By Cheryl Steinberg
According to large studies that focus on diseases, most people who have a diagnosable addiction problem tend to quit using drugs around their mid-20s and, without treatment. That may be due to the fact that, around your early to mid-20s is the period when the prefrontal cortex finally reaches maturity. This is the part of the brain that’s responsible for good judgment and self-restraint.
The American Society of Addiction Medicine defines addiction as “a primary, chronic disease of brain reward, motivation, memory and related circuitry.” And yet, that is not what these large epidemiological studies are showing.
For example, in a study of over 42,000 Americans in a sample designed to represent the adult population, by age 35, 50% of all people who, during their teens and 20s, qualified for a diagnosis of wither active alcoholism or drug addiction no longer do.
Therefore, if addiction truly was a progressive disease, the data would show that the odds of quitting drugs and alcohol get worse over time. What the studies show, instead, that as people get older, a higher and higher percentage end up in recovery.
‘The Clinician’s Error’
Why is it, then, that so many people still regard addiction as hopeless? One reason is a phenomenon known as “the clinician’s error,” which is so frequently reflected in articles and other such reporting on drug use and abuse. Journalists and rehabs tend to see only the extreme aspects of drug abuse and addiction. Those who can quit on their own you probably will and therefore go unknown to treatment programs and other sources of reporting and information.
Similarly, treatment providers get a skewed view of addiction and the nature of addicts: The people who keep coming back are not typical of drug addiction—they’re simply the ones who need the most help. Therefore, to base your concept of addiction only on the chronic relapsers is to create an overly pessimistic picture.
Addiction as a Developmental Disorder
One school of thought is to view addiction as a learning or developmental disorder, instead of the commonly touted disease model. If addiction really were a primary, chronic, progressive disease, natural recovery rates would not be so high and addiction rates wouldn’t peak so prevalently in young people.
If addiction is viewed as a developmental disorder, 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 when the cortical development is not yet complete. In early adolescence, when the drug use that leads to addiction by the 20s typically begins, this is when the emotional systems that deal with love and sex are kicking in but before the cognitive systems that regulate risk-taking are fully active.
Therefore, excessive drug use at this time probably interferes with both biological/physiological and psychological development. Biologically-speaking, it’s the impact of the drugs on the developing circuitry, itself, that is brain structure and chemistry. Psychologically – and just as important – if, as a teen, you don’t learn healthy ways of coping with the inevitable ups and downs of life and relationships, you miss out on a critical period for doing so. If you turn to drug use as a way to self-soothe, known as self-medicating, then you are of course more likely to develop a substance use disorder.
On the other hand, if you learn healthy coping skills in adolescence, even heavy drug use later may not be as difficult to kick because you already have a frame of reference for healthy coping methods.
Can You “Grow Out” of Your Drug Addiction: Research and Data
Data supports the concept of addiction as a developmental issue: If you start drinking/using with peers before age 18, you have a 25% chance of becoming addicted but, if your use starts later, your odds drop to as low as 4%. Very few people without a prior history of addiction get hooked later in life, even if they are exposed to the harder, more powerful drugs like opiate painkillers.
How This Can Support Recovery
Merely focusing on clinical samples, those who go to treatment, excludes vital information from the picture as a whole. To better understand recovery as well as how to teach it, it’s important to look at how people who quit without treatment were able to do so – what strengths and tactics they used to accomplish this.
In many cases of successful recovery without treatment, commonalities include finding a new passion in sobriety – whether in work, hobbies, spirituality, religion or other area of life, adding structure to one’s environment (such as going from college-life to a more regimented one of 9 to 5 employment), and developing important life goals that are at odds with continuing heavy drinking and/or drug use. Another really important similarity that was found in the research is that people who recover without treatment tend not to self-identify as ‘addicts.’
There are many paths to recovery—and if we want to achieve long-lasting sobriety as well as help others to recover, we need to explore all of them. That means recognizing that recovery outside of treatment and conventional methods exists—and not dismissing data we don’t like or that doesn’t “fit” with what we’ve read or been told. If you are seeking recovery from substance abuse or addiction, call an Addiction Specialist today at toll-free 1-800-951-6135. We can answer your questions about treatment options and other ways to recover.