January 18, 2015
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.
85 Substance
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The experiences of most young people with addiction are brushed under the carpet. Photo via
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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79 Comments
79 comments on “Most People With Addiction Simply Grow Out of It: Why Is This Widely Denied?”
Craig Dickinson
Addiction which used to be called a Habit when I was growing up is exactly that a ” Habit”… Therefor for this addict has become harder and harder to get out of as I grew older. Now clean for 11/2 yrs. still feel it’s around the corner awaiting my return. Though I find this article and its statistics or ODDs a bit confused, this has been the story of my life. Get well Y,all ! I do feel great , Craig/Dad-2 https://www.facebook.com/pages/DAAD-Drug-Addicts-Against-DRUGS/827943680551991
Shaun Shelly
This aligns very much with what I wrote in a recent article on some of the myths of addiction: http://www.addictioncapetown.blogspot.com/2014/09/myths-of-addiction.html
It is about time we started challenging the academic articles which start with what is considered “accepted knowledge”: “Addiction is a chronic progressive disorder which left untreated…..blah blah blah”. We know that these “facts” are not true, and peer reviewed articles should not be perpetuating this misinformation.
I have been criticised on various forums for my stance, but I am merely repeating what the data says. This message is important because it directly informs treatment approach.
Chris
I don’t really have dog in this fight. I’m sober 17 years without the assistance of any outside system, group, program, etc. Though I have no animosity towards any effort that helps people get sober.
So, I’d like nothing more than to embrace your position but it’s hard when one of the first pieces you link to (it would seem in order to suggest that seeking assistance in the cessation of one’s active addiction is almost without value—or worse, negative consequences) concludes:
“Help-seeking plays a significant role in the achievement of abstinent recovery from alcohol dependence, with 12-Step participation playing a major role.”
James Morris
I think the point isn’t that help-seeking is bad, just that most people don’t and still recover. This fact goes some way to disproving addiction as a ‘chronic disease’.
However if you look at people that do seek help, they’re level of addiction is typically much more severe and so 12 step or peer support does play a major role. Severity of dependence brings different challenges. One includes the (un)liklihood of being able to achieve ‘normal’ or ‘controlled’ drinking – far less likely in more severely dependent drinkers.
Kenneth Anderson
Follow the money. Rehabs get rich off of selling treatments that don’t work because they are not forced to prove effectiveness better than a control group. They just parade testimonials in front of your face like any classic snake oil salesman.
chris graviss
nailed it
colechance
The most valuable part of treatment is probably the distance between you and the substance. To some people, that is priceless. But I agree that treatments are big business….
Tony
I quit smoking cigarettes at age 19 and quit getting drunk about age 20. It was at that age that I just started to realize my dumb choices. The data in this article coincides with my experience. Most of my friends had similar experiences. Other drugs like heroin and cocaine seem to be more difficult to kick. Being educated at a young age kept me away from those “harder” drugs.
Being forced into AA at 16 largely contributed to my smoking habit – due to church basements filled with smoke. I believe if I had been court ordered to stay in treatment for addiction, I would be addicted to alcohol today. There’s just something about that taboo that makes you want to do it – like if you’re on a diet and you spend 3 nights a week talking about cupcakes and bacon cheeseburgers…… you will be salivating.
Mimi Kate
Just had this discussion with a former addict family member who has recently reached the magic age at which people sometimes naturally age out of addiction. He went to rehab and was required to continue with AA and NA and now says that both of those are horrible ideas. They require you to continue to think of yourself as a lifelong addict that always needs help.
When i quit smoking, I remember one of the best pieces of advice I received was to think of myself as a non-smoker. Why encourage addicts to continue to think of themselves as such? Perpetuating myths of “help” and “care” is getting out of hand in this country.
Kristen
I think you are confusing true alcoholics/addicts with people who become physically addicted to alcohol/drugs. The disease of addiction for a TRUE alcoholic/addict centers in the mind. The alcohol and drugs are just a symptom of the disease. It is almost impossible for true alcoholics/addicts to grow out of their addiction without help. They may become sober on their own (physically withdraw themselves), but staying sober is the problem because the obsession of the mind. Take alcohol and drugs away from them, their problem begins.
Other people who don’t suffer from the mental obsession can easily detox themselves from the drug that their body has become physically addicted to. Take the alcohol and drugs away from them, their problems go away.
You don’t see many older True alcoholics/addicts because unfortunately, they are dead. Addiction is a hell of a disease that you don’t grow out of. You would know if you actually had it.
Kenneth Anderson
If there are such things as “true” and “false” alcoholics then why are there no clinical tests which can tell one from the other?
James Morris
Indeed – an ‘addicted’ brain may have changed but the brain changes when any learning occurs. Addiction is a disorder, but not a ‘disease’ in a scientific sense, like a brain tumuor.
Mimi Kate
Wrong. Look at non-smokers. Supposedly an addiction stronger than cocaine. Give it up, no more addiction. Might take a few tries.
Jonas
No, Kristen – You’re making the no true Scotsman fallacious argument. You see this often when your fellow cult members get offended by truth online. You believe that there’s a “real” or “true” alcoholic but you don’t realize that this is utter bs. It just feels that way to people who have been indoctrinated in AA.
