Addiction Myths That Are Hard To Quit
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Which Addiction-Quitting Methods Work Best?
In Tuesday’s newsletter we asked you what, in your opinion, is the best way to cure an addiction. We got the above-depicted, below-described, interesting distribution of responses:
- About 29% said: “Addiction cannot be cured; once an addict, always an addict”
- About 26% said “Cold turkey (stop 100% and don’t look back)”
- About 17% said “Gradually reduce usage over an extended period of time”
- About 11% said “A healthier, but somewhat like-for-like, substitution”
- About 9% said “Therapy (whether mainstream, like CBT, or alternative, like hypnosis)”
- About 6% said “Peer support programs and/or community efforts (e.g. church etc)”
- About 3% said “Another method (mention it in the comment field)” and then did not mention it in the comment field
So what does the science say?
Addiction cannot be cured; once an addict, always an addict: True or False?
False, which some of the people who voted for it seemed to know, as some went on to add in the comment field what they thought was the best way to overcome the addiction.
The widespread belief that “once an addict, always an addict” is a “popular truism” in the same sense as “once a cheater, always a cheater”. It’s an observation of behavioral probability phrased as a strong generalization, but it’s not actually any kind of special unbreakable law of the universe.
And, certainly the notion that one cannot be cured keeps membership in many 12-step programs and similar going—because if you’re never cured, then you need to stick around.
However…
❝What is the definition of addiction?
Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.
Prevention efforts and treatment approaches for addiction are generally as successful as those for other chronic diseases.❞
~ American Society of Addiction Medicine
Or if we want peer-reviewed source science, rather than appeal to mere authority as above, then:
❝What is drug addiction?
Addiction is defined as a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences. It is considered a brain disorder, because it involves functional changes to brain circuits involved in reward, stress, and self-control. Those changes may last a long time after a person has stopped taking drugs.
Addiction is a lot like other diseases, such as heart disease. Both disrupt the normal, healthy functioning of an organ in the body, both have serious harmful effects, and both are, in many cases, preventable and treatable.❞
~ Nora D. Volkow (Director, National Institute of Drug Abuse)
Read more: Drugs, Brains, and Behavior: The Science of Addiction
In short: part of the definition of addiction is the continued use; if the effects of the substance are no longer active in your physiology, and you are no longer using, then you are not addicted.
Just because you would probably become addicted again if you used again does not make you addicted when neither the substance nor its after-effects are remaining in your body. Otherwise, we could define all people as addicted to all things based on “well if they use in the future they will probably become addicted”.
This means: the effects of addiction can and often will last for long after cessation of use, but ultimately, addiction can be treated and cured.
(yes, you should still abstain from the thing to which you were formerly addicted though, or you indeed most probably will become addicted again)
Cold turkey is best: True or False?
True if and only if certain conditions are met, and then only for certain addictions. For all other situations… False.
To decide whether cold turkey is a safe approach (before even considering “effective”), the first thing to check is how dangerous the withdrawal symptoms are. In some cases (e.g. alcohol, cocaine, heroin, and others), the withdrawal symptoms can kill.
That doesn’t mean they will kill, so knowing (or being!) someone who quit this way does not refute this science by counterexample. The mortality rates that we saw while researching varied from 8% to 37%, so most people did not die, but do you really want (yourself or a loved one) to play those odds unnecessarily?
See also: Detoxification and Substance Abuse Treatment
Even in those cases where it is considered completely safe for most people to quit cold turkey, such as smoking, it is only effective when the quitter has appropriate reliable medical support, e.g.
- Without support: 3–5% success rate
- With support: 22% success rate
And yes, that 22% was for the “abrupt cessation” group; the “gradual cessation” group had a success rate of 15.5%. On which note…
Gradual reduction is the best approach: True or False?
False based on the above data, in the case of addictions where abrupt cessation is safe. True in other cases where abrupt cessation is not safe.
Because if you quit abruptly and then die from the withdrawal symptoms, then well, technically you did stay off the substance for the rest of your life, but we can’t really claim that as a success!
A healthier, but somewhat like-for-like substitution is best: True or False?
True where such is possible!
This is why, for example, medical institutions recommend the use of buprenorphine (e.g. Naloxone) in the case of opioid addiction. It’s a partial opioid receptor agonist, meaning it does some of the job of opioids, while being less dangerous:
It’s also why vaping—despite itself being a health hazard—is recommended as a method of quitting smoking:
Similarly, “zero alcohol drinks that seem like alcohol” are a popular way to stop drinking alcohol, alongside other methods:
This is also why it’s recommended that if you have multiple addictions, to quit one thing at a time, unless for example multiple doctors are telling you otherwise for some specific-to-your-situation reason.
Take care!
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Passion Fruit vs Pomegranate – Which is Healthier?
