Research published in high-quality peer-reviewed journals reveals key information on the realities of addiction, exposing pervasive myths and misconceptions, as in these examples.

False Belief 1: Drug experimentation is normal for teens and shouldn’t alarm parents.

Drug use and experimentation among teens often is ignored by many—even parents, who then may be unaware that any use places adolescent brains in jeopardy. For today’s teens, life often feels overwhelming, but avoiding alcohol, tobacco, marijuana, and other drugs is their one best choice to promote continued healthy physical and mental development. Preventing or delaying all teenage substance use not only reduces their current risks for depression, psychosis, and school/learning problems, but it also significantly decreases their probability of addiction as adults.

Harvard’s Sharon Levy, MD, MPH, and founding National Institute of Drug Abuse Director Robert DuPont, MD, strongly advocate a zero-tolerance approach to youth substance use. They emphasize that no amount of drug use is safe for young people. They promote the One Choice initiative encouraging adolescents to avoid substance use: alcohol, tobacco, marijuana, and other drugs.

It’s now known that THC in marijuana interferes with the developing brain circuits responsible for regulating behavior, leading to increased risk-taking and poor decision-making. Even infrequent teen use can impede judgment, increasing the probability of risky behaviors and accidents. Adolescents also are more likely than adults to develop cannabis use disorder (CUD) due to their heightened neuroplasticity during this developmental stage. The resulting impairment may lead to academic underperformance and problematic interpersonal relationships.

False Belief 2: Addiction is a personal weakness.

Addiction is not about people being weak-minded. It’s far more complicated. Becoming addicted depends on the drug used, dose, route, frequency, and risk factors like ages of users. Also, the same drug at the same dose affects people differently because of personal differences, as well as the presence/absence of traumatic past life experiences.

Yale’s Joel Gelernter identified genetic variants associated with vulnerability to addictions. However, genetic characteristics themselves interact with environmental factors in developing substance use disorders (SUDs). As Nora Volkow, director of NIDA, has said, “Addiction is a complex disease of a complex brain; ignoring this fact will only hamper our efforts to find effective solutions …”

False Belief 3: People must hit “rock bottom” to recover from addiction.

No, no, and no! Roadside alcohol testing has prevented thousands of deaths and helped many people with alcohol use disorders (AUD) obtain help, sometimes by coercion of courts. About 50 percent of those arrested for DUI have an AUD. Users often deny they have a problem with drugs or alcohol and believe they are truthful. But they are lying to themselves.

Addiction is a chronic, relapsing condition driven by changes in brain circuitry, particularly in areas controlling reward, stress, and decision-making. While some people seek help after suffering dire consequences, others are compelled into treatment by the courts, based on a past offense. Waiting to hit “rock bottom” increases major risks of harming the person’s relationships, job, and health—and strengthens the hold of the drug over the person.

False Belief 4: Addiction treatment never works.

Researchers from the University of British Columbia and Harvard Medical School recently analyzed survey data from nearly 57,000 participants in 21 countries over 19 years, providing clear data. They discovered that the number-one barrier to treatment was addicted people themselves: Most were in denial and did not recognize they needed treatment.

Alcoholics Anonymous is often successful, non-judgmentally providing new members a roadmap, role models, hope, and social connections. Successful people actively involved in AA complain that their friends kept asking them why they “weren’t cured yet” since they went to so many meetings. But going to meetings is what works.

Even among experts, there’s no consensus on what constitutes successful treatment. To some, success is that the person is still alive and hasn’t been rushed to the emergency room because of an overdose in the past 6 months or year. To others, it is taking treatment medications. And to still others, only abstinence and a full resumption of all family and work obligations counted as success.

Another issue is that most people with SUDs have multiple addictions. Even when they overdosed, most took multiple drugs. It’s also true that many people come to treatment also needing treatment for other medical, addiction, and psychiatric problems. Yet only rarely are patients evaluated and treated for all issues.

False Belief 5: Overdoses of drugs don’t cause brain damage.

Drugs of abuse can harm the brain. Overdose survivors may suffer from undetected brain damage and hypoxic brain injury caused by opioid-induced respiratory depression. As a society, we better understand hypoxia as associated with drowning or choking than its much more common occurrence in drug overdoses with loss of consciousness.

Recent studies estimate that at least half of people using opioids have illicitly experienced a non-fatal overdose or witnessed an overdose. People who regularly use drugs are at elevated risk of brain injury due to accidents, fights, and overdoses. A single fentanyl overdose could cause hypoxia, brain injury, and memory and concentration problems.

Overdoses with counterfeit pills, cocaine, methamphetamine, xylazine, or heroin usually also include fentanyl, making neurologically compromising overdoses more common.

Summary

Myths and misconceptions increase stigma and decrease the likelihood that someone with an addictive illness will receive prompt, effective treatment. We need early intervention and treatment during the preaddiction phase. Bottom line: Preventing teen and young adult use is crucial.