Justin
You quote a lot of research and statistics in your article but fail to include the reference material you used to obtain this data. Without this information no one can verify any of the information,. Please list your references
Guy Lamunyon
Like Justin, I too am interested in the underlying research data. Please post here if possible
Kenneth Anderson
Every link in the article is a reference–click on the links
Shaun Shelly
Look at the link in my comment above, go to my Myths of Addiction Article and all the research and more is there. http://www.addictioncapetown.blogspot.com/2014/09/myths-of-addiction.html
Jeff Lake
I think this author is confusing people that experiment with drugs in their late teen years/early 20’s (typical coming of age stuff / rebellion) versus those with an addictive personality or chemical dependency.
Obviously, those that are just experimenting will leave it quite quickly.
The author fails to mention other addictions, such as food, shoes, shopping, etc.
But, those with an addictive personality and those that have a chemical dependency will have issues all of their life.
Food addiction is the worst as it’s something you need to live. More than two-thirds (68.8 percent) of adults are considered to be overweight or obese. http://win.niddk.nih.gov/statistics/
And people are NOT getting thinner as they age.
Yet, most of us will eat our way into obesity and heart disease.
Perhaps the author also forgot that the majority of cigarette smokers will smoke all of their life.
Most won’t even stop after being diagnosed with cancer or lung disease.
Kenneth Anderson
Your statements are false Jeff Lake–read this and weep http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227547/
I Can
Most people who are overweight or obese do not suffer from binge eating or compulsive overeating. Indeed, only about a third of obese people suffer from one of these disorders.
Stop spewing myths.
walt stawicki
adictive perdonality or cornered rat? read dr hearts book about crack, the docisl frames it occured in, and his references to the csnadisn Rat Park” experiments. the addict in the system is a victim of the system. as dr Gabor Maté so well nsiled it: ” if you want to design a system to fail, just adopt the current system.”
jacob
Please note: this quote is from ‘in the realm of hungry ghosts’ and refers to the political policies associated with America’s war on drugs. It is not a comment about the efficacy of rehab or 12 step programs.
walt stawicki
adictive personality or cornered rat? read dr hearts book about crack, the docisl frames it occured in, and his references to the csnadisn Rat Park” experiments. the addict in the system is a victim of the system. as dr Gabor Maté so well nsiled it: ” if you want to design a system to fail, just adopt the current system.”
Ellen Sousares
While the “cornered rat” theory may speak to social and cultural issues that lead to widespread drug USE within a community, that in no way negates or detracts from the effects on the brain brought on by ADDICTION. Dr Hart has said flat out in interviews that he’s not speaking of addiction, he’s speaking of drug use, given that only about 20% of crack users, supposedly, become addicted. And none of this even gets into how different substances may have much different potential for addiction, and thus different needs for treatment, nor does it address one’s genetic propensity for addiction
Ellen Sousares
This article leaves me with hope, and also a few questions. My son is a 22 year old heroin addict who has been using, daily, since age 17. After a horrid experience with drug court, he opted out and is now in jail. He sounds wonderful…better than i’ve witnessed in all these years, through multiple attempts as treatment. It’s a wonderful thought to imagine perhaps he’ll grow out of this, perhaps his brain will finish developing. I question though, how effectively does this completion of brain development happen in the midst of a daily bombardment of opiates? And while I recognize that socioeconomics, culture and early childhood trauma may play a role in the development of addiction, this in no way negates the research that also shows the entrenched neuropathways created from longterm drug abuse and the the long term abstinence it takes for that to heal. I’ve experienced the effects of those entrenched pathways myself, when after 5 years abstinent from smoking, one night and one cigarette was all it took for me to be back to a pack a day, as horribly addicted as I’d been years before. I can see where brain development can have a role in natural recovery, but what about the brain effects brought on by years of substance use? How does that figure in?
ronsonal
i used heroin recreationally since i was about 17 intravenously but never experienced addiction, rebound depression on the other hand, but i simply don’t use it anymore it isn’t even that big of a deal, i would also run it through medical filters to negate the effects of particles lodging themselves in my veins or heart
Nada Daytona
Very good article. I always had a problem with AA and NA telling people to stop working and discourage going to school. When in reality that is most likely the best thing for the person. They are doing something positive with their lives and filling their time with healthy choices.
I think AA did this so they would have more free help to run meetings and be sponsors. It is self serving for 12 step programs and does nothing for the addicted.
aareding@live.com
I’ve been to many AA meetings, and never has anyone encouraged others to quit school or work. Well, maybe if they work in a bar…
steeleweed
I smoked for 45 years, with a few gaps of a month or two as I tried to quit. At 60, I quit overnight. I quit simply because I became a non-smoker.
I have known several alcoholics who have been ‘dry’ for decades but are still alcoholics. I’ve know only one who stop drinking because he stopped being an alcoholic. One stops when one’s self-image changes so that the addiction iis ego-dystonic.
