we do so sufficiently with additions such as smoking (tobacco companies), alcoholism (spirit, wine and beer manufacturers) and gambling (casinos and governments). These can be very destructive behaviour which we allow.

Tristan May 23, 2010 at 7:18 am

More important than the regulation of the ability of services is the regulation of the circulation of information. As such, I think it is more important to ban advertising than ban the sale of products. It goes without saying, then, that I think advertising of tobacco, alcohol, other drugs, and gambling should all be illegal.

The point of advertising is to ensure an atmosphere of imperfect information – and addictive products are those where imperfect information is the most destructive. They reveal the economy as primarily libidinal, not rational, and therefore we need to stop the liberal pretence of rational agency and take account of how people really act if we want to reduce harm.

Antonia May 24, 2010 at 8:58 am

The academic literature is complicated and conflicting Naturally because addiction does not have a singular nature – apart from psychological aspects of addiction, the pathways affected by physically addictive substances vary considerably and often lie amid the subtleties of physiology which have great diversity between individuals. Unless focusing on a single compound, it is the literature of addictions not of addiction.

However, everyone I’ve met involved with conducting or (from the civil service end) analysing drug rehabillitation success programmes agrees that the approaches you mention are the ones that the evidence-base supports.

Nearly a century of criminalisation-based control policies haven’t yet offered control of the problem.

As well as consumer-nation benefits, it would be likely also significantly assist narco-dependent national economies efforts at domestic stabilisation. Once a government can stop burning farmers crops (effectively paying over-the odds for increasing hostility to government authority and agencies) you can actually start to work with the agricultural sector more effectively to reduce the proportion of narcotics crops by supporting and developing replacement crops over time. There’d probably be an immediate incentive if reduced security overheads etc reduced the value of drugs crops and supply (I strongly recommend ‘consumer’ nation governments arranging supply so that, whatever tax income they decided to slap on, quality was affordable to users so as to avoid perpetuating the local and global might (including armament) of black market suppliers.). (btw I ran across a few weeks back)

If legal, there are issues for social services management and funding though – there would need to be more mechanisms for disincentivising uptake and motivating and funding user rehabillitation (including streaming approaches with alcoholism services, where appropriate). Passing the costs of rehabilitation straight back to users is problematic as is discourages or blocks people whose resources have been consumed by their habit from entering the process and charging back from earning afterwards can keep them trapped in a poverty loop. Direct taxation on the products paying for related mop-up services (and anything over going to other projects) seems best but only so long as it doesn’t raise prices so far that the black markets control the game again.

Illegal drugs control measures could then include more public awareness and general focus on the widescale problem of counterfeit and substandard pharmaceuticals

Antonia May 24, 2010 at 9:00 am

Sorry Milan – I accidentally appended gmail rather than yahoo to my address a moment ago – should have been yahoo. Please correct or replies will go astray.

Antonia May 24, 2010 at 9:05 am

hold producers responsible This aspect of your argument I have a problem with. Producer nations and farmers are by and large least capable to address or afford the consumer-nation costs of dealing with the problem and enforcement attempts would lead to a similar, if not more aggressive, treatment of farmers and producer nations than at present. The profits are eaten up by the heavyweights involved in the supply chain (including bribed government officials). Penalising already damaged local and national economies won’t give them the room to climb out of economic reliance on narcotics. It will just further cripple them.
Where drugs-production occurs in the consumer nation, making domestic producers bear some responsibility (though they couldn’t carry the imported problem) would make sense.

Antonia May 24, 2010 at 9:14 am

Afghanistan, for example, needs time to deal with its widespread internal drug-use problems and find alternatives for agriculture where climate issues, farming and transport infrastructure need careful consideration for any replacement crop to take hold.

So many growing regions are controlled (there and elsewhere) by armed groups looking for easy funding that alternatives aren’t easy for farmers. The hunt (and expertise + labour) for profitable mixed crops after commercial monocultures of any sort is hard even without such pressures.

Milan May 24, 2010 at 10:20 am

I accidentally appended gmail rather than yahoo to my address a moment ago – should have been yahoo.