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Our Verdict
When comparing passion fruit to pomegranate, we picked the passion fruit.
Why?
Both of these fruits have beaten a lot of other contenders, so it’s time to pit them against each other:
In terms of macros, passion fruit has more protein, carbs, and fiber, the ratio of which meaning also that passion fruit has the lower glycemic index. So, we say passion fruit wins on macros.
In the category of vitamins, things are more even; passion fruit has more of vitamins A, B2, B3, B6, and C, while pomegranate has more of vitamins B1, B5, B9, E, and K. In light of this 5:5 tie, and since passion fruit’s overall vitamin coverage is better (in terms of meeting RDA needs) but pomegranate’s vitamins are often in shorter supply in diet, we’re calling it a tie on vitamins.
When it comes to minerals, passion fruit has more calcium, iron, magnesium, phosphorus, potassium, and selenium, while pomegranate has more copper, manganese, and zinc. That’s already an easy 6:3 win for passion fruit, before we even consider the fact that passion fruit’s minerals’ margin of difference is greater too.
Adding it up makes for a clear win for passion fruit. As ever when it comes to plants, enjoy both if you can, though!
Want to learn more?
You might like to read:
What’s Your Plant Diversity Score?
Take care!
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Burned Out By Tuesday?
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Avoiding Burnout, The Active Way
This is Dr. Claudine Holt. She’s double board-certified, in Occupational & Environmental Medicine, and Lifestyle Medicine.
In short: preventative medicine in all parts of our life.
Hopefully, you are reading this bright-eyed and bushy-tailed and ready to take on another exciting day in this wonderful, beautiful world!
On the other hand, it’s possible that you’re reading this semi-focussed, looking for a crumb of dopamine as much as you are looking for information.
If you’ve ever had the “What a week!” / “It’s only Tuesday” moment, this one’s for you.
What does Dr. Holt want us to know?
You can recover from burnout without guilt
Sometimes, we overreach ourselves. Sometimes, life overreaches us! Sometimes it’s not that we overcommitted—it’s just that we were taking each day as it comes, but sometimes several days gang up on us at once.
Sometimes, even, we can feel exhausted when it seems like we haven’t done anything.
Note: if you feel exhausted and it seems like you haven’t done anything, then be aware: you are exhausted for a reason!
What that reason might be may vary, but contrary to popular belief, energy does not just vanish. It went somewhere.
This goes double if you have any chronic illness(es), even if you’re not aware of having had a flare-up, chances are you were just exceptionally busy (on a cellular level).
And it’s easy to think that “mere” cellular activity shouldn’t be exhausting, but that is 100% of where our energy transactions happen—whether or not we are consciously aware of them!
See also: Eat To Beat Chronic Fatigue ← yes, this also covers when you are too exhausted to shop and cook like a TV chef
Dr. Holt specializes in working with burned out medical professionals (and also specifically specializes in working with women), but there are lessons for everyone in her advice. For example:
Fiction: ”Medicine is my calling–it’s who I am.”
Fact: You are more than medicine! Remember that your career is just one aspect of your life. Don’t forget to create your big-picture vision and tend the garden of the other areas of your life too.
Read more: Dr. Claudine Holt | Burnout: Fact vs Fiction
This same thing can go for whatever part of your identity frequently follows “I’m a…”, and is somewhere that you put a lot of your energy; it could equally be a non-professional job like “homemaker”, or a relational status like “husband”, or a cultural identifier like “Christian”, or a hobby like “gardener” (assuming that is not also your profession, in which case, same item, different category).
Indeed, a lot of women especially get hit by “the triple burden” of professional work, housework, and childcare. And it’s not even necessarily that we resent any of those things or feel like they’re a burden; we (hopefully) love our professions, homes, children. But, here’s the thing:
No amount of love will add extra hours to the day.
So what does she recommend doing about it, when sometimes we’re juggling things that can’t be dropped?
Start simple, but start!
Dr. Holt recommends to start with a smile (yes even if, and sometimes especially when, the circumstances do not feel like they merit it), and deploy some CBT tools:
Two Hacks to Quickly Rise Above Burnout (Or Any Circumstance)
We’ve expanded on this topic here:
With a more level head on, it becomes easier to take on the next step, which creating healthy boundaries—and that doesn’t just mean with other people!
It also means slaying our own perfectionism and imposter syndrome—both things that will have us chasing our tails 36 hours per day if we let them.
See also:
❝Burnout is the culture of our times. A culture that expects us to do more and think our way out of everything. A culture that asks for more than the body can bear. Unfortunately, even though the situation might not be of our creation, burnout culture is our inheritance.
