# Everything We Think We Know About Addiction Is Wrong? **URL:** \ **Category:** Great Debates\ **Created:** [November 1, 2015, 11:18pm UTC](https://boards.straightdope.com/t/everything-we-think-we-know-about-addiction-is-wrong/736372 "2015-11-01T23:18:50Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![puddleglum](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puddleglum/32/137_2.png) [@puddleglum](https://boards.straightdope.com/u/puddleglum)\ **Post date:** [November 3, 2015, 5:15pm UTC](https://boards.straightdope.com/t/everything-we-think-we-know-about-addiction-is-wrong/736372/21 "2015-11-03T17:15:05Z")
The rat park analogy is not true. Think of famous drug addicts, Rush Limbaugh, Doc Gooden, Robert Downey Jr, etc. These are people who are rich, famous, and the world is their oyster. They became addicted not because their lives were bleak and boring but they had a psychological predilection for addiction. About ten percent of the population has it and those that do react differently to drugs than the rest of society. For these people reconnecting to people is an important part of getting better, but it is not the miracle solution. ---
**Author:** ![Freudian\_Slit](https://avatars.discourse-cdn.com/v4/letter/f/5daacb/32.png) [@Freudian\_Slit](https://boards.straightdope.com/u/Freudian_Slit)\ **Post date:** [November 3, 2015, 5:24pm UTC](https://boards.straightdope.com/t/everything-we-think-we-know-about-addiction-is-wrong/736372/22 "2015-11-03T17:24:53Z")
> [@txjim](#): > > Two years ago, my son was in the hospital for two months and was on morphine for 3 weeks or so while on ECMO. He spent the last 3 weeks of his stay on methadone to counter the potential addiction. Based on this, I don’t accept the statement that post-surgery patients have no issues with morphine. Yes, and prescription drug abuse is a huge problem…and a lot of those people do start because they’re given legitimate drugs and never are able to get off them. I guess you could argue the ones who don’t get off them have great social connections, etc…but I don’t think it’s quite as simple as the video’s making it out to be. Plus, what about nicotine? I don’t think that the average smoker is someone who’s all by themselves looking for something to fulfill themselves. I think a lot of folks just start and no matter how great or fulfilling their lives are, it’s really, really hard to quit. ---
**Author:** ![Little\_Nemo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/little_nemo/32/3120_2.png) [@Little\_Nemo](https://boards.straightdope.com/u/Little_Nemo)\ **Post date:** [November 3, 2015, 5:42pm UTC](https://boards.straightdope.com/t/everything-we-think-we-know-about-addiction-is-wrong/736372/23 "2015-11-03T17:42:02Z")
My speculation is that there is a genetic component to addiction. Some people have genes that make addiction likely and other people do not. So some people could use addictive substances and quit relatively easily is they chose to and other people could use those same substances in the same amount and find it almost impossible to stop. ---
**Author:** ![MrQwertyasd](https://avatars.discourse-cdn.com/v4/letter/m/9d8465/32.png) [@MrQwertyasd](https://boards.straightdope.com/u/MrQwertyasd)\ **Post date:** [November 3, 2015, 6:07pm UTC](https://boards.straightdope.com/t/everything-we-think-we-know-about-addiction-is-wrong/736372/24 "2015-11-03T18:07:39Z")
> [@Freudian\_Slit](#): > > Yes, and prescription drug abuse is a huge problem…and a lot of those people do start because they’re given legitimate drugs and never are able to get off them. I guess you could argue the ones who don’t get off them have great social connections, etc…but I don’t think it’s quite as simple as the video’s making it out to be. > > Plus, what about nicotine? I don’t think that the average smoker is someone who’s all by themselves looking for something to fulfill themselves. I think a lot of folks just start and no matter how great or fulfilling their lives are, it’s really, really hard to quit. Consider the [advertising campaigns for cigarettes](https://en.wikipedia.org/wiki/Torches_of_Freedom) - all based around very primitive instincts such as status, desire, femininity, masculinity. The advertisers know that average people’s lives aren’t that fulfilling, or the advertisers will insinuate a message that that is the case. Consider advertising as a bad parent constantly criticising it’s child, inculcating dissatisfaction and trying to break it’s connections with the rest of humanity, exploiting envy, insecurity, senses of inadequacy. ---
