March 1, 2004 By: Maia Szalavitz STATS

Alcohol, tobacco and other drugs are constantly in the news - but unfortunately, most of what is reported on drug use, misuse and addiction is badly flawed. There are numerous agendas: drug warriors want to support their policies; their opponents want to push theirs; government officials want to keep their jobs and their funding; treatment providers want to ensure their programs look good; self-help group members want their message heard; and the media itself doesn’t look too deeply beyond what it is given in press releases from these various factions.

In the last decade or so, research has provided greater insight into addictions and other drug problems than was ever available before. But the media hasn’t caught up. This section will revisit this issue from time to time, looking at how particular coverage concords with the data and at what the research consensus on various issues is.

Here are some myths to watch out for while critically examining drugs coverage:

There is an addictive personality

How often have you heard addicts described as selfish liars who care only for their own pleasure or heard people discuss their “addictive personalities?” Both ideas are simply not supported by research. Says Reid Hester, Ph.d., co-author of the definitive overview of the alcohol treatment literature, “Handbook of Alcohol Treatment Approaches,” (Allyn and Bacon, 1995, 2003)

“Research has tried to figure out what that personality is for about 50 years and has never come up with a consistent picture. A lot of the more severely dependent addicts are pretty savvy and they can be manipulative but so can Wall Street traders and politicians.” Some characteristics are more common in people with addictive disorders than others (a propensity for risk-taking, for example), but there is no trait, aside from the habit itself, which all addicts share. Even denial - supposedly the hallmark of addictive behavior - is no more common in addicts than others.

Also false is the idea that someone who is addicted to one drug will automatically not be able to handle any psychoactive substance - or will become compulsive about eating or sex if she kicks drugs. In some cases, people do shift compulsive behavior from one arena to another, but many don’t.

There’s only one way to recover

Many people believe what the media constantly repeats - particularly in coverage of celebrity addicts like Rush Limbaugh and Darryl Strawberry - namely, that the only way to recover from an alcohol or drug problem is with total abstinence from all psychoactive substances and 12 step programs like Alcoholics Anonymous. There is no evidence that Alcoholics Anonymous, or Narcotics Anonymous for drugs, are more effective than other treatments.

Most people with drug problems actually recover without any treatment or self-help group attendance. More people end alcohol problems by moderating their drinking than by quitting entirely - though the more severe the alcohol problem is, the less likely it is that moderation will be achieved.

Cognitive-behavioral therapies are effective, but unfortunately, research-based treatment is rare in the community, with most providers still pushing the idea that the twelve steps are the only, or at least the best, way.

“Tough Love” and coercion are necessary for recovery

This is one of the most pernicious myths about dealing with drug problems. Confrontational and humiliating “attack therapy” - often used in rehabs - actually increases the chances of relapse and treatment drop-out. People threatened with prison if they don’t quit drugs are no more likely to succeed in treatment than those who seek help on their own, according to a summary of the research published by the National Institute on Drug Abuse.

Boot camps for teens are no more effective than juvenile prison, according to the Department of Justice. Tough interventions - which threaten loss of employment or relationships if the person doesn’t shape up immediately - have resulted in suicides as well as recovery.

“There is no doubt that aggressive, hostilely confrontational treatment protocols do more harm than good,” says Hester.

Most drug users get addicted - and physical dependence on a substance is the same thing as addiction

Addiction refers to compulsive use of a substance despite negative consequences. The condition used to be defined as developing a physical need for a drug in order to function normally and suffering withdrawal when that substance was withheld.

But this didn’t account for why heroin addicts repeatedly relapse long after withdrawal symptoms have ended; nor did it explain cocaine addiction, which doesn’t involve physical withdrawal.

Many medications - from some antidepressants to certain high blood pressure drugs - produce physical dependence, but no craving. Anyone who takes drugs that produce physical dependence for long enough will become dependent; but that person is not addicted unless the drug produces craving despite negative life consequences.

The vast majority of people who try any drug - even heroin or strong opiates like Oxycontin - do not become addicts. Addiction rates amongst drug takers typically vary from 1-20%, depending on factors that increase risk such as young age, male gender, drug taking for recreational rather than medical reasons, current severe stress, genetics and past traumatic stress.

Research funded by the government, which was frightened that Viet Nam vets returning from that war would bring massive rates of heroin addiction home with them found the opposite - even though the vets were at high risk because of their age, gender and stressful experience. Although 45% of U.S. soldiers in Viet Nam reported trying heroin, only 20% spent some time addicted and just 12% returned to heroin addiction once they got home. And this occurred despite the fact that 60% of those who had been addicted in Viet Nam used heroin at least once after returning stateside.

[Insert newest scary drug here] is the most addictive drug ever

Right now, the media is claiming that methamphetamine is the most addictive and dangerous drug - and that recovery from it is much more difficult than from other drugs. The research shows, however, that methamphetamine addicts have about the same recovery rates as those trying to kick other drugs. Previously, crack was the most addictive; before that it was heroin. Next year it will be something else.

If you want to know the relative dangers of various drugs, look at death rates amongst long term users, typical length of addiction, overdose risk and treatment statistics. Search for this information in medical journals or on government websites like that of the National Institute on Drug Abuse. Rely more on what academic researchers say than on anecdotes from “experts” like treatment center owners or police officers. You’ll rarely find accurate information in the popular press, particularly about a new, hot drug.