Milan May 24, 2010 at 10:22 am

Producer nations and farmers are by and large least capable to address or afford the consumer-nation costs of dealing with the problem and enforcement attempts would lead to a similar, if not more aggressive, treatment of farmers and producer nations than at present.

I wasn’t thinking of producer nations so much as of the companies that would produce and sell drugs if they were legalized. Johnny Walker and Absolut are already liable if they make a batch of liquor that is tainted with methanol or some other nasty thing. It also seems fair that they should pay some of the costs associated with alcoholism.

It seems like the same should apply to companies that sold cannabis, cocaine, etc.

Tristan May 24, 2010 at 4:17 pm

I don’t think it’s obvious that alcohol or drug manufacturers should pay directly for the costs associated with alcoholism – what is wrong with taxing their products and using that tax money to pay for the social costs?

I think it’s incorrect to say that the producers of alcohol and cannabis “cause” the social ills associated with these products – because the “baseline” of the non-existence of their products is a right-wing childlike fantasy. In effect, if you ban the sale of these products, alternative manners of production simply come into existence. With alcohol – people make it themselves (this is very easy, as it turns out, as long as you make only beer, cider and wine). As for drugs, we all know the situation.

Taxing is more appropriate because it doesn’t decide between the producer or the consumer as for the “cause” of the ill.

But, as usual, my comments about the role of public relations in the distribution of products associated with social ills is ignored. We internet savvy should know – information is far more powerful than matter.

Tristan May 24, 2010 at 4:19 pm

“Afghanistan, for example, needs time to deal with its widespread internal drug-use problems”

Afghanistan, as with most countries in the world, has a poverty problem. Address poverty and these problems will largely disappear – although of course the capitalist libidinal machine will do its best to encourage new problems in the name of freedom, with the goal of slavery.

Milan May 24, 2010 at 5:33 pm

It doesn’t really matter whether you oblige firms that sell addictive products to provide assistance to addicts directly, or just tax them more and use that revenue to run government services.

All I am saying is that there is are externalities associated with addictions, and that enterprises that profit from selling addictive products should recompense the public at large for some of them.

That being said, it does seem possible that there could be a good counter-advertising effect to have beer, wine, and spirits vendors publicly associated with the treatment of alcoholism, liver disease, etc. Same goes for lung cancer and cigarette makers.

Tristan May 24, 2010 at 5:45 pm

You could, and this could be paid out of the taxes – but why not at the same time ban them from advertising at all? Or at least start limiting the places where they can advertise. There is already a model for this – the increasing limits on the placement of cigarette advertisements.

Part of building a fairer world is letting the positive aspects of free markets breath – and this requires letting information become less-imperfect. And the best way to do this is simply to ban marketing – because it always has as its goal to encourage you to overspend on any particular commodity.

Milan May 24, 2010 at 5:46 pm

On a separate note, I think it is very objectionable that government run lotteries advertise as much as they do, and in the way that they do. They feed the notion that gamblers have that they might end up big winners.

It is clearly much better for the government to run lotteries than to allow criminal groups to do so. That being said, the government should be honest with the people playing and remind them that they might as well just be burning their money. Why don’t lottery tickets have the kind of warnings on them that cigarette packages do?

“Warning: The real value of this scratch-and-win ticket is a fraction of the retail price.”

“Studies have shown that lottery winners don’t generally end up happier than they were before winning.”


Of course the reason such warnings aren’t there is because government revenues are addictive. Governments easily discover what a cash cow lotteries can be (as well as excise taxes on things like alcohol and tobacco) and their public-spirited desire to cut down on the use of such things within society ends up being weaker than their desire for more dollars to spend.

Tristan May 25, 2010 at 2:01 am

I don’t think that is a separate note. I agree with you – but why is it any more objectionable that the state should run deceptive advertising than for private corporations to do so? Why should we not, as citizens, demand honesty from all market actors?

Of course, it is normal to be more perturbed at state advertising, since the government – imperfect as it is – is the only form we have of acting together, the only means by which advertising such as deceptive gambling advertising could be banned. My point is only that the same reasoning which makes this unacceptable makes advertising other addictive substances (i.e. drink, food, drugs) also unacceptable.

