1. Addiction is a disease.
Addiction is a behavior, and about the only place in the world where behavior is thought of as a disease is in the United States of America. Although other approaches are gaining ground, the disease model is still the dominant view in this country. Eventually, more practical cognitive approaches will replace the disease model and the Twelve Steps theory of treatment. Cognitive approaches believe that addiction is a choice (Schaler, 2000) and treatment focuses on people’s belief about themselves and their environments. Many cognitive approaches use an appraisal process in which addicts weigh the costs and benefits of their continuing addiction. Recent examples of this approach are Miller (2002) and Peele (2004).
2. The disease model approach to treatment works.
It would be more accurate to say that the disease model approach to treatment does not work. George Vaillant (1983), a proponent and leading authority on the disease model, says, “there is compelling evidence that the results of our treatment were no better than the natural history of the disease” (284). Unfortunately, the failure of the disease model treatment approach only reinforces the belief in the minds of many that alcohol addiction is a biological disease. The disease model is actually counter productive in that it instills in people the false belief that they are sick instead of behaving badly. It also encourages people to believe they are helpless and cannot control their behavior.
3. Gateway drugs.
A gateway drug is said to naturally lead the user to supposedly more dangerous drugs. To frighten people away from certain illegal drugs, for example, marijuana, the argument is often made that marijuana use leads to heroin use. What these drugs have in common, however, is the personality of the user and not some mysterious connection. It would be just as ridiculous to argue that nicotine and alcohol are gateway drugs to gambling.
In Las Vegas, the casinos resist nicotine restrictions and bring alcohol drinks to gamblers because people who consume large amounts of nicotine and alcohol also tend to gamble large amounts of money. The reason they do this is because of the similarities of people’s personalities and values and not because of some biological connection between drugs and gambling. In defense of the gateway concept, the argument is made that statistics show that people experiment with marijuana before they consume heroin. This may be true, but statistics also show that most people smoke marijuana after they have smoked nicotine, and there is a statistical relationship between drinking coffee and smoking cigarettes. So, is caffeine a gateway drug to heroin?
4. You cannot understand addiction unless you have been there.
I usually get this from clients who think that unless I have been addicted to their particular drug I do not know how to help them stop their addictions. I am not sure how being an expert in messing up your life qualifies you to be an addictions counselor, but this is a myth that is believed and accepted by many. This same argument could be applied to every kind of addiction and it would be impossible for therapists to have personal experience with every conceivable kind of addiction or behavior. There is no empirical evidence to suggest that personal experience with an addiction helps in the treatment of others. A good reason not to answer a question like this is that it is impossible to answer without doing some harm. Regardless of which way you answer, the client now feels differently about you as a counselor, and it is unlikely your response is helpful to the client.
5. Drugs cause behavior.
I heard a news report about a young man who was arrested for breaking in several businesses to steal what he could find. The news reporter said, “His parents blame a cocaine addiction for his behavior.” Drugs may lower inhibitions, or cause us to feel powerful and euphoric, but they do not force us to behave in certain ways.
The idea of involuntary behavior is a myth. People take drugs because they want to, and sometimes the drugs give them the courage to act in ways they would not when they are sober, but the decision to act is always in the individual’s power to make. It is also false to suggest that drugs cause addiction. People cause addiction because addiction is a behavior. Drugs do not cause addiction any more than guns kill people or SUVs run over pedestrians; yet, these myths continue to exist in our culture and these beliefs are often written in newspaper headlines.
The idea of blaming others, or even non-living objects, for our behavior is as old as the Garden of Eden. Adam told God that it was “the woman you put here with me” (Genesis 3:12) that caused him to eat of the fruit. When Moses confronted Aaron about the golden calf, Aaron said the people gave him their gold and “I threw it into the fire, and out came this calf!” (Exodus 32:24). This is the same kind of logic employed by many addicts to justify their irresponsible behaviors. Many in the treatment field encourage this kind of thinking when they argue that addicts are helpless and powerless in the face of addiction. People made the golden calf just like people take drugs.
An attribution error occurs when we falsely attribute behaviors to non-living substances like gold and drugs. An error in reasoning occurs when people focus on the object of the addiction rather than the behavior, as in a public service announcement I heard recently, “Nicotine may be addictive to some people.” The impression given is that this drug is dangerous because some people do not have any control over its power. No drug has the power to suddenly take over your life. I know this goes against conventional wisdom and the myths regarding the supposed overwhelming power of drugs, but the focus in the public service announcement is on the wrong thing and it is a misunderstanding of the nature of addiction.
6. I take drugs and gamble because I want to be free.
Many people are under the illusion that they are expressing their freedoms when they give in to compulsions, but the opposite occurs because people lose their freedoms to addictions. All one has to do is visit the prison system to understand how confining drugs and alcohol can be or just observe a nicotine addict desperately searching for a place where he can legally smoke a cigarette. Addiction, like sin, gives the illusion of freedom, but Jesus said, “everyone who sins is a slave to sin” (John 8:34). Paul rightly asks, “Don’t you know that when you offer yourselves to someone to obey him as slaves, you are slaves to the one whom you obey—whether you are slaves to sin, which leads to death, or to obedience, which leads to righteousness?” (Romans 6:16). There is a saying, “Only he that is tied to chart and compass has freedom of the seas.” Likewise, only those who control their behaviors are masters of their world.
J B Myers