Substance abuse is a frequently misunderstood topic, subject to evolving and inaccurate understandings of psychology, science, socioeconomics, and human nature. The myths of drug abuse are numerous, and each one of them harmful; for every misconception, an opportunity for help and treatment is closed off. The more light is shed on drug abuse, the more (and the better) people can be helped.
Why Is Drug Abuse So Misunderstood?
Part of the problem that causes myths of drug abuse to be perpetuated is that the scientific understanding of addiction is relatively recent. A blog on Psych Central points out that researched-based treatment models have been developed only over the past two decades. Behind those two decades are generations of misunderstandings (and outdated and debunked theories) about the causes of addiction, the people who become addicted, and the substances of addiction themselves.
Some misconceptions are relatively harmless, but most of them contribute to people being afraid or ashamed to seek help, either for themselves or for people they know. Misconceptions can spread much faster than truth or accuracy, and they do extensive damage.
The ‘Rock Bottom’ Misconception
HBO’s Addiction Project quoted experts in addiction science giving their opinions about the misconceptions that the general public has on the topic of substance abuse. A professor at the Medical University of South Carolina said that the idea that bothers her the most is that a person needs to “hit rock bottom” before the person is ready to get help.
On “Upvoted,” the content news site of the social news platform Reddit, “rock bottom” is defined as the moment that changes everything – the one that shocks people with drug or alcohol addictions out of their haze, and makes them realize the extent and toll their habit has taken. Users shared stories of passing out at parties in front of friends and family members, experiencing withdrawal symptoms when they went a few days without drinking, and going out of their way to buy beer so cashiers wouldn’t recognize them; one user even writes about assaulting his 7-year-old son.
Such “rock bottom” revelations can help put a substance abuse problem in much-needed perspective, says the professor on HBO’s Addiction Project, but they oftentimes come with a cost that could have been avoided had the person sought help sooner. Addiction can be a very long process; the earlier a person searches for treatment, the less damage will be done (both to the individual and to the individual’s family), and the more the person has to live for.
The idea of waiting until the worst comes to pass may be inspired by dramatic depictions of addiction in TV and movies. Dramatic scenes, of a violent fight, a withdrawal-induced seizure, or the breakup of a family, all make for compelling content, but real-life problems require real solutions. Different forms of addiction affect different people in different ways; therefore, each person has an individual “rock bottom” threshold. For some people, it takes facing a family ultimatum as a result of irresponsible behavior while under the influence; for others, getting arrested is the wakeup call needed. Others might be fired from their jobs or dismissed from school for consistently poor grades before they realize that their substance abuse is out of control.
The Ticking Time Bomb
Whatever the point of no return, there is no scientific evidence that waiting to hit rock bottom does any good. Quoted in the Huffington Post, the author of two bestselling books on the topic of addiction says that hoping for a moment of rock bottom does nothing but give time for a drug or alcohol habit to become even stronger, perhaps irreparably corrupting lives and relationships as it does so.
Why, then, does the myth persist? One reason is, as mentioned above, that TV shows and movies, while drawing attention to the ugliness and corruption of the problem, can’t sell the drama of addiction if a person’s substance abuse is nipped in the bud. The Huffington Post suggests another reason: Despite addiction being a chronic disease that can be treated, there is still the perception that falling to the sway of drugs or alcohol is a moral failing, one that brings shame and humiliation to a social (or familial) circle.
For that reason, warning signs are ignored. Instead of talking with a friend of loved one about how drinking has become problematic, the problem is pushed away, in the hopes that not dealing with it will deprive it of any attention that might exacerbate it, or that an alcohol or drug problem is the user’s problem to solve alone.
Of course, such an approach is fundamentally flawed. Letting a person spiral out of control, as a way of avoidance (or even punishment), is merely letting a disease grow and fester until a terminal event happens. Left to its own devices, “rock bottom” might not be simply passing out at a party; it could involve violence or death.
Addiction as a Moral Failing
Attempting to use the rock-bottom threshold as a way of punishing a person with a drug or alcohol problem overlaps with another key myth of addiction: that being addicted to a substance means you are a bad, weak, or immoral person.