R.K. May 27, 2010 at 11:48 am

Governments easily discover what a cash cow lotteries can be (as well as excise taxes on things like alcohol and tobacco) and their public-spirited desire to cut down on the use of such things within society ends up being weaker than their desire for more dollars to spend.

There is a small upside to this. It stops governments from being swayed too much by puritanical sorts who want to ban gambling, restore prohibition, etc.

Those addictive revenues are one force that helps prevent democratic societies from going the way of the Puritans or the Taliban.

R.K. May 27, 2010 at 11:52 am

The same would likely become true of revenue from drug legalization and regulation.

Give countries a few tens of billions of dollars of revenue from taxes on drugs – combined with tens of billions of dollars in savings on police and prison costs – and they will start paying a lot less attention to those peddling ‘gateway drug’ theories, or other weak arguments for continued prohibition.

Tristan May 27, 2010 at 7:42 pm

I certainly wouldn’t want to see drugs advertised like we see gambling or alcohol. Drugs, taken responsibly, won’t generate much revenue for anyone. Letting the capitalist machine take over yet another aspect of the libidinal economy will make the political situation worse, not better.

. June 3, 2010 at 11:24 am

“Since we first prowled the savannahs of Africa, human beings have displayed a few overpowering and ineradicable impulses—for food, for sex, and for drugs. Every human society has hunted for its short cuts to an altered state: The hunger for a chemical high, low, or pleasingly new shuffle sideways is universal. Peer back through history, and it’s everywhere. Ovid said drug-induced ecstasy was a divine gift. The Chinese were brewing alcohol in prehistory and cultivating opium by 700 A.D. Cocaine was found in clay-pipe fragments from William Shakespeare’s house. George Washington insisted American soldiers be given whiskey every day as part of their rations. Human history is filled with chemicals, come-downs, and hangovers.

And in every generation, there are moralists who try to douse this natural impulse in moral condemnation and burn it away. They believe that humans, stripped of their intoxicants, will become more rational or ethical or good. They point to the addicts and the overdoses and believe they reveal the true face—and the logical endpoint—of your order at the bar or your roll-up. And they believe we can be saved from ourselves, if only we choose to do it. Their vision holds an intoxicating promise of its own.”

. June 3, 2010 at 11:38 am

“One insight, more than any other, ripples down from Okrent’s history to our own bout of prohibition. Armed criminal gangs don’t fear prohibition: They love it. He has uncovered fascinating evidence that the criminal gangs sometimes financially supported dry politicians, precisely to keep it in place. They knew if it ended, most of organized crime in America would be bankrupted. So it’s a nasty irony that prohibitionists try to present legalizers—then and now—as “the bootlegger’s friend” or “the drug-dealer’s ally.” Precisely the opposite is the truth. Legalizers are the only people who can bankrupt and destroy the drug gangs, just as they destroyed Capone. Only the prohibitionists can keep them alive.

Once a product is controlled only by criminals, all safety controls vanish and the drug becomes far more deadly. After 1921, it became common to dilute and relabel poisonous industrial alcohol, which could still legally be bought, and sell it by the pint glass. This “rotgut” caused epidemics of paralysis and poisoning. For example, one single batch of bad booze permanently crippled 500 people in Wichita, Kan., in early 1927—a usual event. That year, 760 people were poisoned to death by bad booze in New York City alone. Wayne Wheeler persuaded the government not to remove fatal toxins from industrial alcohol, saying it was good to keep this “disincentive” in place.”

Tristan June 3, 2010 at 4:30 pm

Maybe it would be better to let capitalism take over the drugs game, rather than have them remain in the hands of the drug gangs. Still, once legalized, I would be as opposed to the marketing of drugs as I am to the marketing of alcohol and gambling.

Milan June 7, 2010 at 12:42 pm

One way to deal with the risk of more people wanting to try ‘hard’ drugs if they are legalized would be to restrict them to uncool settings. Let people try heroin if they want to, but only in some ugly government-run clinic.

