Myths and Beliefs About Substance Abuse
This post is intended for non-step recovery members. It is
not intended as a gauntlet thrown down for adherents of AA. But discussion is
Some widely held beliefs about substance abuse are
questionable, debatable, or even provably false. Why does this matter? Because
our beliefs can affect, effect, or otherwise shape our behavior.
The notion that any amount of alcohol will trigger more
This belief is so widespread in popular culture that I first
read it in Dear Abby or Ann Landers, many years ago. In Chapter 2 of Alcoholics
Anonymous, we find this quote:
“We are equally positive that once he takes any alcohol
whatever into his system, something happens, both in the bodily and mental
sense, which makes it virtually impossible for him to stop.”
But studies have shown that people who think they are
drinking act drunk even if they aren’t drinking alcohol. And people who don’t
know they are drinking alcohol don’t act drunk. The behavior results from their
Studies have also shown that chronic drinkers will stop
drinking even after they’ve started if they have to give up the drinking place
or situation they have come to prefer in order to continue. Even people who are
drinking can make partially rational decisions about their behavior.
Why is this belief potentially
harmful? Because it can become a self-fulfilling prophecy. Cognitive approaches
begin with the idea that our beliefs lead to our behavior. If you believe
something will trigger a binge, it probably will. And this can be an
intensifying belief when a lapse does occur.
The notion that abstinence is the only successful approach
to problem drinking behavior.
Obviously, most of us have come to that conclusion about
our selves, based on our own past histories. I certainly believe it is my
healthiest choice. And evidence suggests that most people gradually
re-habituate to heavy drinking if they’ve done it before.
The problem comes when we project those experiences and
statistics onto everyone. Some people do eventually drink moderately, or
socially, or just reduce the harmful levels at which they were drinking. So the
statement that “there is no such thing as making a normal drinker out of an
alcoholic” is questionable at best (depending on how you define ‘alcoholic’).
Dire predictions are unproductive, possibly even
counterproductive (think back to your junior high school drug “education”
classes). This is a pretty easy notion to test for ourselves anyway, and if
someone wants to try moderate drinking the resources at Moderation Management
(moderation . org) are very useful.
The notion that substance abuse is incurable.
Recently a young man said to me, “Once a tweaker, always a
tweaker.” Just a variant of “Once an alcoholic, always an alcoholic.” Nope.
Cognitive approaches based on CBT embrace the concept that
one can move beyond any behavior. Since they are based on the concept that your
beliefs cause your behavior, the logical extension of the principle is that
your behavior has largely changed once you have firmly adopted new beliefs.
Relapses occur for some people. But they aren’t
necessarily a full-blown return to the previous behavior. This is one of the
reasons secular approaches resist the use of labels. ųAlcoholic? ųRecovering’
or ‘recovered’? You decide for yourself. If the fear of relapse motivates you,
then the label and the notion that it’s incurable may be useful. But it’s a
belief, and it’s individual: it’s not a fact applicable to everyone.
Why is this notion potentially
harmful? Because IMO it fails to acknowledge the accomplishment of behavior
change. Although fear is useful in early abstinence, I believe long term
sobriety comes from recognizing and internalizing the benefits we’ve found.
The notion that change is not possible on our own.
This one is incredibly common: that only in recovery
groups, or rehab, or counseling (take your pick, or all three) will we be able
to get sober.
We will be “unable to stop drinking on the basis of
(Chapter 3, Big Book). “The first requirement is that we
be convinced that any life run on self-will can hardly be a success.”(Chapter
This gets at the basic concept of where change comes from.
People vary in this regard! ‘Self’ is at the core of cognitive behavioral
approaches. The recovery jargon is ‘internal’ or ‘external locus of control’,
and you can take online quizzes to see what your own beliefs are.
Secularists are likely, IMO, to believe change is
internal. So sobriety is mostly a matter of learning new tools for changing
behavior, and new ways to cope with life’s stress factors. People predisposed
to believe in a god are likely to accept that change will be external.
This notion that we can’t get
sober on our own ignores the beliefs and values of a significant percentage of
the population. Cognitive approaches, by comparison, reinforce those beliefs.
The notion that a higher power is necessary for change is
a logical extension of the ‘external locus’ idea. No problem if you are
predisposed to such a belief. But it’s a real stretch for agnostics, atheists,
and secularists. Indeed, when taken as an absolute (“his defense must come from
a Higher Power”, Chapter 3) it clearly states that failing to accept an
‘external locus’ of change is doomed to failure. Yet such people do achieve
Note: secularists are often referred to the Big Book’s
Chapter 4: We Agnostics. But the whole premise of that chapter is non-agnostic:
“Actually we were fooling ourselves, for deep down in
every man, woman, and child, is the fundamental idea of God.
We finally saw that faith in some kind of God was a part
of our make-up.”
Certainly no atheist would write that. Most agnostics
wouldn’t. It seems to argue against our core theological beliefs by implying
that they are character defects (there are numerous examples; just re-read the
chapter if you don’t believe me).
Again, it is a vigorous defense
of the notion of an “external locus” of control. Again, it doesn’t recognize
how people differ. There is no one-size recovery approach. “We have found”
would be preferable to “must come from”.
The notion that we must grapple with the urge to drink
every day. One Day At A Time, and all that.
This certainly seems true in early sobriety. It really has
to do with the immediacy and intensity of urges. Dr.Thomas Horvath, President
of SMART Recovery, describes common misconceptions about urges:
Urges are awful or unbearable.
Urges are constant, and get worse.
Urges force one to use or act, that we can’t control
our behavior when we really want something.
We will suffer serious mental anguish if we don’t act
on our urges.
If you believe these things, each day may be an argument
about using or drinking. But in fact, we CAN stand them, they are time-limited,
they don’t MAKE us use or drink, and nobody goes crazy or dies because they
want to drink or use drugs.
My own experience has been that
the farther I have left drinking behind, the less I think about actually doing
it. I have memories of drinking, and there are times when situations or smells
or emotions make me recall what it was like. But those thoughts aren’t really
urges. They’re memories. And they don’t happen every day.
Progress can be celebrated even if it isn’t perfect (seems
to me there’s a slogan about that somewhere). You can do it on your own, but the
good news is you don’t have to. Nothing is inevitable. You can find the power
from within, or find comfort in seeking it elsewhere. What you believe is key.
It’s your recovery.