Note: About two-thirds of this article was taken from The White Paper: Effectiveness of Substance Abuse Treatment, U.S. Department of Health and Human Services, February, 1995. The balance was written by Charles N. Roper, PhD.

Among the hundreds of myths surrounding addiction and treatment, the following are especially relevant to individuals who are beginning to question the true nature of their relationship with addictive substances and are considering the possibility of seeking treatment.

Myth: Addiction is a bad habit, the result of moral weakness and over-indulgence.

Fact: Addiction is a chronic, life-threatening condition, like hypertension, atherosclerosis, and adult diabetes.

Fact: Addiction has roots in genetic susceptibility, social circumstance, and personal behavior.

Fact: Certain drugs are highly addictive, rapidly causing biochemical and structural changes in the brain. Others can be used for longer periods of time before they begin to cause inescapable cravings and compulsive use.

Myth: Bad, stupid, and crazy people are most susceptible to becoming addicted to alcohol and drugs.

Fact: Addiction is an equal opportunity disease. It does not discriminate in any way against any class of people. It strikes equally among individuals in all ethnic, socio-economic, intelligence, and emotional wellness categories.

Myth: If an addict has enough willpower, he or she can stop abusing alcohol and using drugs.

Fact: Few people addicted to alcohol and other drugs can simply stop using them, no matter how strong their inner resolve. Most need at least one course of structured substance abuse treatment to end their dependence on alcohol and other drugs. Some achieve sobriety through participation in community-based support organizations (e.g., Alcoholics Anonymous), but relapse rates under this condition are very high. The most effective approach is one that combines structured treatment and community-based support.

Myth: Many people relapse, so treatment obviously does not work.

Fact: Like every other medical treatment, addiction treatment cannot guarantee lifelong recovery. Relapse is often a part of the recovery process; it is always possible--and treatable. Even if a person never achieves perfect abstinence, addiction treatment can reduce the number and duration of relapses, lower the incidence of related problems such as crime and poor overall health, improve the individual's ability to function in daily life, and strengthen the individual to better cope with the next temptation or craving. These improvements reduce the social and economic costs of addiction.

Myth: People with alcohol and other drug problems must attend 28-day hospital-based treatment programs, where they dry out and emerge new individuals, cured of their problems.

Fact: Treatment is provided in many different settings, in many different ways, and for different lengths of time. It is provided in hospitals, residential facilities, free-standing clinics, and counselors' and therapists' private offices. Treatment often follows a "continuum of care," within which the individual participates in one or more levels of care. These levels range from highly restrictive and intensive to only slightly restrictive and intensive, as follows:

Myth: Once sobriety is achieved, whether with or without the benefit of treatment, most individuals can eventually return to social use of alcohol and/or drugs.

Fact: Addiction is a chronic condition that does not disappear, even after extended periods of sobriety. This is true regardless of the individual's drug of choice, level of self-control, or length of abstinence.

Myth: An individual who is addicted to one drug or family of drugs can undergo treatment for and recover from addiction to that particular drug and still use other drugs with impunity.

Fact: Cross-addiction nearly always occurs when an addict tries to switch drugs, regardless of the reason. Cross-addiction invariably takes the form of one or the other of two possible outcomes: 1) The individual quickly becomes addicted to the second substance, or 2) The individual returns to the original drug while under the influence of the second one.

Myth: We have reached the limits of what we can do to treat addiction.