**Author:** ![Amateur\_Barbarian](https://avatars.discourse-cdn.com/v4/letter/a/59ef9b/32.png) [@Amateur\_Barbarian](https://boards.straightdope.com/u/Amateur_Barbarian)\ **Post date:** [November 3, 2015, 6:16pm UTC](https://boards.straightdope.com/t/everything-we-think-we-know-about-addiction-is-wrong/736372/25 "2015-11-03T18:16:08Z")
> [@MrQwertyasd](#): > > Consider the [advertising campaigns for cigarettes](https://en.wikipedia.org/wiki/Torches_of_Freedom) - all based around very primitive instincts such as status, desire, femininity, masculinity. The advertisers know that average people’s lives aren’t that fulfilling, or the advertisers will insinuate a message that that is the case. > Consider advertising as a bad parent constantly criticising it’s child, inculcating dissatisfaction and trying to break it’s connections with the rest of humanity, exploiting envy, insecurity, senses of inadequacy. There is little advertising that doesn’t fall into your first sentence’s summary. Most consumer goods are sold with the implication that you are less of a person without that product. So you’re correct - at least, in my view - but you can’t be so selective about the scope. I think it has more to do with it being an effective general tactic than anything specific to tobacco, or, I suppose, liquor. ---
**Author:** ![MrQwertyasd](https://avatars.discourse-cdn.com/v4/letter/m/9d8465/32.png) [@MrQwertyasd](https://boards.straightdope.com/u/MrQwertyasd)\ **Post date:** [November 3, 2015, 6:20pm UTC](https://boards.straightdope.com/t/everything-we-think-we-know-about-addiction-is-wrong/736372/26 "2015-11-03T18:20:08Z")
> [@puddleglum](#): > > The rat park analogy is not true. Think of famous drug addicts, Rush Limbaugh, Doc Gooden, Robert Downey Jr, etc. These are people who are rich, famous, and the world is their oyster. They became addicted not because their lives were bleak and boring but they had a psychological predilection for addiction. About ten percent of the population has it and those that do react differently to drugs than the rest of society. For these people reconnecting to people is an important part of getting better, but it is not the miracle solution. Well, but it’s a myth that being rich and famous equals psychological health. The rats were all given simulations of a comfy natural environment, not excessive wealth - it was rat park not rat palace. > [@](#): > > As a child, Downey was “surrounded by drugs”. His father, a drug addict, allowed Downey to use [marijuana](https://en.wikipedia.org/wiki/Marijuana) at age six, an incident which his father has said he now regrets.[[8]](https://en.wikipedia.org/wiki/Robert_Downey,_Jr.#cite_note-toughest-8) Downey stated that drug use became an emotional bond between him and his father: “When my dad and I would do drugs together, it was like him trying to express his love for me in the only way he knew how.” Eventually, Downey began spending every night abusing alcohol and “making a thousand phone calls in pursuit of drugs”.[[9]](https://en.wikipedia.org/wiki/Robert_Downey,_Jr.#cite_note-Hitting_Bottom-9) So did Downey grow up in a fully connected way ? But I suppose you could say “ah but they had a relatively comfy life - four walls, running water, furniture - it’s obviously a gene thing” - if normal human life was fulfilling instead of a rat race that may be true. [URL=“[Robert Downey Jr. - Wikipedia](https://en.wikipedia.org/wiki/Robert_Downey,_Jr.#cite_note-Hitting_Bottom-9)”] ---
**Author:** ![MrQwertyasd](https://avatars.discourse-cdn.com/v4/letter/m/9d8465/32.png) [@MrQwertyasd](https://boards.straightdope.com/u/MrQwertyasd)\ **Post date:** [November 3, 2015, 6:26pm UTC](https://boards.straightdope.com/t/everything-we-think-we-know-about-addiction-is-wrong/736372/27 "2015-11-03T18:26:06Z")
… or maybe it was more like a palace. Hmm, gotta think about this. ---
**Author:** ![Dangerosa](https://avatars.discourse-cdn.com/v4/letter/d/22d042/32.png) [@Dangerosa](https://boards.straightdope.com/u/Dangerosa)\ **Post date:** [November 4, 2015, 1:41am UTC](https://boards.straightdope.com/t/everything-we-think-we-know-about-addiction-is-wrong/736372/28 "2015-11-04T01:41:14Z")
> [@MrQwertyasd](#): > > So did Downey grow up in a fully connected way ? But I suppose you could say “ah but they had a relatively comfy life - four walls, running water, furniture - it’s obviously a gene thing” - if normal human life was fulfilling instead of a rat race that may be true. > [URL=“[Robert Downey Jr. - Wikipedia](https://en.wikipedia.org/wiki/Robert_Downey,_Jr.