One friend could stand up at AA and say, “I’m Joe, and I’m an alcoholic”. I challenged him to say, “I’m Joe, and I’m a pedophile”. He could not being himself to utter the words . A self-image as an alcoholic was tolerable or acceptable to him in a way that a self-image as a pedophile wasn’t.
You quit being addicted when you quit being an addict.
hshugar
100% agree! My father in law told me it would be easier to become a non smoker than to try to quit. He was right. I became a nonsmoker in Oct of 2007. After a few years clean in recovery, I applied that to the concept of being an addict. I no longer wanted to be viewed that way. I am so much more than my past mistakes and dwelling on them doesn’t make me a better person. I haven’t had a drink since Dec of 2004 and I haven’t had a drug since Aug of 2005.
Sarah
Everyone I know is an alcoholic, yet in denial, how does this data reflect that? I’ve known life long alcoholics, several who have died from it, so that was just a fluke? How does the data and conclusion account for heroin overdoses? Saying most stop by a certain age, may be moreso a matter of that most have passed by then. There is a huge difference between recreational users and actual addicts. People who partied on weekends vs the person who needs it everyday are not comparable. Some saying this proves is not a disease, but I think it only strengtgens that argument. Some people can go tanning without any concern, others, with genetic predisposition towards it, will develop cancer, same concept.
Do I think most people tone down the partying as they age? Yes! But they were social recreational users, the ones who waited all day to get home and drink to not feel, most likely still are.
Bon Jovi
“By age 35, half of all people who qualified for active alcoholism or addiction diagnoses during their teens and 20s no longer do.”
And half will. And will continue to suffer, will be at great risk of death, will continue to ruin their families, impact the lives of others negatively, create billions in health-care costs, etc.
Folks, we’re talking about MILLIONS of people who will struggle for most of their lives.
Tell us again how this translates to some kind of rosier picture about addiction?
ColGraff
Very interesting. What about those addicts who have encounters with the criminal justice system, though? Can we tell whether *they* normally age out of addiction? It might be hard to tell, since once you’re in the system, you often get some sort of treatment (even if it’s just “cold turkey”). But if those addicts who have run-ins with the law are the sorts who *don’t* tend to age out of addiction (because their addictions are more severe), then the fact that most addicts age out of addiction wouldn’t seem to have much relevance to criminal law and policy. (Though it would still be important in other fields).
Gary Olson
I am wondering why I haven’t seen this study. It reinforces our number one priority: keeping people alive during the acute phases of drug and alcohol addiction.
In any case, the article mentions heroin, but the NIH paper does not. So where does the information on remission from heroin addiction come from. Am I missing something?
Dave
Addiction is risky to the addict and anyone in the path of an addict. Some addicts commit crime, some drive drunk, some are bad friends, parents, and employees etc……to simply wait for them to outgrow their addiction has no significance. A truck running down a mountain road will also simply stop on its own….does the writer pretend that there will be no damage along the way?
Nicole
There is a HUGE difference between using addictive drugs and being and addict. And does this article mean aging out to abstinence or able to partake responsibly?\
colechance
I did not get sober through treatment though I went to many, not aa though I went a LOT. I did however get sober eventually knowing that I would NEVER GROW OUT of this disease. Telling people wait it out is irresponsible and dangerous. It’s not puberty!!!! Life threatening!!!
sam brown
This author persists in trying to minimize the consequences of drug/alcohol addiction in every piece she writes even as she admits the consequence she suffered. The author got treatment, so how does she know she would have outgrown addiction without it? Teenagers and young adults who get addicted suffer consequences that can persist many years and even result in death and have a huge impact on family members as well. The best approach is prevention and early intervention to prevent these huge consequences. This aging out may or may not happen, so waiting for the problem to resolve is too risky. Many people in treatment are young, but many are middle aged or older, especially alcoholics. The first part of the article gives a length of an addiction, but that is not tied to age, just average duration, so one could last much longer. Drug and alcohol abuse is not something that people need to go through. It is not normal to shoot up a drug and weigh 85 pounds. It’s not normal to get kicked out of college. I have a son who went through this and much more and continued despite multiple interventions and treatments, but after the last treatment finally has stopped…at least for now. But he and I and other family members have PTSD from the horror of all his consequences that ruined his life chances and almost killed him multiple times. He will need to struggle for years and may never retain the potential he had when he was 17. Let’s not normalize drug use on the basis of it somehow going away on its own for some people, as a so-called phase.
colechance
Indeed. I’ve been really shocked about all the feedback in line with the article. This is a dangerous way to treat addiction. I hope the best for your son. I know and my mother would also attest that my addiction years were also tragic for all involved. No one who has been through it hard, like it sounds your family has can support these statements. I just wonder what the point is of the article though? Is it she thinks this is hopeful? Is she against treatment and would rather folks just wait? So baffling.
Melvyn Bowler
One of the most interesting outcomes of this article is the way that many of those who comment misrepresent what the author wrote. This misrepresentation is then used to “prove” Maia is wrong, and their own take on this is right.
And this, of course, is what happens in 12 step groups and many rehabs.. Anything that disagrees with the accepted “truth” is denigrated and discarded.