I think this idea has promise. One of the most successful advertising strategies for alcohol and tobacco has been associating them with glamour. There is nothing glamorous about a steel cubicle with a syringe inside and doctors on hand to deal with overdoses.

mek June 9, 2010 at 9:53 pm

The idea we need to deal with the increased drug use that will result from legalization is a red herring. Countries that have actually attempted decriminalization (Portugal, Netherlands, etc) have not seen an increase in drug use; quite the opposite. Canada already has some of the highest rates of drug use on the planet, and it’s extremely unlikely they would increase further given decriminalization or full legalization.

. June 15, 2010 at 2:10 pm

The casino operator offered [Terrance Watanabe] lucrative terms to gamble at its casinos, according to Mr. Watanabe’s letter to the Control Board and copies of emails sent from Harrah’s to Mr. Watanabe’s assistant that were included in the court filings.

In a series of emails signed by Mr. Ning, the Harrah’s marketing executive, the casino company laid out the terms that it was willing to offer him, which included “a special formula just for Mr. Watanabe.”

Mr. Ning specified such offers as tickets to the Rolling Stones, $12,500 a month for airfare and $500,000 in credit at the gift stores. Harrah’s also offered 15% cash back on table losses greater than $500,000, special high-limit games and other incentives. Mr. Watanabe alleges that Harrah’s later rolled those terms back.

Mr. Ning didn’t respond to requests for comment. Ms. Jones declined to comment on whether the company rolled back any incentives, but says “the practice of offering incentives and discounts to significant players is not unusual.””

. June 18, 2010 at 3:59 pm

“Reality can be reduced, at its sparest, to chemical reactions, our body craving the release of GABA, oxytocins, endorphins, serotonin, dopamine. It doesn’t care about their provenance. It just doesn’t. Cut off the source—any source—and you will pay.”

. June 29, 2010 at 12:57 pm

The war on drugs is in truth a war on some drugs, their enemy status the result of historical accident, cultural prejudice, and institutional imperative. The taxonomy on behalf of which this war is being fought would be difficult to explain to an extraterrestrial, or even a farmer like Matyas. Is it the quality of addictiveness that renders a substance illicit? Not in the case of tobacco, which I am free to grow in this garden. Curiously, the current campaign against tobacco dwells less on cigarettes’ addictiveness than on their threat to our health. So is it toxicity that renders a substance a public menace? Well, my garden is full of plants—datura and euphorbia, castor beans, and even the stems of my rhubarb—that would sicken and possibly kill me if I ingested them, but the government trusts me to be careful. Is it, then, the prospect of pleasure—of “recreational use”—that puts a substance beyond the pale? Not in the case of alcohol: I can legally produce wine or hard cider or beer from my garden for my personal use (though there are regulations governing its distribution to others). So could it be a drug’s “mind-altering” properties that make it evil? Certainly not in the case of Prozac, a drug that, much like opium, mimics chemical compounds manufactured in the brain.”

. August 9, 2010 at 4:36 pm

The Acceleration of Addictiveness

July 2010

What hard liquor, cigarettes, heroin, and crack have in common is that they’re all more concentrated forms of less addictive predecessors. Most if not all the things we describe as addictive are. And the scary thing is, the process that created them is accelerating.

We wouldn’t want to stop it. It’s the same process that cures diseases: technological progress. Technological progress means making things do more of what we want. When the thing we want is something we want to want, we consider technological progress good. If some new technique makes solar cells x% more efficient, that seems strictly better. When progress concentrates something we don’t want to want—when it transforms opium into heroin—it seems bad. But it’s the same process at work.

People commonly use the word “procrastination” to describe what they do on the Internet. It seems to me too mild to describe what’s happening as merely not-doing-work. We don’t call it procrastination when someone gets drunk instead of working.

. August 9, 2010 at 4:38 pm

“[A]s the world becomes more addictive, the two senses in which one can live a normal life will be driven ever further apart. One sense of “normal” is statistically normal: what everyone else does. The other is the sense we mean when we talk about the normal operating range of a piece of machinery: what works best.

These two senses are already quite far apart. Already someone trying to live well would seem eccentrically abstemious in most of the US. That phenomenon is only going to become more pronounced. You can probably take it as a rule of thumb from now on that if people don’t think you’re weird, you’re living badly.

