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It’s often the case that people struggling with substance use disorders (SUDs), especially the most severe cases, which we typically call “addictions,”have learned some myths about what “addiction” is and how it “should” be treated. In this article, we’re going to explore briefly our Top 5 Myths about substance use disorders and their treatment. Generally speaking, more well-informed consumers make better choices about how to utilize services. At PCI, we want to give everyone the best chance to get the help they need, whether or not they ever receive services at one of our facilities.

Myth #1: “Weed” isn’t “addictive.”

Why is this the number one myth? Well, to be frank this is one of the more harmful myths, but in an insidious way. From the point of view of neuroscience research, we know, definitively, that cannabis and related THC heavy substance (i.e., “wax, “dabs,” “budder, “shadder,” and so on) hyperstimulate that habit formation and motivation areas of the brain (typically referred to as the “reward” areas of the brain, but that’s not accurate anymore). We know that heavy cannabis users, not recreational or occasional users, show the same structural brain deficits and changes seen in all other substance addictions. Moreover, the most recent data indicate that 1 in 5 people will struggle with a cannabis use disorder. This is not a small issue, as strains of cannabis become stronger and stronger, more people will likely struggle with the drug. Also, the data on adolescence and cannabis use are mostly clear: long-term/consistent use of cannabis in adolescence pre-disposes teens to mental health issues like depression, increases risk of psychosis, and is a mild to moderate risk of substance use disorders in adulthood (even though the “gateway” hypothesis is now debunked).

Myth #2: If you have a substance use disorder, you have to go to “rehab” to get better.

Not true at all. A substantial proportion of people with a mild or moderate substance use disorder can limit or cease their use of drugs to a no-longer clinically significant level without ever even going to treatment. For some, however, their substance use disorder and/or the co-occurring mental health conditions (ex. Depression or PTSD) make it so difficult to stop that professional assistance is needed. A 30-day rehabilitation facility (i.e., residential treatment) is sometimes helpful, especially for those whose compulsive drug use is causing significant health risk or who are at risk of injury or suicidal behavior is involved, but not necessary for many. Many can be adequately treated at a less intense level of care, such as an intensive outpatient program.

Myth #3: Addiction is an individual problem, they can just stop using drugs.

Nope. Generally, the professional community understands that people with a severe SUD is generally what the Surgeon General calls a “brain disease,” so in that sense yes, addiction requires an individual to make substance behavioral and psychological changes to recover and stay in a recovery mindset. That said…addiction is a comprehensive biopsychosocial condition. On the “social” side of biopsychosocial are family and friends. We know, from both years of clinical practice and research, that healing the family and developing healthy/sober peers is key to long-term wellbeing for people with SUDs (and mental illnesses). Outcomes are worse when family isn’t involved and/or the peer group is still unsupportive/uneducated about the patient’s issues. This is where topics like enabling and codependency can also become a problem.

Myth #4: Using Medication Assisted Treatment (MAT) means the person isn’t really “sober.”

This is an unfortunate myth because it harms the patient. For some patients, MAT approaches for opioid (i.e., suboxone or methadone), nicotine (i.e., chantix or Wellbutrin), or alcohol disorders (i.e., naltrexone or campral) can be life saving. In many “recovery” communities, and even at some treatment centers, there is a stigma about using MAT, wherein lay people and professionals alike are uniformed, sometimes spreading myths like people are “getting high” without consequences or that using these medications is just switching from one habit to another. First, there is no “high” or euphoria associated with any MAT options. These various medications are designed to either blunt the intensity of cravings and/or prevent the “withdrawal system” in the brain from becoming overactive due to stress, acute withdrawal, or post-acute withdrawal. These MAT options are simply meant to help lower the relapse potential for the patient, not become long term drug substitutions (with the exception of methadone, which is reserved for the most severe opioid problems). So, yes, just like a person with depression and an alcohol use disorder, who may take an SSRI, is sober, so is a person on MAT.

Myth #5: You Should Know What Kind of Treatment You Need.

Not at all. The vast majority of people struggling with SUDs and/or mental illness have an intuitive sense that “something is wrong” or “I feel off,” and they probably see the consequences of their illness. There are so many treatments being offered by different types of facilities, some of which sound good, but are really hocus pocus. Other treatments sound exotic, or facilities offer nice looking landscapes and try to convince you that a peaceful scene is the key to your well-being. Will these things “cure” you, no. What works? Well, it’s not your job to know what you need with regard to professional help. This is why it’s so important to do 3 things if you or your loved one is struggling with a SUD and/or mental illness and seeking out treatment:
1. Get clear on the symptoms/struggles that are prompting you to seek treatment, the more information the better. The more information a professional has the easier it is to find the best fit.
2. Know your financial/insurance support/coverage.
3. Ask as many questions as possible to the professional you’re speaking with. Be listening for transparency, false confidence, and clarity of responses. Also, if they sell you a definitive timeline, that’s probably not realistic, because there is no perfect amount of time for someone to be in treatment, it’s all subjective and specific to the individual and their complex issues/dynamics.