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.

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:

SAMSHA.gov | Buprenorphine

It’s also why vaping—despite itself being a health hazard—is recommended as a method of quitting smoking:

Vaping: A Lot Of Hot Air?

Similarly, “zero alcohol drinks that seem like alcohol” are a popular way to stop drinking alcohol, alongside other methods:

How To Reduce Or Quit Alcohol

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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  • Stretching for 50+ – by Dr. Karl Knopf

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    Dr. Knopf explores in this book the two-way relationship between aging and stretching (i.e., each can have a large impact on the other). Thinking about stretching in those terms is an important reframe for going into any stretching program. We’d say “after the age of 50”, but honestly, at any age. But this book is written with over-50s in mind, as the title goes.

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  • How To Avoid Self-Hatred & Learn To Love Oneself More

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    Alain de Botton gives a compassionate, but realistic, explanation in this video:

    The enemy within

    Or rather, the collaborator within. Because there’s usually first an enemy without—those who are critical of us, who consider that we are bad people in some fashion, and may indeed get quite colorful in their expressions of this.

    Sometimes, their words will bounce straight off us; sometimes, their words will stick. So what’s the difference, and can we do anything about it?

    The difference is: when their words stick, it’s usually because on some level we believe their words may be true. That doesn’t mean they necessarily are true!

    They could be (and it would be a special kind of hubris to assume no detractor could ever find a valid criticism of us), but very often the reason we have that belief, or at least that fear/insecurity, is simply because it was taught to us at an early age, often by harsh words/actions of those around us; perhaps our parents, perhaps our schoolteachers, perhaps our classmates, and so forth.

    The problem—and solution—is that we learn emotions much the same way that we learn language; only in part by reasoned thought, and rather for the most part, by immersion and repetition.

    It can take a lot of conscious self-talk to undo the harm of decades of unconscious self-talk based on what was probably a few years of external criticisms when we were small and very impressionable… But, having missed the opportunity to start fixing this sooner, the next best time to do it is now.

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  • Bold Beans – by Amelia Christie-Miller

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  • Currants vs Grapes – Which is Healthier?

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    Our Verdict

    When comparing currants to grapes, we picked the currants.

    Why?

    First, a note on nomenclature: when we say “currants”, we are talking about actual currants, of the Ribes genus, and in this case (as per the image) red ones. We are not talking about “currants” that are secretly tiny grapes that also get called currants in the US. So, there are important botanical differences here, beyond how they have been cultivated; they are literally entirely different plants.

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    In terms of macros, currants have nearly 5x the fiber, while grapes are slightly higher in carbs. So there’s an easy choice here in terms of fiber and on the glycemic index front; currants win easily.

    In the category of vitamins, currants have more of vitamins B5, B9, C, and choline, while grapes have more of vitamins A, B1, B2, B3, B6, E, and K. So, a win for grapes in this round.

    When it comes to minerals, currants have more calcium, copper, iron, magnesium, phosphorus, potassium, selenium, and zinc, while grapes have more manganese. A win, therefore, for currants again this time.

    In terms of polyphenols, currants have a lot more in terms of total polyphenols, including (as a matter of interest) approximately 5x the resveratrol content compared to grapes—and that’s compared to black grapes, which are the “best” kind of grapes for such. Grapes really aren’t a very good source of resveratrol; people just really like the idea of red wine being a health food, so it has been talked up a lot and got a popular reputation despite its extreme paucity of nutritional value.

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  • Pistachios vs Almonds – Which is Healthier?

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    Our Verdict

    When comparing pistachios to almonds, we picked the almonds.

    Why?

    It was very close! And those who’ve been following our “This or That” comparisons might be aware that pistachios and almonds have both been winning their respective comparisons with other nuts so far, so today we put them head-to-head.

    In terms of macros, almonds have a little more protein and a little more fiber—as well as slightly more fat, though the fats are healthy. Pistachios, meanwhile, are higher in carbs. A moderate win for almonds on the macro front.

    When it comes to vitamins, pistachios have more of vitamins A, B1, and B6, while almonds have more of vitamins B2, B3, and E. We could claim a slight victory for pistachios, based on the larger margins, or else a slight victory for almonds, based on vitamin E being a more common nutritional deficiency than vitamin A, and therefore the more useful vitamin to have more of. We’re going to call this category a tie.

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    Take care!

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