Societies eventually develop antibodies to addictive new things. I’ve seen that happen with cigarettes. When cigarettes first appeared, they spread the way an infectious disease spreads through a previously isolated population. Smoking rapidly became a (statistically) normal thing. There were ashtrays everywhere. We had ashtrays in our house when I was a kid, even though neither of my parents smoked. You had to for guests.

As knowledge spread about the dangers of smoking, customs changed. In the last 20 years, smoking has been transformed from something that seemed totally normal into a rather seedy habit: from something movie stars did in publicity shots to something small huddles of addicts do outside the doors of office buildings. A lot of the change was due to legislation, of course, but the legislation couldn’t have happened if customs hadn’t already changed.”

. February 12, 2011 at 7:34 pm

Alcohol kills more than AIDS, TB or violence: WHO

(Reuters) – Alcohol causes nearly 4 percent of deaths worldwide, more than AIDS, tuberculosis or violence, the World Health Organization warned on Friday.

Rising incomes have triggered more drinking in heavily populated countries in Africa and Asia, including India and South Africa, and binge drinking is a problem in many developed countries, the United Nations agency said.

Yet alcohol control policies are weak and remain a low priority for most governments despite drinking’s heavy toll on society from road accidents, violence, disease, child neglect and job absenteeism, it said.

Approximately 2.5 million people die each year from alcohol related causes, the WHO said in its “Global Status Report on Alcohol and Health.”

“The harmful use of alcohol is especially fatal for younger age groups and alcohol is the world’s leading risk factor for death among males aged 15-59,” the report found.

. June 2, 2012 at 5:14 pm

“Dopamine release is narrowed by addiction, specialized, stilted, inaccessible through the ordinary pleasures and pursuits of life, but gushing suddenly when anything associated with the drug comes into awareness.”

Lewis, Marc. Memoirs of an Addicted Brain. p.223 (hardcover)

. July 22, 2012 at 8:04 pm

“How did the impulse materialize and grow so suddenly, with such power? We’ve seen how craving works in the mind and the brain. We’ve seen how synaptic narrowing occludes all possibilities except for the one repeatedly practised. We’ve seen how self-control gets used up by ego fatigue, and how defiance turns that failure into some stilted sense of freedom. But the last ingredient of my addiction – maybe anyone’s addiction – was the self-accusation and self-contempt that tormented me, hour after hour, until there was nowhere to go but away. I’m behaving myself: I should feel good. But instead I feel bad and alone.”

Lewis, Mark. Memoirs of an Addicted Brain: A Neuroscientist Examines His Former Life on Drugs. p.274 (hardcover)

. July 22, 2012 at 8:07 pm

“And thoughts of drugs blossomed in these shadows. I was able to resist them for those early weeks. And then something changed. Somehow, all the sadness of the place came crashing in on me, and it fed my own loneliness until I felt suffocated by it. Suffocated and restless. Night after night. And what grew from that turmoil was a sense of hopelessness. Some part of me could no longer believe that I would be able to resist temptation for much longer. And, as any addict knows, that’s the ticket to relapse. If it’s going to happen anyway, it might as well be tonight.”

Lewis, Mark. Memoirs of an Addicted Brain: A Neuroscientist Examines His Former Life on Drugs. p.281 (hardcover)

. August 24, 2012 at 3:32 pm

His main message is that addicts are not suffering from a disease. In fact, he argues, addictive behaviour is essentially voluntary: disordered brain chemistry may influence addicts to make bad choices, but they are still choices. Environment heightens temptation too: he cites the epidemic of heroin addiction among American troops in the Vietnam war. The soldiers mostly ditched their habit when they returned home. Modern over-indulgers in food, drink and other goodies are in the same pickle as soldiers on the battlefield, he argues: “disorientated, fearful, and relentlessly tempted by fixes that promise to make reality more bearable.”

Mr Thompson leaves no room for smugness. Everyone is potentially at risk from addiction, not just “coke-snorting hedge-fund managers, bulimic receptionists and absent fathers glued to World of Warcraft”. He sees no difference in principle between the high of illegal drugs, the sugar rush of cupcakes and the blinking red light on a BlackBerry that signals a new message. All involve the replacement of real relationships and real people with surrogates. Whether these are events, processes, objects or consumable substances (or a mixture) depends on the person concerned. He reserves particular scorn for the abuse of medicines that supposedly act on the brain, from the Ritalin habitually doled out to lively children to the Modafinil and Adderall munched by students seeking an advantage over their peers.

