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Old Ideas

Since so much of our scientific understanding of addiction is relatively new, and since so much about drug and alcohol addiction is tied up in belief systems, it’s not surprising that myths about this disease abound.

“There are two main misconceptions that really drive me crazy when it comes to addictions,” says Dr. Kathleen Brady, a professor at the Medical University of South Carolina. “One of them is this whole idea that an individual needs to reach rock bottom before they can get any help. That is absolutely wrong. There is no evidence that that’s true. In fact, quite the contrary. The earlier in the addiction process that you can intervene and get someone help, the more they have to live for. The more they have to get better for.”

The other big myth, says Dr. Nora Volkow, director of the federal government’s National Institute on Drug Abuse, is that you have to want to be treated in order to get better. Even as an internationally respected researcher, she once believed that to be true, Volkow says, but she knows now that people who are forced into treatment do recover. Addicts may be pushed to enter a detox center or treatment program by an employer, a companion or the criminal justice system. Employers may threaten to fire a person unless treated; a spouse may threaten to leave the relationship, or the court may offer treatment in lieu of prison. (In this case, people convicted of nonviolent, drug-related crimes may go through specialized alternative courts, called drug courts, in which they can reduce their sentence or avoid jail altogether by getting intensive addiction treatment.) In fact, research has shown that the outcomes for those who are legally mandated to enter treatment can be as good as the outcomes for those who entered treatment voluntarily.

Myths About Drug and Alcohol Addiction*

* Adapted from Myths of Addiction. Carlton K. Erickson, Ph.D., University of Texas Addiction Science

1. Addicts are bad, crazy, or stupid.

Evolving research is demonstrating that addicts are not bad people who need to get good, crazy people who need to get sane, or stupid people who need education. Addicts have a brain disease that goes beyond their use of drugs.

2. Addiction is a willpower problem.

This is an old belief, probably based upon wanting to blame addicts for using drugs to excess. This myth is reinforced by the observation that most treatments for alcoholism and addiction are behavioral (talk) therapies, which are perceived to build self-control. But addiction occurs in an area of the brain called the mesolimbic dopamine system that is not under conscious control.

3. Addicts should be punished, not treated, for using drugs.

Science is demonstrating that drug addicts have a brain disease that causes them to have impaired control over their use of drugs. Drug Addicts need drug detox treatment for their neurochemically driven brain pathology.

4. People addicted to one drug are addicted to all drugs.

While this sometimes occurs, most people who are dependent on a drug may be dependent on one or two drugs, but not all. This is probably due to how each drug “matches up” with the person’s brain chemistry.

5. Addicts cannot be treated with medications.

Actually, addicts are medically detoxified in hospitals, when appropriate, all the time. But can they be treated with medications after detox? New pharmacotherapies (medicines) are being developed to help patients who have already become abstinent to further curb their craving for addicting drugs. These medications reduce the chances of relapse and enhance the effectiveness of existing behavioral (talk) therapies.

6. Addiction is treated behaviorally, so it must be a behavioral problem.

New brain scan studies are showing that behavioral treatments (i.e., psychotherapy) and medications work similarly in changing brain function. So addiction is a brain disease that can be treated by changing brain function, through several types of treatments.

7. Alcoholics can stop drinking simply by attending AA meetings, so they can’t have a brain disease.

The key word here is “simply.” For most people, Alcoholics Anonymous (AA) is a tough, lifelong working of the Twelve Steps. On the basis of research, we know that this support system of people with a common experience is one of the active ingredients of recovery in AA. AA and the Twelve Step Program doesn’t work for everyone, even for many people who truly want to stop drinking.

Source: HBO Addiction

A dual diagnosis is when a person has been diagnosed with two or “dual” conditions: an alcohol, drug or other substance addiction coupled with a mental health disorder. Many patients that are in addiction treatment are found to have a dual diagnosis. Of the two million people in the United States that suffer from mental illness, about 50% of them also are an alcohol, drug or other type of substance abuser. For an alcoholic, whether they have a dual diagnosis or not, they need to enter an alcohol addiction treatment program. For others that have substance abuse and addiction, a dual diagnosis, addiction treatment is not only warranted but desperately needed. Not every addiction treatment center is equipped to help this illness. It’s vitally important that a center with professional staff prepared to work with patients with a dual diagnosis is chosen.

Probably the most challenging area for health care providers is diagnosing patients who truly have a dual diagnosis. The reason a dual diagnosis is so difficult to determine is because more cases than not, a mental illness is coupled with a substance abuse and addiction situation. It is for this reason that many of these patients are placed in addiction treatment homes or centers only to discover that they are in fact dealing with a dual diagnosis. The problem is that substance dependence can masquerade as a psychiatric disorder, so many times the mental illness is not discovered or revealed until much later than at the initial evaluation.

It can be a very difficult situation to identify a patient with dual diagnosis. Most times they are in denial about their substance abuse so when the addiction is discovered, they overlook the fact that the mental illness is still exacerbating the substance problem and vice-versa. Therefore only one of the two issues is identified. And with teens it is even more difficult. With kids going through puberty and all of the emotional fluctuations that accompany that, how can you be sure that this young man or woman are actually suffering from a bi-polar disorder or even depression? For that very reason it is imperative that when seeking an addiction treatment center you find one that has an acute awareness of this dual disease. It is only then that you can truly have hope for a full recovery.

by Groshan Fabiola