This really needs to be broadly understood. Quite simply everyone can shake their habit through developing matured thinking habits. It really is about how you think. It may still need a heavy dose of motivation but that is often possible.
The surprise is that all addictions have a true half life in which the victim exits the scene. That is very good news and was not obvious until someone looked at the data. It is also a loud warning that all addictive substances need to be tightly controlled until a person reaches the age of twenty five to ensure adult brain maturation.
Better it indirectly provides a rule book and almost a manual for dealing with the problem. We can assemble the guidelines and properly train therapists. Knowing that one will grow up also motivates as well.
Most People With Addiction Simply Grow Out of It: Why Is This Widely Denied?
The idea that addiction is typically a chronic, progressive disease
that requires treatment is false, the evidence shows. Yet the "aging
out" experience of the majority is ignored by treatment providers and
journalists.
http://www.substance.com/most-people-with-addiction-simply-grow-out-of-it-why-is-this-widely-denied/13017/
When I stopped shooting coke and heroin, I was 23. I had no life
outside of my addiction. I was facing serious drug charges and I weighed
85 pounds, after months of injecting, often dozens of times a day.
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.
According to the American Society of Addiction Medicine, addiction
is “a primary, chronic disease of brain reward, motivation, memory and
related circuitry.” However, that’s not what the epidemiology of the
disorder suggests. By age 35, half of all people who qualified for active alcoholism or addiction diagnoses during their teens and 20s no longer do, according to a study of over 42,000 Americans in a sample designed to represent the adult population.
The average cocaine addiction lasts four years, the average marijuana
addiction lasts six years, and the average alcohol addiction is resolved within 15 years. Heroin addictions tend to last as long as alcoholism, but prescription opioid problems, on average, last five years. In these large samples, which are drawn from the general population, only a quarter of people who recover have ever sought assistance in doing so (including via 12-step programs). This actually makes addictions the psychiatric disorder with the highest odds of recovery.
While some addictions clearly do take a chronic course, this data, which replicates earlier research,
suggests that many do not. And this remains true even for people like
me, who have used drugs in such high, frequent doses and in such a
compulsive fashion that it is hard to argue that we “weren’t really
addicted.” I don’t know many non-addicts who shoot up 40 times a day,
get suspended from college for dealing and spend several months in a
methadone program.
Only a quarter of people who recover have ever sought assistance in doing so (including via 12-step programs). This actually makes addictions the psychiatric disorder with the highest odds of recovery.
Moreover, if addiction were truly a progressive disease, the data
should show that the odds of quitting get worse over time. In fact, they
remain the same on an annual basis, which means that as people get
older, a higher and higher percentage wind up in recovery. If your
addiction really is “doing push-ups” while you sit in AA meetings, it
should get harder, not easier, to quit over time. (This is not an
argument in favor of relapsing; it simply means that your odds of
recovery actually get better with age!)
So why do so many people still see addiction as hopeless? One reason
is a phenomenon known as “the clinician’s error,” which could also be
known as the “journalist’s error” because it is so frequently replicated
in reporting on drugs. That is, journalists and rehabs tend to see the
extremes: Given the expensive and often harsh nature of treatment, if
you can quit on your own you probably will. And it will be hard for
journalists or treatment providers to find you.
Similarly, if your only knowledge of alcohol came from working in an ER on Saturday nights, you might start thinking that prohibition is a good idea.
All you would see are overdoses, DTs, or car crash, rape or assault
victims. You wouldn’t be aware of the patients whose alcohol use wasn’t
causing problems. And so, although the overwhelming majority of alcohol
users drink responsibly, your “clinical” picture of what the drug does
would be distorted by the source of your sample of drinkers.
Treatment providers get a similarly skewed view of addicts: The
people who keep coming back aren’t typical—they’re simply the ones who
need the most help. Basing your concept of addiction only on people who
chronically relapse creates an overly pessimistic picture.
This is one of many reasons why I prefer to see addiction as a learning or developmental disorder,
rather than taking the classical disease view. If addiction really were
a primary, chronic, progressive disease, natural recovery rates would
not be so high and addiction wouldn’t have such a pronounced peak
prevalence in young people.
But if addiction is seen as a disorder of development, its
association with age makes a great deal more sense. The most common
years for full onset of addiction are 19 and 20, which coincides with
late adolescence, before cortical development is complete. In early
adolescence, when the drug taking that leads to addiction by the 20s
typically begins, the emotional systems involved in love and sex are
coming online, before the cognitive systems that rein in risk-taking are
fully active.
Taking drugs excessively at this time probably interferes with both
biological and psychological development. The biological part is due to
the impact of the drugs on the developing circuitry itself—but the
psychological part is probably at least as important. If as a teen you
don’t learn non-drug ways of soothing yourself through the inevitable
ups and downs of relationships, you miss out on a critical period for
doing so. Alternatively, if you do hone these skills in adolescence,
even heavy use later may not be as hard to kick because you already know
how to use other options for coping.
The data supports this idea: If you start drinking or taking drugs
with peers before age 18, you have a 25% chance of becoming addicted,
but if your use starts later, the odds
drop to 4%. Very few people without a prior history of addiction get
hooked later in life, even if they are exposed to drugs like opioid
painkillers.
So why do so many people see addiction as hopeless? One reason is “the clinician’s error,” which could also be known as the “journalist’s error” because it is so frequently replicated in reporting on drugs.
If we see addiction as a developmental disorder, all of this makes
much more sense. Many kids “age out” of classical developmental
disorders like attention deficit/hyperactivity disorder (ADHD) as their
brains catch up to those of their peers or they develop workarounds for
coping with their different wiring. One study, for example, which followed 367 children with ADHD into adulthood found that 70% no longer had significant symptoms.
That didn’t mean, however, that a significant minority didn’t still
need help, of course, or that ADHD isn’t “real.” Like addiction (and
actually strongly linked with risk for it), ADHD is a wiring difference
and a key period for brain-circuit-building is adolescence. In both
cases, maturity can help correct the problem, but doesn’t always do so
automatically.
To better understand recovery and how to teach it, then, we need to
look to the strengths and tactics of people who quit without
treatment—and not merely focus on clinical samples. Common threads in
stories of recovery without treatment include finding a new passion
(whether in work, hobbies, religion or a person), moving from a less
structured environment like college into a more constraining one like 9
to 5 employment, and realizing that heavy use stands in the way of
achieving important life goals. People who recover without treatment
also tend not to see themselves as addicts, according to the research in
this area.
While treatment can often support the principles of natural recovery,
too often it does the opposite. For example, many programs interfere
with healthy family and romantic relationships by isolating patients.
Some threaten employment and education, suggesting or even requiring
that people quit jobs or school to “focus on recovery,” when doing so
might do more harm than good. Others pay too much attention to getting
people to take on an addict identity—rather than on harm related to drug
use—when, in fact, looking at other facets of the self may be more
helpful.
There are many paths to recovery—and if we want to help people get
there, we need to explore all of them. That means recognizing that
natural recovery exists—and not dismissing data we don’t like.
Maia Szalavitz is one of the nation’s leading neuroscience and addiction journalists, and a columnist at Substance.com. She has contributed to Time, the New York Times, Scientific American Mind, the Washington Post and many other publications. She has also published five books, including Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006), and is currently finishing her sixth, Unbroken Brain, which
examines why seeing addiction as a developmental or learning disorder
can help us better understand, prevent and treat it. Her last column
for Substance.com was about which parts of the 12 Steps she would keep, which she would throw away and why.
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