An inheritance we can either perpetuate—or change—depending on what we embody.❞
Source: The Embodied MD on Burnout with Dr Claudine Holt
That “embodiment” is partly our choices and actions that we bring and own just as we bring and own our body—and it’s partly our relationship with our body itself, and learning to love it, and work with it to achieve wonderful things, instead of just getting through the day.
Which yes, does also mean making space for good diet, exercise, sleep and so forth, per:
These Top Five Things Make The Biggest Difference To Health
Want to know more?
You might like to check out Dr. Holt’s website:
The Embodied M.D. | Burnout Coach
…where she also offers resources such as a blog and a podcast.
Enjoy!
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Brave – by Dr. Margie Warrell
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Whether it’s the courage to jump out of a plane or the courage to have a difficult conversation, bravery is an important quality that we often don’t go far out of our way to grow. At least, not as adults.
Rather than viewing bravery as a static attribute—you either have it or you don’t—psychologist Dr. Margie Warrell makes the case for its potential for lifelong development.
The book is divided into five sections:
- Live purposefully
- Speak bravely
- Work passionately
- Dig deep
- Dare boldly
…and each has approximately 10 chapters, each a few pages long, the kind that can easily make this a “chapter-a-day” daily reader.
As a quick clarification: that “speak bravely” section isn’t about public speaking, but is rather about speaking up when it counts. Life is too short for regrets, and our interactions with others tend to be what matters most in the long-run. It makes a huge difference to our life!
Dr. Warrell gives us tools to reframe our challenges and tackle them. Rather than just saying “Feel the fear and do it anyway”, she also delivers the how, in all aspects. This is one of the main values the book brings, as well as a sometimes-needed reminder of how and why being brave is something to which we should always aspire… and hold.
Bottom line: if you’d like to be more brave—in any context—this book can help. We only get one life; might as well live it.
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Quit Drinking – by Rebecca Dolton
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Many “quit drinking” books focus on tips you’ve heard already—cut down like this, rearrange your habits like that, make yourself accountable like so, add a reward element this way, etc.
Dolton takes a different approach.
She focuses instead on the underlying processes of addiction, so as to not merely understand them to fight them, but also to use them against the addiction itself.
This is not just a social or behavioral analysis, by the way, and goes into some detail into the physiological factors of the addiction—including such things as the little-talked about relationship between addiction and gut flora. Candida albans, found in most if not all humans to some extent, gets really out of control when given certain kinds of sugars (including those from alcohol); it grows, eventually puts roots through the intestinal walls (ouch!) and the more it grows, the more it demands the sugars it craves, so the more you feed it.
Quite a motivator to not listen to such cravings! It’s not even you that wants it, it’s the Candida!
Anyway, that’s just one example; there are many. The point here is that this is a well-researched, well-written book that sets itself apart from many of its genre.
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PTSD, But, Well…. Complex.
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PTSD is typically associated with military veterans, for example, or sexual assault survivors. There was a clear, indisputable, Bad Thing™ that was experienced, and it left a psychological scar. When something happens to remind us of that—say, there are fireworks, or somebody touches us a certain way—it’ll trigger an immediate strong response of some kind.
These days the word “triggered” has been popularly misappropriated to mean any adverse emotional reaction, often to something trivial.
But, not all trauma is so clear. If PTSD refers to the result of that one time you were smashed with a sledgehammer, C-PTSD (Complex PTSD) refers to the result of having been hit with a rolled-up newspaper every few days for fifteen years, say.
This might have been…
- childhood emotional neglect
- a parent with a hair-trigger temper
- bullying at school
- extended financial hardship as a young adult
- “just” being told or shown all too often that your best was never good enough
- the persistent threat (real or imagined) of doom of some kind
- the often-reinforced idea that you might lose everything at any moment
If you’re reading this list and thinking “that’s just life though”, you might be in the estimated 1 in 5 people with (often undiagnosed) C-PTSD.
How About You? Take The (5mins) Test Here
Now, we at 10almonds are not doctors or therapists and even if we were, we certainly wouldn’t try to diagnose from afar. But, even if there’s only a partial match, sometimes the same advice can help.
So what are the symptoms of C-PTSD?
- A feeling that nothing is safe; we might suddenly lose what we have gained
- The body keeps the score… And it shows. We may have trouble relaxing, an aversion to exercise for reasons that don’t really add up, or an aversion to being touched.
- Trouble sleeping, born of nagging sense that to sleep is to be vulnerable to attack, and/or lazy, and/or negligent of our duties
- Poor self-image, about our body and/or about ourself as a person.
- We’re often drawn to highly unavailable people—or we are the highly unavailable person to which our complementary C-PTSD sufferers are attracted.
- We are prone to feelings of rage. Whether we keep a calm lid on it or lose our temper, we know it’s there. We’re angry at the world and at ourselves.