This is one of the most enduring misunderstandings about addiction and probably the single most harmful and detrimental belief. As recently as 2014, surveys indicated that people who were addicted to drugs and alcohol, and even people who were in the process of recovering from their addictions, were at risk for facing stigma and prejudice because they were perceived to have a “moral failing” (compared to victims of mental illnesses, who faced reduced, but nonetheless existent, judgments). The study, published in the journal of Psychiatric Services, suggested that the idea of addiction being a personal weakness, and not a treatable medical condition, still persists, regardless of the science, research, and awareness to the contrary.
Speaking from the Johns Hopkins Bloomberg School of Public Health, the lead researcher of the study explained that mental illnesses (such as major depression and bipolar disorder) have become socially acceptable to discuss, and members of the general public feel a greater degree of comfort sympathizing with people who suffer from mental health disorders.
Legal vs. Illegal Drugs: How Abuse Is Perceived
When it comes to people with substance use disorders, however, the predominant perception is that the individuals in question are bad or weak people. One reason for this view is that a great deal of drug use is still illegal; therefore, the people who use such drugs are not victims fallen afoul of powerful and dangerous substances, but knowing and culpable criminals who need to be punished and ostracized.
Even the language of the addiction treatment community, such as the terms unclean and dirty when referring to a drug-positive urine sample, for example, further casts people with substance abuse issues in a negative light, which is then picked up and carried on by the general public.
Adderall and Heroin
The difference in opinion between illegal drugs (like heroin and methamphetamines) and legal drugs (like prescription medication) is very telling in how people who abuse such substances are received.
Consider Adderall, a combination medication used in the treatment of narcolepsy and attention deficit hyperactivity disorder. Phrased like that, it’s hard to think of Adderall having much in common with a drug like heroin. In reality, Adderall, heroin, and hundreds of other controlled substances across the addiction spectrum work in very similar ways: driving the brain to release a neurotransmitter that makes a user feel euphoric and blissful, creating such a powerful impression that the sensation becomes an all-encompassing obsession. That is the basic mechanism of drug addiction that is shared across nearly all chemical substances with the potential for causing physical and psychological dependence.
It’s that potential that has led the U.S. Drug Enforcement Administration to tightly regulate the manufacture and distribution of Adderall. But among college students who stay up all night and cram for exams, “Adderall is definitely not a drug.” The journal Substance Use and Misuse published a survey conducted on students at a sizeable, urban research university, where most of the interviewees felt that since Adderall could be legally obtained (via a prescription), there was nothing harmful or ethical about consuming the drug for its stimulating properties.
Finger-Pointing and Whispering
Adderall has a high potential for addiction, but how it is perceived (a pick-me-up for hardworking and hard-partying students) may be responsible for why its abusers are not shunned or looked down upon. On the other hand, when an 18-year-old Ohio woman died from a heroin overdose in 2015, her family made the unusual decision to truthfully cite her cause of death in her obituary, rebuffing any “finger-pointing, whispers or family stigma.”
The deceased woman’s mother explained that families tend to feel shame or guilt when one of their own succumbs to addiction. Pushing back against that was her and her husband’s way of not only honoring their daughter, but also giving hope to other parents who have to confront the burden of their child using drugs.
The director of a local treatment center praised the family for their efforts, saying that drug overdose deaths tend to get swept under the rug, and that shroud of secrecy and perceived disgrace contributes to more people refusing to come forward and admit their drug problems, putting them at significant risk for worsening their addictions or dying as a result.
Rehab, Relapse, and Shaming
Even though an Adderall addiction can be physically and psychologically devastating (effects ranging from insomnia to personality changes to full-blown psychosis), it doesn’t have a fraction of the vitriol that is reserved for heroin. When the actor Phillip Seymour Hoffman overdosed on heroin in 2014, Twitter users responded by shaming drug abusers, claiming that addiction was a choice, and the consequences that befell victims was of their own doing. Hoffman’s short stint in rehab before his death was seen by some as a sign that heroin addicts were beyond saving, and that Hoffman wasted the chance he was given to get sober.
But a blog on Psychology Today points out that constantly berating and criticizing those who relapse – thinking that such people are beyond help or undeserving of the chance they were given – is what drives such individuals away from seeking help and deeper into their problems. They overdose, they die, the rest of the world feels vindicated, and the myth that those struggling with addiction are flawed and forsaken human beings continues.
