Is There Really a “Cure” for Addiction?
Medicine.net defines cure this way:
Cure: 1. to heal, to make well, to restore to good health. Cures are easy to claim and, all too often, difficult to confirm. (emphasis added)
Merriam-Webster’s defines it thus:
n. recovery or relief from a disease; something (as a drug or treatment) that cures a disease; a period or course of treatment
Although the word “cure” has a more subtle meaning than many recognize, it is clear that in the case of addiction, the word can be terribly misused. People believe a cure means they are no longer an addict or alcoholic. The truth is, alcoholism and other addictions are more like a chronic disease that can be held in remission indefinitely if the right steps are taken, but it cannot be cured in that you must remain aware of your vulnerabilities as well as environment cues that could set you up for relapse.
The risk of suggesting a cure for addiction is that it misleads people into believing someone has the magic bullet. Although someone might manage their diabetes through diet, exercise, and medication, you don’t really cure diabetes. You have to maintain a certain lifestyle or you risk your health and life.
Claims of a cure for serious diseases have a long history. Certainly everyone has heard of snake-oil salesman. You can probably recall at least one character in a Western who stood on a makeshift stage peddling his miracle cure – it cures baldness! Back pain! Influenza! Heck it wards off the plague!
The typical snake oil salesman would often have a shill, a plant in the audience, who would rave about how the oil cured his every malady. After selling his wares, the “doctor” would move to the next town. There wasn’t much you could do by the time you figured out this so-called cure was phony.
Reputable alcohol and drug treatment centers will never use the word “cure” because they know it is misleading and dangerous. In truth, it is a manipulative marketing technique and usually based on anecdotes. Of course, the success stories abound, and all the failures are conveniently forgotten.
You have likely heard the phrase, “alcoholism is a progressive disease.” What does this mean? Why does it preclude any “cure” in the purest sense of the word? As the body becomes conditioned to alcohol use, it develops tolerance. The alcoholic needs more alcohol to get the same effect from drinking. The mind and body continue to deteriorate as the alcoholic drinks more and more to achieve the feelings they got when they first “discovered” alcohol made them feel a certain way: blocked negative feelings, made them more comfortable in social settings, or calmed their nerves. During this progression the brain essentially changes, and the alcoholic or addict experiences cravings – powerful impulses to use again and again.
When the alcoholic quits drinking, the physiology that predisposed them to abusive drinking lays in wait – dormant, but waiting for the fuel to be added to progress once again.
“Addiction involves inseparable biological and behavioral components. It is the quintessential biobehavioral disorder…Addiction should be understood as a chronic recurring illness. Although some addicts do gain full control over their drug use after a single treatment episode, many have relapses. Repeated treatments become necessary to increase the intervals between and diminish the intensity of relapses, until the individual achieves abstinence.” (Alan I. Leshner, Director of the National Institute on Drug Abuse at the National Institutes of Health.)
The idea of a place curing you misses one of the essential elements of alcoholism: environmental cues and influences. You go home to the same neighborhood, the same friends, the same pressures you had when you were drinking. These contextual elements put people at high risk for relapse unless they find ways to cope in the familiar environment. In some cases, the environment must be changed completely.
“One of the major goals of drug addiction treatment is to teach addicts how to deal with the cravings caused by inevitable exposure to these conditioned cues.” (AI Leshner)
If someone claims they have cured you, they would assume you will no longer have cravings. They are basically claiming all the historic evidence of the impact of environmental cues on addictive behavior doesn’t apply to you. In essence, they are saying you are no longer a human being influenced by your environment. This is hardly plausible.
“It is essential to understand when dealing with addicts that we are dealing with individuals whose brains have been altered by drug use.” (AI Leshner)
Clinical research into addiction has shown that addiction must be treated as a chronic, long-term condition with recurrent cycles of relapse and recovery. Evidence-based treatment programs would, therefore, never make the specious claim that they can cure addiction. You wouldn’t want someone treating your cancer based on “ideas” – you would want it based on evidence. Why would you want someone to treat your addiction based on ideas rather than evidence? If the treatment provider does not understand the chronic nature of addiction, they will, over time, be less and less able to make their claims as relapsing clients begin to feel cheated by the fact they did not deliver on their guarantee.
“When we frame addiction as a chronic disease, we begin to think in terms of a life-long effort to control certain vulnerabilities. ‘Managing’ becomes the operative term – as it is with other chronic conditions. There’s no saying, ’28 days, check out, and you’re cured’.” William M. Taylor, MSW, Houston Council for Drug and Alcohol Abuse