- We are not quick to trust—we may go through the motions of showing trust, but we’re already half-expecting that trust to have been misplaced.
- “Hell is other people” has become such a rule of life that we may tend to cloister ourselves away from company.
- We may try to order our environment around us as a matter of safety, and be easily perturbed by sudden changes being imposed on us, even if ostensibly quite minor or harmless.
- In a bid to try to find safety, we may throw ourselves into work—whatever that is for us. It could be literally our job, or passion projects, or our family, or community, and in and of itself that’s great! But the motivation is more of an attempt to distract ourselves from The Horrors™.
“Alright, I scored more of those than I care to admit. What now?”
A lot of the answer lies in first acknowledging to yourself what happened, to make you feel the way you do now. If you, for example, have an abject hatred of Christmas, what were your childhood Christmases like? If you fear losing money that you’ve accumulated, what underpins that fear? It could be something that directly happened to you, but it also could just be repeated messages you received from your parents, for example.
It could even be that you had superficially an idyllic perfect childhood. Health, wealth, security, a loving family… and simply a chemical imbalance in your brain made it a special kind of Hell for you that nobody understood, and perhaps you didn’t either.
Unfortunately, a difficult task now lies ahead: giving love, understanding, compassion, and reassurance to the person for whom you may have the most contempt in the world: yourself.
If you’d like some help with that, here are some resources:
ComplexTrauma.org (a lot of very good free resources, with no need for interaction)
CPTSD Foundation (mostly paid courses and the like)
Some final words about healing…
- You are in fact amazing,
- You can do it, and
- You deserve it.
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You’re Not Forgetful: How To Remember Everything
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Elizabeth Filips, medical student busy learning a lot of information, explains how in today’s video:
Active processing
An important thing to keep in mind is that forgetting is an active process, not passive as once believed. It has its own neurotransmitters and pathways, and as such, to improve memory, it’s essential to understand and manage forgetting.
So, how does forgetting occur? Memories are stored with cues or tags, which help retrieve information. However, overloading cues with too much information can cause “transient forgetting”—that is to say, the information is still in there somewhere; you just don’t have the filing system required to retrieve the data. This is the kind of thing that you will try hard to remember at some point in the day when you need it, fail, and then wake up at 3am with an “Aha!” because your brain finally found what you were looking for. So, to avoid that, use unique and strong cues to help improve recall (mnemonics are good for this, as are conceptual anchors).
While memory does not appear to actually be finite, there is some practical truth in the “finite storage” model insofar as learning new information can overwrite previous knowledge, iff your brain mistakes it for an update rather than addition. So for that reason, it’s good to periodically go over old information—in psychology this is called rehearsal, which may conjure theatrical images, but it can be as simple as mentally repeating a phone number, a mnemonic, or visually remembering a route one used to take to go somewhere.
Self-perception affects memory performance. Negative beliefs about one’s memory can worsen performance (so don’t say “I have a bad memory”, even to yourself, and in contrast, find more positive affirmations to make about your memory), and mental health in general plays a significant role in memory. For example, if you have ever had an extended period of depression, then chances are good you have some huge gaps in your memory for that time in your life.
A lot of what we learned in school was wrong—especially what we learned about learning. Traditional (vertical) learning is harder to retain, whereas horizontal learning (connecting topics through shared characteristics) creates stronger, interconnected memories. In short, your memories should tell contextual stories, not be isolated points of data.
Embarking on a new course of study? Yes? (If not, then why not? Pick something!)
It may be difficult at first, but experts memorize things more quickly due to built-up intuition in their field. For example a chess master can glance at a chess board for about 5 seconds and memorize the position—but only if the position is one that could reasonably arise in a game; if the pieces are just placed at random, then their memorization ability plummets to that of the average person, because their expertise has been nullified.
What this means in practical terms: building a “skeleton” framework before learning can enhance memorization through logical connections. For this reason, if embarking on a serious course of study, getting a good initial overview when you start is critical, so that you have a context for the rest of what you learn to go into. For example, let’s say you want to learn a language; if you first quickly do a very basic bare-bones course, such as from Duolingo or similar, then even though you’ll have a very small vocabulary and a modest grasp of grammar and make many mistakes and have a lot of holes in your knowledge, you now have somewhere to “fit” every new word or idea you learn. Same goes for other fields of study; for example, a doctor can be told about a new drug and remember everything about it immediately, because they understand the systems it interacts with, understand how it does what it does, and can compare it mentally to similar drugs, and they thus have a “place” in that overall system for the drug information to reside. But for someone who knows nothing about medicine, it’s just a lot of big words with no meaning. So: framework first, details later.
For more on all this, enjoy:
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Want to learn more?
You might also like to read:
How To Boost Your Memory Immediately (Without Supplements)
Take care!
Don’t Forget…
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