#cite_note-Hitting_Bottom-9)”] My sister grew up in a fully connected way. She had a loving family, a ton of friends. Addiction runs in our family, but it was distant to her - a great aunt and great grandmother she barely had exposure to. She had enough money to be comfortable. She’s a recovering alcoholic. Depression also runs in our family, which is part of her issue. And then she made a bunch of poor choices starting from a young age. A friend of mine lost her son to an overdose. Again, monetarily comfortable. Good family. He was popular with a lot of friends. Smart. Again, a bunch of poor choices starting from a young age let to continual battles with addiction. Another friend has a 22 year old in and out of treatment. They surround him with friends and activities to support his sobriety. They do everything desperate parents do when they read an article like this talking about “its all about connecting and not being lonely or bored.” So far, the kid continues to choose drugs over family and friends and comfort. Its simply more complicated than that article makes out. Some people turn to self destructive behavior because they are bored, others to hide pain - physical or psychological, some try it to fit in - because in moderation little is truly self destructive - or to have fun. Some people will easily escape the pull - they decide to quit smoking on Tuesday and throw away the pack and never look back. Some will struggle and try a few times before succeeding - and it will be easy or maybe hard. And for some people, with all the support and connectedness being given them as possible, they’ll never be able to quit. ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [November 4, 2015, 2:29am UTC](https://boards.straightdope.com/t/everything-we-think-we-know-about-addiction-is-wrong/736372/29 "2015-11-04T02:29:20Z")
> [@txjim](#): > > Two years ago, my son was in the hospital for two months and was on morphine for 3 weeks or so while on ECMO. He spent the last 3 weeks of his stay on methadone to counter the potential addiction. Based on this, I don’t accept the statement that post-surgery patients have no issues with morphine. Methadone is addictive, so how does it counteract any potential addictive effects of another med? It’s an opiate. ---
**Author:** ![puddleglum](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puddleglum/32/137_2.png) [@puddleglum](https://boards.straightdope.com/u/puddleglum)\ **Post date:** [November 4, 2015, 4:06pm UTC](https://boards.straightdope.com/t/everything-we-think-we-know-about-addiction-is-wrong/736372/30 "2015-11-04T16:06:28Z")
> [@MrQwertyasd](#): > > Well, but it’s a myth that being rich and famous equals psychological health. The rats were all given simulations of a comfy natural environment, not excessive wealth - it was rat park not rat palace. > > So did Downey grow up in a fully connected way ? But I suppose you could say “ah but they had a relatively comfy life - four walls, running water, furniture - it’s obviously a gene thing” - if normal human life was fulfilling instead of a rat race that may be true. > [URL=“[Robert Downey Jr. - Wikipedia](https://en.wikipedia.org/wiki/Robert_Downey,_Jr.#cite_note-Hitting_Bottom-9)”] That is moving the goalposts. It is no longer that addicts are living in bad conditions but that they had a bad upbringing. That brings us closer to the conventional wisdom, that there is something in addicts that predisposes them to be addicts whether genetics or upbringing or a combination of the two. ---
**Author:** ![MrQwertyasd](https://avatars.discourse-cdn.com/v4/letter/m/9d8465/32.png) [@MrQwertyasd](https://boards.straightdope.com/u/MrQwertyasd)\ **Post date:** [November 4, 2015, 8:07pm UTC](https://boards.straightdope.com/t/everything-we-think-we-know-about-addiction-is-wrong/736372/31 "2015-11-04T20:07:57Z")
> [@puddleglum](#): > > That is moving the goalposts. It is no longer that addicts are living in bad conditions but that they had a bad upbringing. That brings us closer to the conventional wisdom, that there is something in addicts that predisposes them to be addicts whether genetics or upbringing or a combination of the two. Hmm, sort of. We know that childhood can give permanent predispositions, and create mental cages, and that’s just what addiction psychologists are saying (but not in the OPs video). But as far as comparing the rats study I think you’re right there would have to be a parental deprivation aspect to the experiment too to make it equivalent, so thanks for pointing out my goalpost shifting. Parental deprivation in rats is a heavy studied area, but I’ll leave that for someone else to dig up. ---