Nevertheless, there is nothing new in the main thrust of the article, and the author is simply presenting information which I first learned back in 1976. Long before harm minimization came on the scene.
Back in the early 70’s a couple of Social Workers ran an agency in inner Melbourne called Buoyancy. Their function was to keep heroin addicts alive until the addict decided that he or she had had enough, and stopped. And whilst doing that they would give all necessary support to those who decided to stop.
Some of their clients stopped, some died, and some continued to use heroin.
From a perspective of about 40 years dealing with alcohol and drug addiction I would agree with the point that many addicts grow out of their addiction. And I would say that hitting a personal crisis caused by alcohol or drug use that results in a rock bottom, which if maintained by self, 12 step group, or other, can bring about a change of thinking that results in sobriety.
It appears that some people can maintain that sobriety on their own, whilst others find outside help.
Both are to be commended.
What is not to be commended are closed minds which are resistant to new information (in this case old information) that disagree with currently held beliefs.
Recovery, and therapy, should always be open to progress.
colechance
are you combining that hitting rock bottom and staying sober in one form or another is the same aging out? I’m comparison to what? And is aging out complete abstinence in your view or can you moderate? I’m really trying to figure out where your side of the argument is coming from. I have been to numerous treatments and stints with AA. I do neither now, am a year sober and extremely happy. I also do not consider myself anywhere close to “aging out” . I am cautious of my situations and moods, if I were to start, I again would not be able to stop be cause I have a CHRONIC disease. Learning to manage your disease is not the same from growing out of it. I’m failing to see what your argument is actually against. Addiction is a massive problem, if there are those who are lucky enough to grow out of it well, great, those are not the ‘addicts’ that the problem is about . Back to the disaster at hand already.
Melvyn Bowler
You ask –
“are you combining that hitting rock bottom and staying sober in one form or another is the same aging out? ”
No I am not.
They are two ways of getting to a point where the addict wants to stop. Maturing out (as it is called) can happen without a crisis in the addicts life. A rock-bottom usually involves some kind of crisis. Then the problem becomes “how do I maintain my new thinking about my addiction”.
I thought it was clear that I was against misrepresenting what other people say.
You also say –
“if there are those who are lucky enough to grow out of it well, great, those are not the ‘addicts’ that the problem is about .”
Given that those who mature out had previously led a life of active addiction, during that time they are no different to any other addict.
I know of no method of knowing whether or not an addict will live long enough to mature out. So all we can do is to be thankful that it happens to some addicts; but we had better not be waiting for it to happen.
Personally I wish that all addicts who want to stop find a way that works for them.
colechance
yes, any means possible is what is needed. What info is being “denigrated and discarded?” and turned into misinformation? An article saying that people grow out of it is not and active solution or really any helpful action info.
“if there are those who are lucky enough to grow out of it well, great, those are not the ‘addicts’ that the problem is about .” In regards to this, some comments I’ve read is “I grew out of it” Well, that’s hard to believe you we’re truly and addict but that is wonderful for you. But those that are still addicts are where the problem lies. I agree that we cannot wait it out, my confusion is what this paper is suggesting for people to do. She is vocally against treatment and aa, in this and other articles so I’m just wondering what her solution is. What is the purpose of knowing that some people will stop without help? Some cancer disappears as well but that makes the disease no less serious and offers no solution to those with it still active. Does that make my inquiry make more sense?
Melvyn Bowler
You say
” Well, that’s hard to believe you we’re truly and addict”
Given that you know nothing of my story your above statement tells me that you make assumptions based on no evidence.
End of dialogue.
colechance
huh??? I meant “you” as in a response to the comments of “I grew out of it” I wasn’t speaking to you personally, you didn’t make that comment. Reread that statement….I didn’t know if you were or were not and addict. Don’t get so offended, I’m trying to have a discussion. And to the people who act as if they just woke up one day and they grew out of it as if it was puberty……from my PERSONAL evidence……that’s not how it works. I made no assumptions on you at all.
namnezia
What about the other half that do not recover without help and continue to ruin their lives and those of their families? Moreover the article you cite, as far as I could tell, doesn’t really address whether individuals sought help to treat the addiction, it just reports the number of years before remission (ie. no longer being addicted). So in many cases, it might not be that folks “recover” they may have actively sought treatment. It also suggests that there are various reasons for people to go into remission:
“More than two thirds remissions from cannabis and cocaine dependence occurred within the first decade after onset of dependence, whereas only one-fifth of remissions from nicotine dependence and one-third of remissions from alcohol dependence occurred within that period. The differences in the rate of remission across substances may be explained, at least in part, by the speed at which physical, psychological and social adverse consequences manifest after the onset of dependence. For instance, the risk of early cardiovascular adverse consequences is much higher among individuals with cocaine dependence than among those with nicotine or alcohol dependence [33]. The behavioral disturbances resulting from cannabis or cocaine dependence and their illegal status impose stronger social pressures to remit [15]. The high availability of alcohol and nicotine environmental cues for their consumption may also contribute to explain the difficulty stopping the use of these substances [35]. ”
From: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227547/
So if you are addicted to cocaine, and you crash and burn, you will more likely be forced to deal with the addiction.
