Addiction and Alcoholism are Life Long Diseases That Require Treatment and Maintenance

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By Patrick O’Neil

In 2011 an actor with a well documented history of substance abuse was a guest on The Tonight Show where he loudly proclaimed he had cured himself of addiction, “I closed my eyes and made it so with the power of my mind.” If one were to take that well known actor for his word then his “transformation” would be nothing short of a miracle. According to the American Society of Addiction Medicine the prevailing understanding and definition of what addiction and alcoholism are, “is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences. Prevention efforts and treatment approaches for addiction are generally as successful as those for other chronic diseases.”

Most people suffering from a chronic disease are under the care of professionals and addiction and alcoholism should not be treated any different. However, that well known actor is not alone in his magical thinking. Recent articles and studies have been emerging that promote similar ideas, although maybe not as bizarre. In her article, “Most People With Addiction Simply Grow Out Of It. Why Is This Widely Denied?” columnist Maia Szalavitz writes, “The idea that addiction is typically a chronic, progressive disease that requires treatment is false… Yet the ‘aging out’ experience of the majority is ignored by treatment providers and journalists.” What Ms. Szalavitz is referring to is that she feels that when addicts and alcoholics get older they will simply move on from their addiction without the need for treatment or attending support groups. Citing her own recovery as proof she goes on to say, “When I stopped shooting coke and heroin, I was 23… But although I got treatment, I quit at around the age when, according to large epidemiological studies, most people who have diagnosable addiction problems do so—without treatment. The early to mid-20s is also the period when the prefrontal cortex—the part of the brain responsible for good judgment and self-restraint—finally reaches maturity.” Yet the key element that is being ignored here is that she did go to treatment first, so her “evidence” is not only skewed, but there are no real facts to back it up.  

However, Ms. Szalavitz is not alone in her thinking. Many of her proponents agree, although the majority admit to not having firsthand experience with addiction or alcoholism. But that hasn’t stopped them from attacking the disease model or critically disapproving evidence based treatment facilities. When arguing their case they usual reference a single study conducted by a research team in 2010 that stated, “A significant proportion of individuals with dependence on nicotine, alcohol, cannabis or cocaine achieve remission at some point in their lifetime, although the probability and time to remission varies by substance and racial-ethnic group.” Which is not only vague but misleading. Would someone claim that tapping out of cancer without treatment in their mid-20’s to “achieve remission at some point in their lifetime” was a good idea? Even with treatment the National Cancer Institute warns, “Remission means that the signs and symptoms of your cancer are reduced… If you remain in complete remission for 5 years or more, some doctors may say that you are cured. Still, some cancer cells can remain in your body for many years after treatment. These cells may cause the cancer to come back one day.” And therein lies the rub; who is to say that addiction and alcoholism “cells” do not remain in the body for many years after treatment?  


Another popular school of thought is that, “contrary [to] scientific research evidence” another unnamed study asserts that “some alcoholics can learn to drink in moderation” and that years after treatment “about 12% “returned to controlled moderate drinking.” In response “the National Institute on Alcohol Abuse and Alcoholism (NIAAA) conducted a nation-wide study of 43,000 adults in the U.S. They found that 17.2% those who had been diagnosed as alcohol dependent (alcoholic) were drinking alcohol in a controlled and moderate way. About the same proportion (18.2%) were abstaining. Only 25% of the alcoholics had not moderated their alcohol consumption.” Forget that the NIAAA has totally omitted what the other 40% are doing, the bigger question is, are you willing to gamble on miraculously being one of those in that small percentage that are either abstaining or moderating, or would it be more prudent to follow the methods of recovery that do work?

Successful treatment for addiction typically requires continual evaluation and modification,” suggests The National Institute on Drug Abuse, “similar to the approach taken for other chronic diseases.” The most successful approach entails attending a treatment center for drug and alcohol counseling. While in treatment the addict/alcoholic should reinforce their recovery by beginning to build a strong support system. This can include your treatment team, aftercare, therapists, sober friends, family and community. Self-help groups such as those based in the 12-step, like Alcoholics Anonymous (AA) or alternatives such as the meditation based Refuge Recovery.

But really the most important element isn’t waiting until you’ll just grow out of your addiction. The most important factor is your personal commitment to recovery. Getting sober is challenging and takes time. There’s no quick fixes. Entering treatment and putting in the necessary work is the required treatment. Aftercare, support groups, and continued therapeutic involvement are what’s needed for maintenance.  

CAST Centers offers addiction treatment options for alcohol addiction and drug addiction. “Working towards recovery is about empowering yourself to make better choices. You’ll also learn to hold yourself accountable for the choices you make. By learning healthy ways of dealing with life’s challenges, you’ll start to live free from substance abuse and addiction. If you have a drug or alcohol problem the staff at CAST Centers would like to help guide you in discovering the freedom to be your best self.”  


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