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Does addiction last a lifetime?

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October 8, 2018

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Comments

Lance Watson
November 29, 2018

I found this article extremely relevant to my circumstances and personal experience. I live in the UK and am finally in a stable recovery following a nightmare 27 year heroin addiction.
The UK, in my opinion, has a completely inadequate and outdated model for recovery. There is just one treatment centre that uses an alternative to the 12 step program and even this I believe uses an ineffective program. The statistics speak for themselves as the percentage for a successful recovery is painfully low.
I spent many years desperately looking for help, spending a fortune of my families money in the process. Sadly the help on offer and the help i received often provoked my addiction as opposed to helping it.
Reflecting on my experience and the advice I received is now totally mind blowing and I’m surprised I’m alive to write this post.
I finally managed to get clean doing a fairly rapid brupenorphine detox which I followed with a 9 month ONeil Naltrexone Implant. This without doubt saved my life. With the safety of the implant I was able to focus on CBT and to slowly integrate back into society.
I have tried NA and A.A. and although it does seem to work for some people I found that those people actually became dependant on the fellowship. They would become distant from the world beyond the fellowship and even started to speak a language only used within the fellowship. The fellowship I believe almost brainwashes you into believing that once an addict always an addict and that complete abstinence in the only path to recovery. I was told within NA that if I did not adhere to the guidelines of the fellowship that I would relapse and only those who follow the program 100% would find recovery. To me that is a fear based program.
I cannot speak for the USA but the whole system within the UK needs a massive overhaul. You can no longer get a Naltrexone implant in the UK and addicts are being forced to travel to Eastern Europe. I myself became victim to a £10,000.00 Naltrexone scam in Belgrade where they inserted a fake implant which I still have in my belly today.
I am hoping to become involved in setting up clinics within the UK and would welcome any feedback, thoughts and comments.

Peter Grinspoon, MD
November 29, 2018

Thank you for your thoughts! Your experience and perceptions of your experience sound not unlike mine (though I didn’t get any fake implants…).

Sharan Binning
November 4, 2018

Thanks Peter for your wonderful insight. I have met many people who were addicted to alcohol when they were young but they do not go close to it in their old age days, maybe cause they’re afraid they’ll be addicted to it again.
There are some changes going on even in the legal system, for example the recent legalization of Marijuana in Canada.

Nicolas Ruf
October 30, 2018

“. I was addicted to opiates, but didn’t have difficulties with substances in other classes. I have seen this to mostly be the case with thousands of my brothers and sisters in recovery who I have had the honor to interact with.” Do you mean that these thousands who have been addicted to one class of drug are now using, and have been using for an extended period of time, another class nonproblematically?
Where on the continuum of addiction were they? I mean if we’re talking about a bunch of party boys/girls in their twenties who would probably meet DSM criteria for a SUD and who have ‘matured out’ and now drink socially, maybe. But if they’ve crossed the line (which I would define as having used against one’s will), I doubt it.
Also, there is some research suggesting that some genes can code for vulnerability to certain drugs while others can be more general (addictive personality types).
And also, if addiction begins with self-medication, then whatever fills the bill works, at least at first.

José Nieto
October 25, 2018

I recently read the article “The Opioid Diaries” on Time Magazine. I am an eye doctor from Spain who did some training in the US. I injured my knee while living in the States and had surgery. I had absolutely no pain during my recovery, but still, I was given a prescription for Oxycodone. I can understand how opioid adiction can grow from pills to heroin injection in some individuals.
It is not easy and very uncommon to get a prescription for these drugs in Europe. I think changes in that respect in the US could help the next generation.

J.Nieto
Barcelona

Drew Edwards
October 24, 2018

From beginning this piece you were citing the power of non scientific folklore and tradition and you transition to end with personal opinion. The new science studying phenotypical changes genetic transcription errors and neuroadaptation that usurp the brain’s reward and anti reward system reward system. Plus the discovery that inhibition of the N methyl D aspartate system mediate depression, plus, central hormonal deficits e.g., Oxytocin, are opening a new broader understanding of reward deficiency, including addictive disease, hedonic overeating, depression, PTSD, ADHD, and the finding that up to 30% of US adults are dopamine deficient. Why? Unknot, polymorphisms occur at greater frequency than previously thought. And, yes I have seen and treated the “Accidental Addict” who managed to get through High School and College, experimenting with alcohol and MJ and left it alone, only to have her 1st Percocet from an injury at age 37 and became addicted almost instantly. Patent Centered, Individualized Care is where we should be going, Until then, we can only do what the best available evidence tells us and what works for most–not outliers

