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3 Myths About Alcohol Use Disorder We Need to Stop Believing

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My job involves talking with quite a few people in the addiction recovery field, so I hear a lot of facts, opinions and misconceptions about alcohol dependence from treatment professionals, doctors, and even people in recovery themselves. While it is typically a good idea to keep an open mind and remember opinions and misconceptions are often based in some foundation of personal truth, that does not automatically exclude them from being harmful when applied generally to a population of millions of people. Doing so helps perpetuate stigma, creates a greater resistance to treatment and can lead to more extreme and harmful alcohol use.

Myth #1 – If a person drinks too much, they must also have a mental illness.

A couple of years ago, while at an addiction conference heavily attended by licensed mental health professionals, one of the attendees said to me, “Anyone who drinks too much has something else going on mentally they must address.” Unfortunately, I’ve heard similar statements from many therapists and counselors. But research in this area does not back up the claims of these mental health professionals.

While it is true that many people are struggling with both alcohol use disorder and a co-occurring mental health issue, alcohol use disorder (AUD) is considered a primary condition. The Substance Abuse and Mental Health Services Administration (SAMHSA) estimates only 42 percent of those with substance abuse disorders also have mental health issues. Both addiction and mental illness carry their own daunting amounts stigma. If we force the stigma of mental illness on a person who does not actually have a mental illness, we may make it twice as hard for that person to get the help they need.

Alcohol can have various effects on people. For those with a family history of addiction, genetics can be an enemy with or without mental illness. A gradual increase in tolerance over time can also result in alcohol dependence. Those with co-occurring mental illnesses should certainly be treated by qualified mental health professionals, but for those people who do not, alcohol treatment should not require the added financial burden and stigma of a condition they do not have.

Myth #2 – Before a person can accept help for alcoholism, they must hit “rock bottom.”

One of the most popular concepts in addiction treatment is “rock bottom.” Rock bottom is that place where a person believes they either have lost, or are at risk of losing everything of value to them. Family members, friends, addiction professionals and even those in recovery often point to rock bottom as the only possible turning point in the life of a person struggling with addition.

I met a gentleman at a conference a while back who said something quite profound: “You can’t help someone if they’re dead. True rock bottom is death.” Along the way, many people hit “false bottoms” and thankfully, it scares them into not wanting to fall further. While this may work for many people, it shouldn’t be an ideal starting point to help a person with a progressive condition.

Myth #3 – Taking medication as part of alcohol addiction treatment is only swapping one addiction for another.

There is a downside to combining all addictions and treatments when we discuss substance misuse. Opioid addiction and treatment differs from alcohol, cocaine, gambling and more. Similarly, medication assisted treatment (MAT) for AUD differs from replacement therapy for opioids using methadone or the combined buprenorphine/naloxone medication.

The FDA has approved three medications for treating AUD: disulfiram, acamprosate and naltrexone. None of these medications are considered addictive. If a medication is not addictive, is cannot become a replacement addiction — therefore, this argument simply does not make any sense at all.

MAT for alcohol use disorder can be an incredibly effective harm reduction tool to reduce binge drinking and to reduce the overall number of drinks a person has in a week. It can also be used to help people reach or maintain abstinence. The use of medication as part of recovery is supported by countless addiction agencies, including SAMHSA. Yet, in part because of the myth of swapping addictions, a low percentage of patients who could benefit from this potentially life-saving form of treatment are offered this option.

Alcohol addiction and misuse costs everyone — not just those who drink or are exposed to family and friends who drink. We need to do everything in our power to topple the barriers that keep people from seeking help. These three myths are just the beginning. There are so many more mindsets that make it difficult for people to reduce or eliminate alcohol from their lives.

If you or someone you know needs help with alcohol use disorder and are interested in learning more about medication assisted treatment for AUD, including a harm-reduction technique called the Sinclair Method, please talk to your doctor and check out the free resources at

If you or a loved one is affected by addiction and need help, you can call SAMHSA‘s hotline at 1-800-662-4357.

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Thinkstock photo via Ryan McVay.

Originally published: September 11, 2017
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