Addiction hits closer to home than many of us might realize. According to the 2023 United States National Survey on Drug Use and Health, 48.5 million Americans over the age of 12 — that is, about 1 in 6 — had a substance use disorder in the past year alone.
The destructive effects of addiction are real; they can include anything from infectious disease transmission to legal issues, family problems and suicide. And the stigma surrounding addiction and treatment can jeopardize treatment outcomes, research, policies and societies as a whole. It helps nobody, and it hurts all of us — especially the people it’s aimed at.
For people who have no personal experience with addiction, it’s easy to get a distorted idea of what the disease is actually like. But there’s no better way to correct these misconceptions than to talk to the people who know the subject firsthand. We asked some people whose lives have been touched by addiction to share the single most important message they want everyone to understand.
People with addiction don’t always look or live like you might expect.
When addiction is depicted in the media, it’s often in the context of news stories or TV shows where unhoused folks are stealing money for drugs. Or there’s the other extreme, where we see substance use glamorized. But such stories are simply not representative of the entire community.
“The image you see when you imagine a person who suffers from substance use disorder (SUD) is far from who we actually are,” said Ellen Linde, a family nurse practitioner at Ophelia in Pennsylvania who is in SUD recovery. “In reality, people who suffer from SUD are all around you. They’re your neighbor, your postman, your cousin and yes, your nurse practitioner. They look just like you.”
Linde treats people with SUD, and she came into contact with this stigma when she began that work in her office. “When I was planning to treat opioid use disorder (OUD) at my clinic, the staff was up in arms that I wanted to bring ‘those people’ into our nice little primary care office,” she said. “It took some work to convince them that we are already treating those folks — just not for OUD.”
Addiction can affect anyone.
Along those lines, it’s important to remember that people of all identities can and do experience addiction. It’s not exclusive to one race or gender.
“Addiction doesn’t discriminate,” said Jack Finn, a 37-year-old premium bartender in Indiana. “It can sink its teeth into anyone.”
In fact, the myths that suggest otherwise played a part in his not getting help sooner. He was in denial, he said, thinking he was fine because he worked and paid his bills.
“I think the most common mistake people make is they think it can’t happen to them,” Finn said. “The moment I got honest with myself was the moment that I started to slowly get my life back.”
There are many misconceptions about what addiction itself looks like.
The myths (and their dangers) extend to substance use disorder itself — not just the people who have it.
“The most important thing I want people to know about addiction is that it’s widely misunderstood, and these misconceptions can be harmful,” said Lester Morse, director at Rehabs UK, who has experienced addiction in the past. “This deeply ingrained misunderstanding can prevent people from recognizing it in themselves until it becomes severe and much harder to address.”
The problem extends even to health care settings. Morse spoke about individuals who were misdiagnosed with other conditions, then given treatments that worsened their addiction.
“Unfortunately, we’re still far from a collective understanding of addiction, which is why we see rising death rates and other devastating consequences,” he said. “Substance use disorders are symptoms of a systemic, socioeconomic type of disease. We cannot hope to eradicate addiction until we treat the deeper issues affecting our society.”
Using is a coping mechanism.
Addiction is a disease, not a choice. At the same time, though, it’s important to acknowledge the pain that might underlie a person’s struggles with addiction. Some examples (to scratch the surface) include violence, abuse, neglect and family or social conflict.
“The use of substances to get through life is almost always based on severe emotional disturbances from causes and conditions and/or genetic mental health conditions,” said Violet Kairos, a recovery writer in St. Louis and author of the award-winning book “The Open-Heart Open-Mind Recovery Concept.”
She encouraged people to think about this before judging others. “How do you know you wouldn’t do the same things if you lived within the same or similar circumstances?” she said.
People with an addiction think they’re in control.
If you know someone who has an addiction, it might seem self-evident that they have a problem. But that person may not be able to see or acknowledge the issue as clearly as you.
“We lie to ourselves about our addictions,” said Dennis Kreba, a 52-year-old IT project manager, blogger and writer in Canada. “I always thought that I was in control of alcohol until that night that I call ‘the incident.’ It took a big fight with my best friend to the point where I thought I had lost him to wake me up out of my stupor.”
Kreba said he hid his addiction from the people around him. They weren’t aware of it until he wrote a story about his experience.