Drew Edwards
October 24, 2018

It’ important to not use the term “Cannabis” generically when describing the benefits or risk associated with THC or CBD. Why? Δ⁹-tetrahydrocannabinol (THC)—is the most commonly used psychoactive drug (behind alcohol). And should be called marijuana, not cannabis because Cannabis Sativa also contains Cannabidiol (CBD). an abundant but not psychoactive constituent. The endocanabinoid system (EC) includes CB1 and CB2 receptors. THC primarily exerts it’s effect CB-1 receptors which are most prevalent in the prefrontal cortex, left ventral striatum, hippocampus, amygdala, basal ganglia, and cerebellum. These brain regions undergo prominent developmental changes throughout childhood and myelination during adolescence, and thus may be particularly susceptible to the adverse cognitive effects of marijuana. Adolescents who use marijuana regularly have increased volumes in the cerebellum, possibly from failure to prune synapses effectively. These adolescent marijuana users also show increased brain processing effort on fMRI during an inhibition tasks and task performance, even after 28 days of abstinence. Now loss of 6-8 points of IQ has been established. Taken together, there is compelling evidence that chronic increases in stimulation of the brain’s cannabinoid system can lead to morphologic and physiologic changes especially during adolescence. So stating that cannabis offers neuroprotection or is a treatment for epilepsy is misleading the public. Head to head-double blind placebo controlled studies comparing to THC and CBD, are needed. Epolidex is a CBD product with no THC, yet I hear weekly that Cannabis is proven to treat seizures, assuming that means marijuana. Thank you for your posts.

Peter Grinspoon, MD
October 24, 2018

Much of what you stated in your post is contested. For example, the study that purported to show a 6-8 point IQ drop was roundly debunked as this drop was entirely explained by socioeconomic factors that the authors neglected to factor in.

Bob
October 16, 2018

If a person is abusing and the abusing is leading to negative outcomes then abstinence will form part of the solution. But if the person is no longer abusing and is therefore not producing any negative outcomes then does abstinence still form part of the solution? That seems to be the 6 million dollar question that individuals must answer for themselves based on their ability to predict outcomes. This has been a very honest and stretching discussion and makes me think of a person who walks along a brick fence 2 feet wide with a half mile drop off the side. If you do this walk you will need to possess confidence and knowledge before hand. Very enjoyable read. Thank you.

Peter Grinspoon, MD
October 17, 2018

It is an endlessly interesting discussion, and people tend to have very strong opinions!

RG
October 16, 2018

Although the bulk of your article has no relevance to my situation, the last sentence was the one that struck me most “……never give up hope when dealing with an addicted loved one, no matter how dire the circumstances appear to be”.
We are parents of an alcoholic son who is a serial relapser (20+ times) and has been in numerous rehabs (15+) in various countries with different approaches to recovery, but none of them have managed to get him to surrender himself to the basic fact of his alcoholism. Regardless of the suggestions for recovery he maintains a resistance to proven methods, as if to leave the door to relapse available, and opens it frequently, with ever worsening results. After 13 years of this its hard to maintain hope when no avenues appear to remain. It seems from where we are looking that addiction DOES last a lifetime.

Ali
October 16, 2018

I’m so sorry for your pain. As an addict not using, let me just say that he will not respond to any treatment until he is ready to do so. Period. No matter how many times you put him in rehab, it simply will not work. He will need to hit bottom and then figure out who he is and what he wants to do about it! Keep loving him, but stop the rehab!

Peter Grinspoon, MD
October 17, 2018

I’m sorry to hear of your struggles, and those of your son. Don’t give up on him! Have you tried medications? Vivitrol? A modern scientific team with recovery coaches, therapists, doctors who are up to date on the latest research? That might be a lot more effective than rehab…

Bob
October 17, 2018

You might want to look at this area of investigation to see what is going on in the brain at a physiological and chemical level. I understand that this group gets good results and long term outcomes including recommendations for the carer.

http://pnpcenter.com/

Patrick Doyle
October 30, 2018

I don’t see mention of any support/professional help for the parents. While supportive families are known to be a powerful ally and assist to a loved one with SUD, they are seldom helped or brought in to help the treatment team. Families receiving professional guidance/support with Family Opioid Coaching report a great deal of benefit; promoting recoveries for both the Family as well as the Identified Patient. Either way; get support for yourself as well as your son. Recovery is possible.