The Myth of Race and Drug Use
There may be a racial element behind why heroin addicts have been so looked down upon historically, one that contributes to the spectrum of misunderstandings and misconceptions. Valley News suggests that when heroin abuse was associated with impoverished people of color, it was easy for the public to make accusations about how the epidemic was a question of moral degeneracy. Now that heroin use has spread to suburban and affluent areas, populated primarily by white Americans, the tone of the conversation has dramatically changed. People with a heroin addiction are no longer hardened criminals who should be put in jail; now, they are victims of economics and the pharmaceutical industry creating an opioid epidemic. Now, these people are not criminals; they are people in need of treatment.,
The New Face of Heroin
Of course, heroin affects people across ethnic and demographic categories with equal devastation; but as Valley News points out, there is a world of difference in how its victims are portrayed. Stories of addicted black people in impoverished inner cities are characterized in a markedly different way than stories of white, affluent people who overdose. The Economist juxtaposes the image of a heroin addict from 30 years ago – male and black – to a well-dressed young grandmother from a Denver suburb, who developed her addiction to heroin after becoming addicted to the OxyContin she was prescribed for a hip injury.
That, says The Economist, is what the average heroin user looks like today: more often, white and female. But whether that will dispel the myth of heroin users being destitute, corrupt people (who are, more often than not, black) from the wrong side of the tracks remains to be seen.
The idea of a connection between race and substance abuse goes back a long way. In the early 20th century, black Americans (many of them recently freed from slavery) were scapegoated for the problems of cocaine that were just beginning to be understood. Panic about the “Negro cocaine fiend” was instrumental in the passage of the first piece of drug legislation in American history.
The Addiction Gene
Are some people cursed to be addicted to drugs? In the same way it is believed that people of certain races or demographics are more inclined to use certain drugs (“White America Does the Crime, Black America Gets the Time,” says the Huffington Post on the topic of how drug laws unfairly punish based on factors other than the drug crime itself), it is also held true that whether or not a person falls to substance abuse depends on the fabled “addiction gene.”
Writing in CNN, a researcher at the University of California, Los Angeles, and a former methamphetamine addict, explains that there is no single gene, or a set of genes, that decides whether an individual will develop a substance use disorder. This holds true even if the person’s parents had drug or alcohol problems.
But genes do play a role in the determination of whether a person develops a substance use disorder, says The Fix; however, the nature and the extent of the role is debatable, hence the lasting myth that genes cause addiction.
The Addiction Equation
The journal of Nature quotes the director of the Division of Basic Neuroscience and Behavioral Research at the US National Institute on Drug Abuse in Maryland as saying that the risk of drug use in a person ranges from 40 percent to 60 percent. However, that range exists as part of a much larger equation, one that might even completely negate a 60 percent chance of developing an addiction due to genetics.
The rest of the equation is made of a number of factors that can either exacerbate, or cancel out, genetics, such as:
- Access to other drugs
- Living situation
Various combinations of these dynamics can come together to make genetics a very small piece of the puzzle, even if the risk from a family history of addiction is as high as 60 percent. For example, the journal of Neuropsychopharmacology published a study conducted by researchers at the University of Texas, which found that children who were exposed to traumatic events – such as violence, abuse, or seeing their parents fight – grew up with brains that had difficulty regulating emotion, especially in the face of stressful events. Writing about the study, TIME magazine summarized that people may be susceptible to developing addictions if they cannot control how they react to challenging or difficult situations.
Similarly, a 2015 study published in the Proceedings of the National Academy of Sciences journal looked at pairs of twins and their use of marijuana. The study suggested that childhood development factors may have more of a say in whether people who use marijuana develop a dependence on the drug, to the point where it starts to affect how they think and function.
However, since genes do matter in addiction (as stated by the American Psychological Association), the misunderstanding of how they matter has led to the enduring myth that a family history of substance abuse is the ultimate factor.