namnezia
Also, I can’t find the citation referring to the heroin data.
cmw
“Aging Out,” is the result of a “Life Benefit Analysis.”
hshugar
I could be way off base here but I don’t see the age out theory as a literal “birthday party” event. I tend to think it is the cumulative experiences and opportunities as well as aspirations that causes one to “outgrow” their addiction. I know for me this didn’t occur until I was 32. I got a late start and only spent maybe 2-3 years actively using. The catalyst for me was an abusive relationship with a drug addict. I turned to drugs for solace. Before I knew it, the dragon had me in its claws. I stayed high for about a year. I did a brief stint in treatment and stayed clean for 19 months. I was involved with a guy who did drugs though. I easily slid back into it. Another year or so was spent in absolute desperation. I went to detox and then meetings. Got thoroughly enmeshed in recovery. After a couple years I moved on. I am now 9 years clean and sober and a nonsmoker for 7 years. I outgrew the drugs and the lifestyle. My life got full of college and family and buying a home and raising kids and living the good life. My focus changed. I agree with Steeleweed, I became a non smoker and I stopped being an addict. This means I don’t hang out with the people who have their identities tied to that lifestyle in the present sense or past.
Michael
The addicts and alcoholics that are still alive may grow out of it, which makes me think they weren’t truly addicted. (Addicted to marijuana? Really?) Most addicts and alcoholics will end up in prison or the morgue, which is why their addiction is considered ended or no longer able to be recorded. Most alcoholics die from accidents like falling down stairs or off a roof or car accident, or just bleeding out though. I’m a 45 year old alcoholic that hasn’t had drink in 10 years, but I still have cravings, not for “drinking” though. I never even liked the taste of any alcohol, but I’ve put away enough for 10 lifetimes. It runs in may family. My grandmother and grandfather were addicts, and my grandfather was killed in a hunting accident, while drunk. My father finally had a liver transplant, and quit drinking. I had to go to rehab and now am a statistical oddity in that I’m still dry. But I have to be on my guard all the time.
colechance
fully agree
B More
I also know a family who had the “disease” of eating too much sugary and greasy foods. From grandparents to parents to kids. They were all food abusers with none of them under 250 pounds. A bunch of them are dead, too. Knew a family of heavy smokers that followed a similar pattern. In other words, no doubt bad habits are passed down from generation to generation.
James Ashley Shea
Maia,
I can’t argue with any of your facts, but I wish you could have been in Pasadena OA with me from 1986 through 2001. I learned to love fat people! There was so much joy, so much acceptance, so many hugs, and so many people working hard to make OA meetings available to all. I met anorexics, bulimics, people of normal weight, and fat people.
I began to remember how a fat airline clerk, librarian, teacher, or nurse had saved my butt. I listened to people share success and failure without caring about their bodies, and we applauded whatever the person said.
My first AA meeting was in 1979; in the next 20 years I attended thousands of speaker meetings. I felt sorry for nonalcoholics because they missed out on terrific entertainment every night, and I mean every night. I loved every AA meeting I ever attended. I had a hundred friends, and I mean people who knew who I was, because I stood up in front of the room and told them who I was.
You can think in terms of percentages, recovery rates, statistics, and “most people,” but 12-step meetings have given millions of people all around the world much more than just a way not to get drunk or pig out or shoot up or shop compulsively or chase a few dozen more orgasms.
I think you know all the words about recovery, but you don’t pay much attention to the music.
James Ashley Shea
The OA 12 & 12 is one of the finest books of any kind I’ve ever read, and I’ve read thousands of books of many kinds. Every word had to be approved by representatives of every intergroup, a process that took thirteen years.
Definitely worth reading for anyone in search of recovery or looking for a way to “walk in beauty,” as the Navajo philosophy suggests.
Valentine North
What about those that don’t get a chance to grow up?
You said you weighed 85 pounds at 23. Unless you’re very short, that’s a pretty serious health problem and will most likely see the effects later in life.
A lot of people have a social life by then, even loners. In highschool and college, you get the necessary interaction to build a network of friends/acquaintances and learn how to handle yourself in society.
How about a job? Did you have one? For how long? It doesn’t matter what it was, flipping burgers, or unpaid internship, it hardly matters. Again, it changes how you mature and interact with others and builds your work ethics.
piscescree
My heart hurts today. My body aches, my soul yearns for peace. I read Maia Szalavitz’s article and felt nothing. Nothing. It seems like savvy journalistic rationalizing for some purpose that I can’t decipher. Are you trying to help? Who? Are you trying to get people to stop placing faith in something that works for hundreds of thousands, nay millions, to just “wait” for the madness to end?
I am 43. University educated, gainfully employed. I am good at what I do; have many talents/gifts: I cook, I sing/play guitar, I write, I love the intricacies of life the the panorama of culture. My children are 19, 18, 15, 13, and 6 and 6 respectively. Yet I have spent more in 15 years of active crack addiction than I have spent on them by FAR. This aches in me in a way you can not know.
Yet today, my body aches, my brain is addled and my soul yearns for peace as I was using until 3:00 am again last night. I live alone, away from my family for work, in a cheap motel room, doing wonderful work that I love. Yet, I choose the same instrument of my demise daily.