Thomas E. Camfield
October 16, 2018

I partially agree with Dr. Grinspoon on having an affinity for one class of drug. Switching addictions is the common term thrown around addiction/recovery circles. I myself have abused every substance that alters a persons perception of reality. Hopping from one substance to another is not necessarily the brain looking for the ultimate high but could be explained as simply no longer having access to a particular substance or diminishing returns from a growing tolerance. The Dr. is correct in that there is no one size fits all recovery template. Every person is in a constant state of change and every drug is not the same and has different effects on people through there lifetime. My brother asked me a question that if i had the answer it would be the epiphany of epiphanies. He asked “ Why do you Always have to be on something?”’ Maybe this should be the starting point in any recovery program. I have heard an old saying that the body craves what it needs , so if this holds true for the body then it must for the brain. I agree with the Dr. that the old model of addictive personality is woefully inadequate to adress addictions . My thinking is that people are treating themselves for a reason. Finding the reason incorporates every aspect of the patient. I am just wondering if the chemical structure of the brain is altered during traumatic experiences to the point where the individual requires a substance to alleviate the imbalance.

Peter Grinspoon, MD
October 17, 2018

Wise words…and food for thought.

Maletta Pfeiffer
October 15, 2018

I agree with Philip Bettin. I have been sober for almost 30 years.However I do not feel it warrants any congratulations since that seems to miss the point. For me the reward of sobriety is that I now have a meaningful life that I carefully guard.
I can understand the frustration among the professional experts on how to fix addiction since relapse is the hallmark of SUD. I do question the motive when a medical doctor who is himself in recovery uses his professional authority to claim it may be safe to return to drink or use again. Are you completely honest with yourself?
I have met enough people who were sober for over two decades only to die withing a short span of time after relapsing. Why risk it when
the stakes are so high? As a friend o mine said, ” even if I could safely
return to drink I love my sober life ” .

Jeff t.
October 15, 2018

Thank you…

Peter Grinspoon, MD
October 15, 2018

The point of the article was, at least in part, about asking hard questions, and examining whether there actually is ANY basis for doing what we have been doing for almost 100 years, and whether things can be improved. There is so much folklore and misinformation in the recovery treatment world that it is essential for all of us to question our assumptions. I’ve seen the misinformation kill people e.g. around medication assisted treatment for opioid use disorder. If a definitive study came out that showed that people who practice abstinence for life lived longer and did better, I’d be thrilled to have this complex issue resolved.

Alice Pastorius
October 15, 2018

I am in my 41st year of recovery from alcohol. Other substances aren’t a problem, because I didn’t use them. Why would I? I knew I was addicted to alcohol for 10 years before I joined a fellowship of recovering alcoholics where I got sober. At the time that was all that was available. Treatment centers only opened when insurance companies were required to pay for treatment.
As for substitute addictions…you betcha…sugar and shopping both of which I seem to have modulated. I quit smoking 22 years ago.
The only mind altering substance I’ve taken was muscle relaxers for a bad back, and I don’t plan on taking anything else. Why would I? Why would I risk my recovery for something that means nothing to me today.

Peter Grinspoon, MD
October 15, 2018

Healthy attitude! Congrats on your recovery.

Rick
October 15, 2018

Call your sponsor you are in the middle of a relapse!

Peter Grinspoon, MD
October 15, 2018

What sponsor?? I’ve literally never had a sponsor except when I was forced to have a temporary sponsor during my 90 days of forced rehab in a 12-step program!! (I’m not a 12-step person, though I have lots of friends who are who I support and respect…). The beauty of it is that there are many different paths to recovery.

Dianne McKay
October 15, 2018

I am interested in knowing what the author thinks about a genetic relationship to alcohol or drug addiction. I’ve met people who excuse a relative’s addiction on family genetics, e.g., he didn’t have a chance with alcoholism on both sides of the family.