**Author:** ![sleestak](https://avatars.discourse-cdn.com/v4/letter/s/919ad9/32.png) [@sleestak](https://boards.straightdope.com/u/sleestak)\ **Post date:** [November 5, 2015, 7:17am UTC](https://boards.straightdope.com/t/everything-we-think-we-know-about-addiction-is-wrong/736372/32 "2015-11-05T07:17:22Z")
> [@Amateur\_Barbarian](#): > > I don’t know that “everything we know is wrong,” but the AA-derived model of “addiction is absolute, progressive and incurable” is pretentious bullshit on a par with original sin. IMHO, there needs to be a conscious and total purging of this amateur, pseudo-religious, untestable nonsense from addiction theory and treatment. The research is clear and I have cited it on this board numerous times. Do some reading, check the NIH, and stop spreading shit that can end up killing people. The most effective treatment for alcoholism is therapy and A.A. combined. The second best treatment is A.A alone. There are a bunch of studies on this issue and the findings consise show the same thing, A.A. participation leads to much higher sobriety rates. In short, you are absolutely, 100% wrong on effectiveness. On addictions being progressive and incurable, well, the research here is clear as well. Very few alcoholics can go on to drink normally again. The vast majority of alcoholics who quit then resume drinking end up in the exact same place with worse problems. It is superemely stupid to suggest, in any way, that an alcoholic can drink successfully after quitting. The odds are so low and the repercussions are so bad that it is insanity to suggest that a recovering alcoholic can drink safely again. Slee ---
**Author:** ![MrQwertyasd](https://avatars.discourse-cdn.com/v4/letter/m/9d8465/32.png) [@MrQwertyasd](https://boards.straightdope.com/u/MrQwertyasd)\ **Post date:** [November 5, 2015, 9:23pm UTC](https://boards.straightdope.com/t/everything-we-think-we-know-about-addiction-is-wrong/736372/33 "2015-11-05T21:23:29Z")
> [@sleestak](#): > > The research is clear and I have cited it on this board numerous times. Do some reading, check the NIH, and stop spreading shit that can end up killing people. > > The most effective treatment for alcoholism is therapy and A.A. combined. The second best treatment is A.A alone. There are a bunch of studies on this issue and the findings consise show the same thing, A.A. participation leads to much higher sobriety rates. > > In short, you are absolutely, 100% wrong on effectiveness. > > On addictions being progressive and incurable, well, the research here is clear as well. Very few alcoholics can go on to drink normally again. The vast majority of alcoholics who quit then resume drinking end up in the exact same place with worse problems. It is superemely stupid to suggest, in any way, that an alcoholic can drink successfully after quitting. The odds are so low and the repercussions are so bad that it is insanity to suggest that a recovering alcoholic can drink safely again. > > Slee How does A.A. compare with ibogaine treatment ? ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [November 5, 2015, 9:51pm UTC](https://boards.straightdope.com/t/everything-we-think-we-know-about-addiction-is-wrong/736372/34 "2015-11-05T21:51:40Z")
The evidence in favor of AA is mixed. > [@](#): > > Rates of abstinence are about twice as high among those who attend AA (criteria 1, magnitude); higher levels of attendance are related to higher rates of abstinence (criteria 2, dose-response); these relationships are found for different samples and follow-up periods (criteria 3, consistency); prior AA attendance is predictive of subsequent abstinence (criteria 4, temporal); and mechanisms of action predicted by theories of behavior change are present in AA (criteria 6, plausibility). However, rigorous experimental evidence establishing the specificity of an effect for AA or Twelve Step Facilitation/TSF (criteria 5) is mixed, with 2 trials finding a positive effect for AA, 1 trial finding a negative effect for AA, and 1 trial finding a null effect. Studies addressing specificity using statistical approaches have had two contradictory findings, and two that reported significant effects for AA after adjusting for potential confounders such as motivation to change. [Cite](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2746426/). The evidence for ibogaine is barely more than animal studies and anecdotes. Regards, Shodan ---
