I recently attended a presentation at my community college called “Myths and Facts About Addiction” that was given by a LMFT from a local rehab. As a child of the DARE generation who is now sober and writes on the topic of addiction and recovery, I was very curious to see what was being fed to the gen pop about addiction these days. All I remember from my high school drug and alcohol classes were poorly produced 80s-style videos that starred horrifically dressed people portraying completely unrelatable scenarios about “partying” that made me want to go out and get drunk. So, at the very least, I was hoping the approach to substance abuse and addiction education had changed.
First of All, I Am Annoying
Like a good little middle-aged student, I situated myself in the front row so that I could be attentive and absorb the material. It never occurred to me how utterly annoying I would be to the facilitator who was looking to engage college students in an open discussion about addiction, not conduct a one-on-one dialog with a know-it-all who was probably her age. Considering what I know on subject (both from what I have read and what I have lived), I should have sat in the back of the room and just listened to what other people had to say. Instead, any time the presenter asked a question to the audience I either shot my hand up or shouted out the answer like a real goody-two-shoes asshole. At one point she actually said, “Let’s hear from someone else.” Ouch!
Regardless of my apparent desperate need for validation, the presentation was solid. The therapist opened the seminar by sharing about how she ended up working in the field of addiction, which she has been in for 12 years. As the middle child of three kids, she watched both her older and younger brothers destroy their lives with alcohol and drugs. Her oldest brother progressed from alcohol to drug abuse, eventually ending up using drugs intravenously and contracting Hepatitis C. Thankfully, he is now clean and sober. Her younger brother became an alcoholic and racked up so many DUIs he served time in jail. However, even after doing two year-long stints in rehab, she was sad to report that he is still currently drinking. While a story like this might be considered by some as inappropriate to disclose to high school students, I think this kind of self-disclosure is crucial in a presentation about addiction. It helps the audience trust the presenter and it makes the struggle of alcohol and drug abuse real.
Fast Facts About Addiction
The presenter then went on to state some facts about addiction that, shockingly, not everyone knew—like that it is considered a disease and is treatable but it is not curable. A young girl raised her hand, confused, and said, “My uncle used to be an alcoholic but now he isn’t. He hasn’t drank in 30 years and he doesn’t even care when we all get drunk around him on Christmas Eve.” I wanted to laugh, not at her but at the innocence and logic of her statement. Why would someone identify as being something they hadn’t been in three decades? The therapist explained that alcoholism is a lot like cancer in that someone who has recovered will always be a cancer survivor. This is because cancer, like alcoholism, can always come out of remission and make alcoholics sick again. The only difference is, cancer patients don’t have much control around whether their cancer comes back while alcoholics do—as long as they don’t pick up a drink or a drug, they are guaranteed to remain in remission.
While I liked her analogy, I had to bite my tongue. I desperately wanted to add that while alcoholics who don’t pick up a drink won’t get drunk, they could still get quite sick in their disease even if they are abstinent. In fact, I wanted to say that I know a guy who was sober 20 years and recently shot himself because he was so miserable and lonely in sobriety (per his suicide note that he posted on Facebook). Unfortunately, in my experience, that is what happens to alcoholics and addicts when they don’t have some kind of ongoing “treatment” for their disease, usually something in the form of a supportive community. But I didn’t say anything because even I understood that it was probably too complex of a concept for a 40-minute community college presentation and there was a good chance, as a non-addict, that it was even over the presenter’s head.
Technicalities and Myths
We soon moved on to the technical term and diagnosis for alcoholism and drug addiction as stated in the DSM-V, which is Substance Use Disorder (SUD)—characterized by evidence of impaired control, social impairment, risky use and pharmacological criteria (changes in the brain). According to SAMHSA, in 2015, 20.8 million people 12 years and older were diagnosed with some form of SUD that year and about 4.4 million of those people where struggling with marijuana addiction alone.
One of the myths that the presenter wanted to address was the idea that people with a stable job and family life aren’t addicted. While it used to be thought that addicts needed to hit a bottom in order to recover, that has been found not to be true. More and more, people are seeking help and finding recovery much earlier in their disease, before they destroy their lives and the lives of others. Another myth is the idea that someone with a high tolerance doesn’t have a problem. She said that a high tolerance is often an indicator that someone is addicted.
The Stages of Abuse and Risk Factors
For people who might be concerned about their drinking and drug use, the presentation did a nice job of identifying the stages of abuse as follows: experimentation, occasional use, frequent use, abuse (characterized by negative consequences and continued drinking) and dependence (when the body is physically and mentally addicted). The therapist urged us all to honestly consider where our own using might fall on this scale. This was the point where I wanted to stand up and announce that I was nearly 13 years sober and generate the round of applause I was used to getting at a 12-step meeting. Thankfully, the presenter had already properly shamed me at this point and so I kept my ass in my seat and my mouth shut (generally a good rule for me I think).
Risk factors for addiction where broken down into to categories: genes and environment. We were told that 40- to 60% of person’s vulnerability to addiction comes from being genetically predisposed. And for those who have the gene, the earlier they start using the more likely they are to progress to more serious abuse, especially if heavy use begins before the age of 25 when the brain hasn’t fully developed it’s decision-making mechanisms (a good argument to taking 7 years off before going to college).
Environmental factors include parents or siblings who drink or use drugs. This provides not only a lack of support, guidance or structure for abstinence but also provides easy access to the substances. Socially acceptable beliefs around drinking and drugs use as well as laws that favor it are hard challenges to overcome. Lack of economic opportunity, racism, violence and trauma also contribute to abuse.
Binge Drinking and Self-Monitoring
At the end of the presentation, what almost everyone wanted to know was what was officially considered “troubled drinking.” The therapist said that binge drinking is different for men and women and that currently, it is considered to be five or more drinks in two hours for a man and four or more drinks in two hours for a women (a drink being one and a half ounces of hard liquor, 12 ounces of beer or five ounces of wine). She urged that anyone who thinks they may have a problem should take these steps: monitor use by keeping a journal or recording how often and how much you drink, be conscious of risky behavior and try and reduce it, reach out for support through a 12-step or community-based program (online resources included) and ask for help as early as possible.