Myths and Facts

Almost everything we think we know about addiction is wrong. These myths hurt families, friends and our community – and they make it harder for people to get well.


Myth: Using drugs or alcohol is a choice, so if someone gets addicted, it’s their fault.

Reality: No one would choose to get addiction, any more than they would choose to get cancer. It’s not the substance a person uses – it’s not even the quantity or frequency of use. Addiction is about how a person’s brain is wired. Brain imaging studies show that differences in the brain are both a cause and effect of the disease of addiction. Addiction is more about the reward system in the brain and how it responds to certain chemicals.


Myth: If someone just uses willpower, they should be able to stop using.

Reality: For people who are vulnerable to addiction, use of drugs or alcohol can lead to profound changes in the brain. These changes hijack the natural “reward pathway” of the brain. In nature, rewards usually only come with effort and after a delay. But addictive substances shortcut this process and flood the brain with chemicals that signal pleasure.  

When the disease takes hold, these changes in the brain erode a person’s self-control and ability to make sound decisions, while sending highly intense impulses to take drugs. These are the same circuits linked to survival, driving powerful urges no different from those driving the need to eat or drink water. 

These overwhelming impulses help explain the compulsive and often baffling behavior around addiction. 
The person will keep using, even when terrible things are happening to them. 


Myth: Addiction mostly affects certain types of people.

Reality: This disease does not discriminate. Addiction can affect anyone. No matter your age or income, ethnicity or religion, family or profession. In the Bismarck area, an estimated 20,000 people are suffering from addiction. That’s about 1 in 10 people ages 12 and up.


Myth: If someone has a stable job and family life, they can’t be suffering from addiction.

Reality: Many people live in denial because they’re successful in their professional lives, or because they don’t drink until after 5 pm, or because they come from a “good” home. The reality is that anyone can be vulnerable to addiction. Many people hide the severity of their illness, or don’t get help because of stigma and shame. If drinking or using drugs is causing any kind of conflict or problem in your personal or professional life, it’s worth seeking support.

Learn more about signs and symptoms of the disease.


Myth: People have to hit “rock bottom” before they can get well.

Reality: This simply isn’t true, and it’s dangerous. The longer you wait, the sicker the person gets, and this can have deadly consequences.  Studies show that people forced into treatment have an equal chance of success as people who decide to go on their own.

Also, people who get help before their illness is so severe have more resources to draw upon, such as supportive family or a job, to help them successfully recover. So the sooner someone gets help, the better.


Myth: Going to treatment will fix the problem.

Reality: Addiction is a chronic disease, which means it is a long-lasting condition that can be controlled but not cured.  Treatment can be the first step toward wellness but it’s just the very beginning. Many people need more than one treatment visit to get on a stable path to wellness. More importantly, staying well requires a lifelong commitment to personally managing the disease.


Myth: If someone relapses, they’re a lost cause.

Reality: Try not to be too discouraged by a relapse, which is a reoccurrence of symptoms of the disease. Addiction is a chronic illness very similar to type II diabetes or hypertension, meaning it requires lifelong management. Relapse is no more likely with addiction than it is for these other chronic illnesses.

Getting well involves changing deeply imbedded behaviors, which takes time and effort, and sometimes there are setbacks. This doesn’t mean that previous treatments failed, because the person with the disease still made progress overall in getting well.

A reoccurrence of symptoms may be a sign that the treatment approach or other supports need to reevaluated or strengthened, or that other treatment methods are needed. 

There is hope. Keep in mind that most people with addiction who suffer a reoccurrence of symptoms will return to recovery.


Myth: People with addiction are bad and need to be punished.

Reality: Sometimes, after prolonged substance use, people with addiction do horrible things. These bad acts are often impossible to understand. They are due to profound changes in the brain that compel them to lie, cheat, steal or worse, in order to keep using.  While this behavior can’t be condoned, it’s important to understand that they do it because they are deeply sick and need help. Sick people need treatment, not punishment, to get well.


Myth: Addiction is treated behaviorally so it must be a behavioral problem, not a disease.

Reality: Human behavior begins in the brain. Because of this, for certain people whose brains are not properly wired, negative behaviors are linked to the impacted brain's inability to discern between good and bad behaviors. Moreover, advanced brain studies show that different types of treatments, such as psychotherapy and medication, can both change brain function. This is true for depression and other illnesses, including addiction. Sometimes behavioral treatments, like counseling, are enough. Sometimes medication may be required as well. But the fact that behavioral treatments can be effective does not mean addiction isn’t a real illness. 


Myth: Prescription drugs are not addictive like street drugs because they come from a doctor.

Reality: Addiction to prescription medications, including painkillers, sedatives and stimulants, is a serious and growing problem, among all age groups. These drugs can be highly addictive and have serious harmful effects. Even if these drugs are prescribed by your physician, you may be at risk. If you are concerned about your own use or a loved one’s, talk with your physician or contact us for help. 



NIDA, Prescription drug abuse research update
Myths of Addiction, Carlton K. Erickson, PhD, American Psychiatric Association
Clean, by David Sheff