**Author:** ![Amateur\_Barbarian](https://avatars.discourse-cdn.com/v4/letter/a/59ef9b/32.png) [@Amateur\_Barbarian](https://boards.straightdope.com/u/Amateur_Barbarian)\ **Post date:** [November 5, 2015, 9:55pm UTC](https://boards.straightdope.com/t/everything-we-think-we-know-about-addiction-is-wrong/736372/35 "2015-11-05T21:55:48Z")
> [@sleestak](#): > > The most effective treatment for alcoholism is therapy and A.A. combined. The second best treatment is A.A alone. There are a bunch of studies on this issue and the findings consise show the same thing, A.A. participation leads to much higher sobriety rates. Nice change of topic, there. The studies you so passionately cite tell us absolutely nothing about the effectiveness of AA (practice or theory) at all. They tell us that selected patients who participate in AA have certain outcomes. That’s such a biased, multiply-filtered population that it’s almost meaningless when trying to evaluate the overall effectiveness of the AA approach. You might as well cite how many in the study ate tomatoes or drank distilled water. AA absolutely resists every form of formal study and analysis, and the bottom line is that we only hear from those for whom AA is a success - and that’s what I’ve said over and over here: “AA works great for those AA works great for.” That, from what fuzzy data can be assembled, is a significant minority of those who consider or initially attend AA meetings. (I personally know more people who tried AA and couldn’t hack the regimen and amateur/religious process than who “succeeded” according to AA’s dictates. Most found other ways off their addiction. Some didn’t.) When you can point to studies of significant populations who go to a first AA meeting and then tracks their addiction/life quality to a meaningful outcome, let me know. (I won’t be waiting by the phone, because AA not only resists such study by its very nature, but actively discourages all attempts to study its model in any controlled fashion.) So we’re left with the successes, who naturally cheer the process… just like any religious convert. ---
**Author:** ![HMS\_Irruncible](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hms_irruncible/32/7394_2.png) [@HMS\_Irruncible](https://boards.straightdope.com/u/HMS_Irruncible)\ **Post date:** [November 5, 2015, 10:20pm UTC](https://boards.straightdope.com/t/everything-we-think-we-know-about-addiction-is-wrong/736372/36 "2015-11-05T22:20:10Z")
> [@MrQwertyasd](#): > > How does A.A. compare with ibogaine treatment ? Most of what we know about ibogaine is anecdotal and self-reported by evangelists. It does seem to halt withdrawal symptoms dramatically, but it doesn’t give people any skills to resist the cues that led them to drug use in the first place. A significant number of ibogaine patients relapse if they don’t follow up with immediate therapy. Halting withdrawal and craving is simply not enough to ensure recovery. ---
**Author:** ![MrQwertyasd](https://avatars.discourse-cdn.com/v4/letter/m/9d8465/32.png) [@MrQwertyasd](https://boards.straightdope.com/u/MrQwertyasd)\ **Post date:** [November 6, 2015, 4:40am UTC](https://boards.straightdope.com/t/everything-we-think-we-know-about-addiction-is-wrong/736372/37 "2015-11-06T04:40:02Z")
> [@HMS\_Irruncible](#): > > Most of what we know about ibogaine is anecdotal and self-reported by evangelists. It does seem to halt withdrawal symptoms dramatically, but it doesn’t give people any skills to resist the cues that led them to drug use in the first place. A significant number of ibogaine patients relapse if they don’t follow up with immediate therapy. Halting withdrawal and craving is simply not enough to ensure recovery. Is that an evangelist in a perjorative, blindly enthusiastic sense, or the enthusiasm of someone who has been freed of craving almost instantly and possibly forever ? How much do people need a new skill set after treatment ? Some people might do if returning to a familiar environment, yet many report permanent psychological change, so good question - wonder who’s got the data on that ? ---