The momentary flush in my cheeks that I felt on that day, 32 years ago, walking down Murder Hill with Richard Williamson when he said, “wanna smoke a joint”? is the exact flush I feel when I make it up in my mind that I will be going home and “picking up” nearly every day. I have not grown out of it. I have, in fact, grown into it.
I read Mate’s work – and it resonates. I read the Big Book – and it resonates. I read this, and I’m sick to my stomach. Maybe I’m “different” (one of my sponsors says “I suffer from terminal uniqueness”) from the people in your survey or because I’m not Uhmerrcan. B
piscescree
My heart hurts today. My body aches, my soul yearns for peace. I read Maia Szalavitz’s article and felt nothing. Nothing. It seems like savvy journalistic rationalizing for some purpose that I can’t decipher. Are you trying to help? Who? Are you trying to get people to stop placing faith in something that works for hundreds of thousands, nay millions, to just “wait” for the madness to end?
I am 43. University educated, gainfully employed. I am good at what I do; have many talents/gifts: I cook, I sing/play guitar, I write, I love the intricacies of life the the panorama of culture. My children are 19, 18, 15, 13, and 6 and 6 respectively. Yet I have spent more in 15 years of active crack addiction than I have spent on them by FAR. This aches in me in a way you can not know.
Yet today, my body aches, my brain is addled and my soul yearns for peace as I was using until 3:00 am again last night. I live alone, away from my family for work, in a cheap motel room, doing wonderful work that I love. Yet, I choose the same instrument of my demise daily.
The momentary flush in my cheeks that I felt on that day, 32 years ago, walking down Murder Hill with Richard Williamson when he said, “wanna smoke a joint”? is the exact flush I feel when I make it up in my mind that I will be going home and “picking up” nearly every day. I have not grown out of it. I have, in fact, grown into it.
I read Mate’s work – and it resonates. I read the Big Book – and it resonates. I read this, and I’m sick to my stomach. Maybe I’m “different” (one of my sponsors says “I suffer from terminal uniqueness”) from the people in your survey or because I’m not Uhmerrcan. But I want to stop. I need to stop. In my mind – I KNOW what I must do in order to implement the stop. For me, it will require a colossal effort, (of only a few small steps) of body-mind-spirit alignment. The one thing it will require? The will.
I need to muster the will.
I have had some run ins with sobriety over the years. They have all been synonymous with body-mind-spirit awareness. My heart knows what’s right; my brain is a big fat liar that says what it wants to get what it wants. My body just gets pulled around like Patrick the Starfish.
I know my psyche still has reverberations from the cortisol soup I was stewed in for 9 months (and two weeks: I didn’t want to come out; shit was off the hook out there), and I need to carefully steward my way through life with all of my resources brought into play.
Today I choose life. But I always talk tough when I hurt. I will do everything in my capacity to go to sleep tonight without using. But I said that to myself two days ago.
The will.
Thy will be done. Thine not mine. And I ain’t no Christian or Catholic or Buddhist or New Ager or any of the above… I am a believer in the inherent goodness of the universal energy that connects us all. And when I defer to that place in my brain – in my heart and in my soul – that place wherein originates my prayers – something changes. Something twigs. The world becomes less “about me” than it does “about thee”.
“Having had a spiritual awakening as a result of these steps, we tried to carry the message to other addicts and practice these principles in all our affairs.”
(sigh) gotta get me some of that!
S.
piscescree
I remember when I first heard about crack when I was about 15. “Party All the Time” by Eddie Murphy, “Sledgehammer” by Peter Gabriel and “West End Girls” from Pet Shop Boys were all out that year. I was still spending most of my time with Kabul black hash, Dave, Pat and Leo and no-name beer ($7.60 a 12/pack) and a beat up old LP of Led Zeppelin II.
I said, “Wow. Instantly addictive?” justifiably spooked. “I better not ever try that, or I’m FUCKED!”
Truer word were ne’er spoken.
colechance
My hearts going out to ya. Its a sick wicked rabbit hole. I hope you can find something that resonates enough to make a shift. I don’t suggest waiting to “grow out of it” like the paper says;)
I vividly remember the feeling of my heart drop in the milisecond that the high wore off. HEARTWRENCHING. I wish that not on the worst of the worst.
Yoga finally saved my life. After medical detox of course….Gave me something to hold on to, I really don’t know how to descibe it, I’m still expoloring the realms of it. Forever probably. Hope you find your peace.
piscescree
Funny. Yoga is something that my inner self has always known will help me. I am of mixed ancestry: A true product of colonialism. From mia mater: Scottish/Cree, mi pater: English/E.Indian. My spiritual inclinations tend toward native canadian philosophies with some resonating hindu understandings and catholic underpinnings.
I will move in the direction that my heart knows to be correct. And I’m sure that will be towards yogic activity.
Thanks colechance for your empathy. It feels good to be supported in my positive decision making.