The book—written in a waspish style that belies its depth—pays particular attention to brain chemistry. One set of mental circuits tells people to consume as much as possible: food here today may be gone tomorrow. Other more sophisticated parts allow them to restrain themselves. Modern life, argues Mr Thompson, is overwhelming the clever bits and overstimulating the more primitive functions that encourage overindulgence. Dopamine—the neurotransmitter associated with desire—plays an important role: Mr Thompson terms it the “master-drug”. It helps people to go on craving things that no longer give them pleasure.

. September 10, 2012 at 1:08 pm

“A child who needs Ritalin to function normally is not addicted. If they had diabetes they would need insulin every day and would suffer physical problems without it, but we wouldn’t consider them ‘addicted’ to insulin. Many young people who take these sorts of stimulants don’t really like them – they’re not pleasurable, they can cause headaches and nausea, and make a person feel ‘too focused’ and not spontaneous. As a result young people often stop of their own accord when they reach adolescence (even though this may worsen their educational performance, because many people do find they benefit significantly from the drug long into adulthood).

Nutt, David. Drugs Without the Hot Air: Minimising the Harms of Legal and Illegal Drugs. p.241 (paperback)

. January 3, 2016 at 8:12 pm

5 Myths About Addiction

In Wasted filmmaker Maureen Palmer and her partner Mike Pond start a new conversation about the science of addiction. They examine the biological origins of addiction and why some old models of treatment don’t work for many. Here are five of the most pervasive myths about addiction that are smashed by evidence-based science.

If they just had enough willpower, they’d kick their habit.

Say you do the same thing 100 times on your computer. Your computer doesn’t change. But if your brain does the same thing over and over, the structure itself changes. Neuroscience has proven that the reward circuitry in susceptible person’s brains can be hijacked by repeated use of booze or drugs, essentially overriding the user’s free will to stop — so the choice to not use is much more complicated than a lack of willpower.

Getting tough with the substance user will make him/her stop using.

Studies show tough love, shaming and blaming and humiliating persons addicted to alcohol will only make their addiction worse. They will feel even worse about themselves and may use more, often in secret. To quote Dr. Keith Humphreys, the former senior advisor on alcohol and drug policy to the Obama White house, “It’s remarkable that people believe what’s needed is more punishment. If punishment worked, nobody would be addicted. It’s a pretty punishing experience.”

Relapse is a fail.

It’s common practice to kick people out of rehab if they begin drinking or using again. But it’s wrong, according to the world’s experts. Dr. Humphreys says, “This is the only field where you can be kicked out of treatment for demonstrating that the diagnosis was accurate. I view that as uncompassionate and really poor healthcare.”

“The idea that if you have one drink, then invariably you’re going to drink a huge amount of alcohol just is not how treatment outcome data look,” says Dr. Bill Miller, one of the world’s greatest authorities on alcoholism. “You can find individuals who look that way, but in general, what you see over time is longer and longer periods of going by in between episodes of drinking. And the episodes of drinking get shorter and less severe overtime, and then eventually fade away. “

The Betty Ford Center no longer kicks people out of treatment for relapsing. Instead, treatment is ramped up.

He’s just one of those guys who has to hit rock bottom.

For thousands of people every year, “rock bottom” is injury, disease and death. The evidence shows addiction should be treated like any other serious chronic health disorder, early treatment, utilizing every option available with community and medical support. Early screening and brief interventions for unsafe alcohol use could save thousands of lives and billions of taxpayer dollars spent on the consequences caused by out-of-control substance use.

You don’t use drugs to get off drugs.

There is a widespread but erroneous belief in AA circles that you don’t use one substance to get off another. This is ignorant to the fact that, for many individuals, a proven anti-craving medication can have hugely positive impacts for supporting abstinence. There is a new generation of drugs that block cravings and prevent relapse that can provide sufferers with a valuable new tool to manage their disorder.

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