**Author:** ![MrQwertyasd](https://avatars.discourse-cdn.com/v4/letter/m/9d8465/32.png) [@MrQwertyasd](https://boards.straightdope.com/u/MrQwertyasd)\ **Post date:** [November 6, 2015, 5:04am UTC](https://boards.straightdope.com/t/everything-we-think-we-know-about-addiction-is-wrong/736372/38 "2015-11-06T05:04:00Z")
Exploratory follow up study [http://www.ibogaine.desk.nl/ibogaine\_udi\_bastiaans.pdf](http://www.ibogaine.desk.nl/ibogaine_udi_bastiaans.pdf) > [@](#): > > The results show that 24% (5 out of 21) of all the participants have quit using any substanceswhatsoever, including hard drugs, soft drugs, pain medications, tranquillizers and alcohol. The average drug free period of this group of people was 41.2 months - almost 3.5 years. The median was lower, however - 24 months. This group will be called group 1. > Moreover, from the remaining 76% (group 2), slightly more than half (56%) quit using their > primary and secondary drugs of abuse, but still continued to use other substances (in most > cases, alcohol or cannabis) – which will be referred to as group 3. The average drug free > period (of the primary and the secondary drugs of abuse) of this group of people was 20,8 > months – about one and a half year. The median was lower in this group as well – 4.5 months. > [@](#): > > The participants of the study were also asked about their personal relationships before and > after the Ibogaine treatment, such as friendships, intimate relationships, professional > relationships etc. Eighty-eight percent reported a significant improvement in different aspects > (one or more) of relationships with significant others. The remaining 12% claimed that no > change has taken place in their relationships as a result of the treatment. > One of the participants, P12, writes :”I found that I could not tolerate the 12 year live-in > partner situation I was in (I think the methadone etc. allowed me to tolerate it before) and we > are separating. I have found that I have more interest and empathy for others than I had > before: seek out friends more, feel more connected and caring towards students and coworkers. > Also feel more empowered to make other changes I have wanted for a long time, > such as job change, relocation etc.” Another respondent (P07) shares: ”I became a reliable, > trustworthy person. My family invited me back into the fold. Before they didn’t want me > around. Didn’t trust me with anything, now they offered me cash for Christmas…that would > never happen before. They enjoy being around me and I enjoy being around others. I have > become more focused, positive and energetic.” So that’s interesting, sometimes it’s not so much a case of learning new life skills but of having a newly-cleared head. ---
**Author:** ![MichaelEmouse](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/michaelemouse/32/101_2.png) [@MichaelEmouse](https://boards.straightdope.com/u/MichaelEmouse)\ **Post date:** [November 6, 2015, 5:19am UTC](https://boards.straightdope.com/t/everything-we-think-we-know-about-addiction-is-wrong/736372/39 "2015-11-06T05:19:37Z")
I thought about starting a thread too after watching that video. The title is unfortunately hyperbolic and there is such a thing as physical dependence. Being shorter than 6 minutes, it’s going to lack nuance. I personally think that psychological addiction could be referred to as “procrastinating on doing important things you dislike by doing less important things you enjoy”; it’s much more about the addicted individual than it is about the thing he’s psychologically addicted to. Related to the video, I’ve come to think of a lot of substance abuse, including alcohol and tobacco, as a form of self-medication for depression and anxiety. ETA: Have you stumbled upon the Crash Course channel? ---
**Author:** ![alexandra](https://avatars.discourse-cdn.com/v4/letter/a/e68b1a/32.png) [@alexandra](https://boards.straightdope.com/u/alexandra)\ **Post date:** [November 6, 2015, 8:22am UTC](https://boards.straightdope.com/t/everything-we-think-we-know-about-addiction-is-wrong/736372/40 "2015-11-06T08:22:04Z")
Anything that tries to oversimplify addiction is wrong. Clearly there is a physical dependency aspect to heroin and alcohol addiction for example; that’s why they need to be medically managed to a degree. However, it’s very true that psychological and social factors play a huge factor in dependency and recovery. Common American rhetoric likes to portray addiction as a biological disease, which is understandable, but again an oversimplication. Of the Vietnam war soldiers addicted, most made a full recovery, with no difference between those entering formal treatment and not. Longitudinal data on recovering addicts suggests the presence of a job, supportive family, and good social networks play a big part in rates of success. See this paper - [RACGP - The recovery paradigm - A model of hope and change for alcohol and drug addiction](http://www.racgp.org.au/afp/2012/august/the-recovery-paradigm/) [Previous page](https://boards.straightdope.com/t/everything-we-think-we-know-about-addiction-is-wrong/736372.md?page=1) [Next page](https://boards.straightdope.com/t/everything-we-think-we-know-about-addiction-is-wrong/736372.md?page=3)