The Myths of Drug Abuse
Drugs and substance abuse issues are dangerous enough on their own, but they are unintentionally made worse by incorrect ideas and attitudes about the people who suffer from addiction. There are dozens of other misconceptions about the reality of substance abuse, ranging from people having to want to be treated in order for them to get better (in truth, people who are forced into treatment as part of a drug court program or a personal ultimatum can get better), to marijuana being a gateway drug (a statement that itself ranges from debatable to refutable, with TIME magazine calling it “The Myth That Will Not Die”).,,
Harmful substances and dangerous behavior will always be present, but clamping down on misinformation and prejudice toward the people who most desperately need help and understanding will go a long way to limiting the damage caused by drug abuse.
- “5 Important Advances in Addiction Treatment.” (June 2014). Psych Central. Accessed January 21, 2016
- “Myths of Addiction.” (n.d.) HBO. Accessed January 22, 2016.
- “The Moment I Realized I Was An Alcoholic”: What Does Rock Bottom Really Look Like? (January 2016). Upvoted. Accessed January 22, 2016.
- “Waiting to Hit the Elusive “Rock Bottom.” (June 2013). Huffington Post. Accessed January 22, 2016.
- “Drug Addiction Seen as “Moral Failing,” Survey Finds.” (October 2014). US News & World Report. Accessed January 22, 2016.
- “Coping With The Stigma of Addiction.” (n.d.). HBO. Accessed January 22, 2016.
- “The Deadly Stigma of Addiction.” (May 2012). The Fix. Accessed January 22, 2016.
- “7 Things You Need to Know About Adderall.” (December 2013). The Daily Beast. Accessed January 22, 2016.
- ”Adderall Is Definitely Not a Drug: Justifications for the Illegal Use of ADHD Stimulants.” (2010) Substance Use and Misuse. Accessed January 22, 2016.
- “Adderall: America’s Favorite Amphetamine.” (October 2013). Huffington Post. Accessed January 22, 2016.
- “Ohio Couple Calls Out Heroin in Teen Daughter’s Obituary.” (September 2015). Yahoo! News. Accessed January 22, 2016.
- “Adderall: Uses, Abuses and Side Effects.” (November 2013). Livescience.com. Accessed January 23, 2016.
- “The Only Thing Worse Than Legal Heroin is Illegal Heroin.” (February 2014). Pacific Standard. Accessed January 23, 2016.
- “Shame on Us for Shaming Hoffman.” (February 2014). Psychology Today. Accessed January 23, 2016.
- “Column: Changing Perceptions of Heroin Addiction.” (May 2014). Valley News. Accessed January 23, 2016.
- “America’s Addiction to Opioids: Heroin and Prescription Drug Abuse.” (May 2014). National Institute on Drug Abuse. Accessed January 23, 2016.
- “The Great American Relapse.” (November 2014). The Economist. Accessed January 23, 2016.
- “How the Myth of the ‘Negro Cocaine Fiend’ Helped Shape American Drug Policy.” (January 2014). The Nation.Accessed January 23, 2016.
- “When It Comes To Illegal Drug Use, White America Does The Crime, Black America Gets The Time.” (September 2013). Huffington Post. Accessed January 24, 2016.
- “5 Damaging Myths About Addiction.” (September 2012). CNN. Accessed January 23, 2016.
- “So, Is Addiction Genetic?” (September 2015). The Fix. Accessed January 24, 2016.
- “Genetics: No More Addictive Personality.” (June 2015). Nature. Accessed January 24, 2016.
- “How Childhood Trauma May Make the Brain Vulnerable to Addiction, Depression.” (August 2012). TIME. Accessed January 23, 2016.
- “Impact of Adolescent Marijuana Use on Intelligence: Results from Two Longitudinal Twin Studies.” (August 2015). Proceedings of the National Academy of Sciences. Accessed January 24, 2016.
- “Genes Matter in Addiction.” (June 2008). American Psychological Association. Accessed January 24, 2016.
- “Should States Let Families Force Addicts Into Rehab?” (October 2012). TIME. Accessed January 24, 2016.
- “Marijuana As A Gateway Drug: The Myth That Will Not Die.” (October 2010). TIME. Accessed January 24, 2016.
- “Marijuana and Medicine: Assessing the Science Base.” (1999). National Academy of Sciences. Accessed on January 24, 2016.