He shares his story now to help others. “If you are an addict, you don’t have to suffer alone,” he said. “But you have to want it first … From there, it’s one day at a time.”
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Denial is common, both for people struggling with addiction and for people who love them.
You may have heard (or said) things like “I can stop whenever I want to,” or “They just do drugs for fun.” These can be examples of denial, or a way of feeling like you’re in control when you may not actually be.
Adam Wick, a licensed therapist and alcohol and drug counselor in Roseville, Minnesota, said he didn’t recognize it in himself for years. “I would rationalize, justify and minimize my behaviors to others,” he said.
He convinced others he was fine, too, so he could continue using. In fact, many people who have a family member living with addiction are in denial about what their loved one is going through.
“It wasn’t until I was able to be fully honest with myself that I was able to get well,” Wick said.
Getting sober is hard, but it can be a beautiful thing.
Alcohol and drugs can bring a sort of joy to someone’s life, so there’s grief that comes with recovery and sobriety ― like having to deal with the emotions you blotted out with drugs, or reconciling the friendships you had with people who liked to drink.
“Euphoric recall” ― that is, remembering past negative experiences as better than they really were ― is another phenomenon that can make sobriety harder.
Those examples are just a few of many. But regardless of what makes sobriety hard, self-compassion is crucial. And it’s vital to know that there’s hope it’ll get better.
“Getting sober is not the end of fun,” said MJ Gottlieb, co-founder and CEO of the sobriety app Loosid. “Feeling all the feelings, the pain, and struggling, is actually the beginning of living a truly authentic life with meaning and real connections.”
Gottlieb, who has experienced addiction himself, said he felt fear about that, but he pushed through.
“I was afraid of change and afraid of the feelings that I had to feel, but I realized that those feelings were there before, just not felt,” he said. “I realized that I needed help and realized how great life can be sober.”
It’s crucial not to enable a person struggling with addiction ― or to give up on them.
Many of us don’t know how to support someone with an addiction, and going about it in the “right way” is easier said than done. Chuck Colton, a 56-year-old mental health counselor at Urban Alchemy in Los Angeles who formerly struggled with addiction and was unhoused, has some pointers.
“It’s important not to enable someone with an addiction, but it’s equally crucial not to give up on them,” he said. “Many people struggling with addiction are aware of the pain they cause loved ones, and may distance themselves out of shame or fear of hurting them further.”
This advice comes from firsthand experience. “Two people in my life stopped enabling me, but continued to provide love and support, which made a huge difference in my recovery,” he said. “However, someone I was really close to completely disowned me when they discovered my addiction, and that loss still hurts deeply.”
You have to face problems head on.
Jake Ticknor, a 35-year-old in Sioux Falls, South Dakota, also warned against trying to numb emotions with drugs, alcohol or addictive behaviors.
Ticknor started drinking in college, wanting to escape his old life and have fun. After losing control of his life and feelings, and undergoing withdrawal at the hospital, he realized he needed to get sober. He later relapsed — as 40% to 60% of people do — but he’s been sober for about four years now.
He said that getting sober improved his mood, habits and outlook on life. “Now, facing things head on and working through them is the only option,” he said. “Running away no longer gets or deserves any of my attention.”
Instead, he talks to a therapist and practices meditation.
Lots of addiction resources exist.
Whether you want to be an ally or you see the signs of addiction in a friend or family member, one of the first important steps is becoming aware of resources. The support group Al-Anon is an option for people who are dealing with addiction secondhand.
People in recovery need to know they don’t have to do it alone. “I want people to understand that there are many available options today to treat addiction, and it does not have to feel like you are pedaling uphill or ‘white-knuckling’ it to stay clean,” said Alex Gardella, a 26-year-old in New York City.
Personally, she’s found medication-assisted treatment profoundly helpful, and she wants to destigmatize the idea of getting help. “You can use a mix of modern medicine and therapy to assist in your journey, and there is no shame in that,” she said. “You no longer have to struggle in recovery.”
It’s OK ― indeed, it’s good and helpful ― to reach out for support, no matter what you’re facing.
Need help with substance use disorder or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.
If you or someone you know needs help, call or text 988 or chat 988lifeline.org for mental health support. Additionally, you can find local mental health and crisis resources at dontcallthepolice.com. Outside of the U.S., please visit the International Association for Suicide Prevention.