PS: I went home last night, and didn’t use. Day 1, under my belt.
colechance
JAI !!!! (means victory in sanskrit!) Thanks wonderful piscescree. Mix all the things that resontate with you and create a unique spiritual soup out of it! And your fully supported by the universe as well. I’m not religious at all but one thing that always blows me away is how when I choose “good” the universe or whatever it is steps up and meets me where I am. I guess that’s a law of nature….energy attracting the same energy. ….Pretty incredible. ….. take that first step or shift of thought and action;)
Nat Turner
Why are people who have never experienced addiction allowed to wright and act as if they know anything about it?
Lori Goldie
I think many of you are mistaking what the word addiction means! Addicts are people who have TRIED many many times to quit using and could not succeed. They are people who have TRIED to control their using many, many times and could not succeed for long. Eventually, their controlled usage ends up right back to where it was before they tried or even worse. Their whole lives center around getting and using their drug of choice, and YES alcohol is a drug! Have I seen a true alcoholic quit drinking and stay quit drinking, yes I have, but they are miserable, unhappy, emotionally stunted people! If you can quit on your own without help and progress emotionally, then you are NOT an addict no matter how much you used or for how long. It is a state of mind where drugs and alcohol are our escape from the reality and pain of life. I am one of them who quit using with the help of the programs for about a year and then stopped going to meetings and became sicker and sicker emotionally until I started using again, thinking that after 10 years of not using, I could easily just do it on a social basis. Well I not only got to the same point I was at before I quit the first time, but I went beyond that point. We are the people that use drugs and alcohol to NOT have to feel! You cannot compare people who quit on their own and grow emotionally without help of programs to people who have tried over and over to quit or control their usage and fail. Obviously a TRUE addict is in a different category or EVERYONE in the world would be able to quit whenever they decided to. I really don’t appreciate this reading as it could potentially keep people from seeking the help they need. We are talking about apples and oranges here folks. There is no comparison to a real addict.
Mary Beth
Thank you Lori for stating what no one else seemed to think of. There is a real danger (in my opinion) of minimizing the seriousness of drug and alcohol use and abuse in young people by saying most people grow out of it. While that is demonstrably true, “most” is not all and that leaves a substantial number of people whose substance use may not be taken seriously in the hopes that they will just ‘grow out of it’. I will plead guilty to that myself. My son started using both alcohol and various drugs when he was around 15. I did everything I could think of to encourage him to stop without panicking. He kept using and kept using, birthdays went by and he kept upping the ante, getting in more trouble and outright refusing help until his final year when he entered a short rehab program and then sober living. He died in sober living of an overdose of fentanyl.
So while many or most grow out of it, not everyone does and no one should be encouraged to take substance use by their teen and young adult family members lightly.
Ne11y
I fit the exact pattern you describe. I gave up drugs and alcohol very easily in my mid 20s, but my treatment centre told me I had a life threatening disease and would need to go to 12 step meetings for the rest of my life. I spent the next 7 years mixing with addicts when I should have been getting on with my life. 12 step is a cult. They tell you you’re not like normal people and normal people don’t understand you the way they do. It’s incestuous with everyone in the fellowship having relationships with each other. I got into a relationship with another addict, who like the majority of those in 12 step are like the article refers to, the sickest and those who need the most help. This relationship was incredibly damaging. I shouldn’t have been anywhere near these people – I should have been getting on with my life. But I’d had the life scared out of me by the fellowship telling me if I didn’t go to meetings for the rest of my life I’d relapse and die. Thankfully I finally got the courage to get away, deprogram my mind of all the brainwashing, and now lead a normal life. No former addict needs 12 step to stay clean and sober, you stay clean and sober because, as the article says,you just grow out of all that nonsense. Those who persist in going to 12 step meetings have simply replaced their addiction to a substance with an addiction to the fellowship, and they are not in recovery.
Michael
I would like to see the evidence based research and stats for this
Alannah
Bloody died at 19 again at 20 really wanted to live so I stopped:)
Tombanjo
I would like to know where you get your information. Not all addicts attend AA or NA. There is a great documentary called “Pleasure Unwoven” which explains the addiction as a disease model.
rijkswaanvijand
My main objection to clinical views of addiction is that these are actually habits indeed, the prime parameter for discerning addictions seems to be the cultural acceptance of the habit one tends to endulge in:
My dad won’t miss a soccer match on the telee for instance, any interference with him watching his sports will get him worked up and very jumpy. But such habits are seldom called addictions.
It’s also usually not considered an addiction if one needs to consume mugs of coffee in order to be focussed at work.
I need lots of milk every day, but noone calls me a lactose junky.
There’s been a lot of (journalism) talk recently on how sugary foods are addictive and blablabla because they activate ‘reward centers’ of the brain, right at a time when there’s also a lot of condescending talk on poor dietary choices poor people supposedly make. Though it seems a basic prerequisite for food to be appetitive: we probably wouldn’t eat if it was not rewarding.
Therefor I think that a lot of addiction-science is often more of a retorical vehicle than it is a serious attempt to understanding.
Simon Chapman
Pretty much the same story with nicotine addiction. Between 2/3 & 3/4 of all ex-smokers quit unassisted. They often have several half-hearted attempts that they barely recall, and then one day — often without even planning it carefully, decide to quit & do. See http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000216
Becky
I have a problem with people speaking about alcoholism as though they have sat in AA meetings for years and know what they are talking about. I know many alcoholics who have relapsed after 5, 10, 20+ years of sobriety and come back in with their tail between their legs telling tales of how quickly they progressed from an occasional beer or glass of wine to daily drinking within weeks or months. Only most of the people who go out never make it back. We get to attend their funeral a few years later, dead from alcoholism. That is why we say our disease does push-ups while we are sitting in meetings and that is the fatal progression of this disease. You do many a disservice by saying things that you may think you have clinical proof for but it does not hold true in reality. I agree that their may be some in the rooms of AA who are not alcoholics/addicts. That they may be able to drink safely now that they have “grown out of it.” But is it really worth the risk of jails, institutions and death to find out. For this alcoholic
I think not. Besides keeping me away for self-destruction one day at a time, AA has given my the foundation for living a happy, joyous and free life.
Chuck Sigler
Carleton Erickson makes a distinction between drug abuse and drug dependence (the older DSM-IV categories in substance use disorders). He said on his website Addiction Science Research and Education Center (http://www.utexas.edu/research/asrec/presentations.html) :
“Drug abuse often precedes dependence”. The myth suggests that drug abuse causes drug dependence, when in actuality they are two different drug-use conditions. In many people dependence is preceded by abuse, but some people develop dependence without going through the progression of drug use, abuse, and dependence. In addition, many people abuse drugs for many years without developing the disease of chemical dependence.
Wade
I just wrote an article the other day about success rates in rehabs and what they mean, so I found this very interesting. After working for 8 years with a rehab center in Thailand and talking to literally thousands of people I agree, most people quite on their own. However some just can’t and end up in the cycle or rehab after rehab. I have put it down to allot of the rehabs trying to make you fit their program instead of the program fitting you. I don’t really believe one modality has a better chance of success then any others, but it will have a better chance if it “fits” the person seeking. If your interested in my take on it you can read here. http://rehabthailand.org/blog/thailand-rehab-success-rates/
Michael Y. Simon
The author of this article does not understand ADHD and has obviously misread and misinterpreted the research. She writes that “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.”
She’s wrong, and hasn’t done the work to bring reliable, scientifically valid information to parents and families.
ADHD is a lifetime disorder. Kids do not “age out” of ADHD. That idea has been fairly thoroughly debunked. The presentation of the disorder often changes from childhood into adolescence, and then again in young adulthood. This provides strong evidence that there are no true “subtypes” of ADHD; if there were really subtypes, you’d see the same presentation from childhood into adulthood. But what we know is that many children with ADHD have more symptoms and more debilitating symptoms as they move into adulthood. ADHD is a disorder of childhood onset. But if you apply the same diagnostic criteria to diagnosing adults as you do with children, you’ll OF COURSE find that the disorder has magically “disappeared.” This is nonsense. The symptoms of the disorder shift, going into adolescence and adulthood. The problem is that the diagnostic criteria for ADHD have not changed–and adults are being diagnosed by the same criteria, rather than say, by measures of functional distress. If I spent my time correcting poorly informed journalists about ADHD, I’d have a full time job on my hands. In fact, I could spend all my time correcting New York Times reporters, let alone science “reporters” like Maia Szalavitz.
Gina Pera
I don’t pretend to be an addiction expert, the way that Maia Szalavitz pretends to be a “neuroscience journalist” (a designation that should at least include an advanced degree or two in neuroscience) or an ADHD expert (in her confused reporting at Time.com).
But I am an ADHD expert, and I am aware of the addiction risk around unaddressed ADHD.
First, she is absolutely wrong here:
“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’s ONE study. Other, more thorough studies have shown that up to 90% do NOT outgrow ADHD symptoms. The difference comes in who is asked — the adults themselves or their loved ones. ADHD is associated with low insight – that is, poor self-awareness and objectivity about their challenges.
Using false suppositions about ADHD as her launchpoint further undermines the ridiculous notion that most people outgrow addictions.
Just as kids with ADHD might seem to outgrow ADHD symptoms (as outer manifestations such as hyperactivity mature into more of an inner restlessness) , people who are abuse substances might stop the substance abuse, while still suffering from the brain-based challenges that caused them to turn to substances in the first place. But that’s quite a different thing than addiction. And just because they’ve stopped using, it doesn’t mean their brain function is improved. Anyone heard of a “dry drunk?”
John
“colechance
on October 1, 2014 at 5:42 pm
I did not get sober through treatment though I went to many, not aa though I went a LOT. I did however get sober eventually knowing that I would NEVER GROW OUT of this disease. Telling people wait it out is irresponsible and dangerous. It’s not puberty!!!! Life threatening!!!”
“This disease”. Lol. Why do people with cancer or diabetes never talk like that? Perhaps because it’s bloody well obvious cancer’s a disease, so there’s no propaganda value for a cancer patient to memetically parrot that bizarre-sounding phrase
Berenice
It works all perfectly well as long as we do not consider food as an addiction. Food addiction seems to be the exception of all “drugs”. How comes? Ideas?
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