Peter Grinspoon, MD
October 15, 2018

There is definitely a large genetic component to addiction, though that doesn’t “excuse” or not excuse an addiction, as it is a disease, and not a moral failing, and it doesn’t deserves or trigger blame. Perhaps it partially EXPLAINS a vulnerability to addiction, along with other factors such as anxiety or depression, or childhood trauma…

Barbie
October 15, 2018

I have been in recovery for 24 years, abstinent from all drugs and alcohol. I am a proud member of A.A. and also have worked in the field of substance abuse for the last 15 years as a substance abuse counselor. I personally would not encourage anyone to substitute. I like to use the analogy that substituting one drug for another is like changing seats on the titanic. More than likely you are going down sooner or later. Addiction is not something to be played with. I always encourage total abstinence.

Peter Grinspoon, MD
October 15, 2018

That is a point of view that many, many people share. Others would counter that drugs are very different, and that people grow and change over time, and can shed some/much of their vulnerability. Addictions are known to resolve without any treatment at all in a large percentage of people, these are just not the cases we hear about.

guitarsandmore805
October 15, 2018

I remember quite specifically when the Vietnam war ended there was no longer a reason for me to be angry, no longer a reason to protest. I stopped smoking pot, put down the wine, went back to college and got a degree. I stayed sober for about 12 years and fell off the wagon once when I fell in love with a beautiful, smart, well educated, fun woman who had the same interests as me. Her only fault was she snorted cocaine every day. Dating her for two years was fun but damaged my life severely and so I gave up the woman and the cocaine. It CAN be done. I have no cravings today 30 years later.

Peter Grinspoon, MD
October 15, 2018

Congrats on your recovery!! Glad you were able to turn things around.

David L Kaus
October 15, 2018

I have been working in the arena of addictions for 30 years as a CAP& LMHC. Was raised by an alcoholic Father & my first wife was the same. This is a question I hear often from the user as well as the family members . My best answer is each person must HONESTLY decide if it must be total abstinence or a return to social use. Cocaiane & other drugs are not for recreational use. If you can live without than do so. And go to meetings of some kind.
Truly a good article, thank you.

Peter Grinspoon, MD
October 15, 2018

Thank you for connecting and sharing your thoughts. (One qualm: people have been using “cocaine and other drugs” for recreational use since the dawn of human history, literally, whatever humans could get their hands on, often alcohol, in virtually every society that we know about, so many argue that altering our consciousness is part of our nature…)

Jocelyn Allgood
October 15, 2018

Having over 27 years if sobriety from alcohol, marijuana, cocaine and shrooms. Through one 21 day rehab stay. Holding two master degrees pre sober and post sober, I understand your points. I do believe I have an addictive personality and have substituted healthier options for that bring me the same focus and mind quietness that came from alcohol and drugs. Not sure about different classes of drugs not bothering me as much as those of choice..(mostly all) I have seen many changes in views in AA and do not agree that an alcoholic can ever use alcohol safely. As a progressive disorder, all those who tell me they picked up after years of sobriety go way over the edge and are lucky to return having not killed themselves or anyone else.

If it works, don’t fix it is my motto!

Peter Grinspoon, MD
October 15, 2018

That is a very sensible way to look at this complex issue; than you for sharing it.

Karen
October 15, 2018

My ex husband was an alcoholic who would stay sober for a year or nine months and then decide it was ok to drink again, because he was able to stop for the long period of time. It turns out he could have a drink and another and another and make me crazy. He should never have another drink again in his life, but he will, he can’t help it. The good news is I don’t have to watch. We’re divorced because of his certainty that he could control his drinking.

Sophia
October 15, 2018

As the mother of a recovering addict, I have seen the relapses that come with addiction. Been to too many of his peers funerals. My son went to a good rehab with addiction specialist medical doctors. The mid brain defect that predisposes one to addiction will always be there. I think this opinion of yours may work for you, but is very dangerous public advice.

Peter Grinspoon, MD
October 15, 2018

Thank you for sharing your thoughts. I wasn’t giving advice as much as starting a discussion. I’m just not sure that it’s true that “the mid brain defect that predisposes one to addiction will always be there.” For six months– definitely. Five years — probably. But, thirty years later? I just don’t think we know, because a lot of our addiction science is brand new…

Bill
October 15, 2018

Dr. Pete – great article! My dad (a 3 pack a day guy) did the same thing as “Bob’s” father (wow what willpower! – I unfortunately am still a casual smoker – is there such a thing?) after a long battle with opiate use for pain control I’ve been a methadone user for years for the same reason – addicted… I hate that word -dependent certainly (because of other medical issues I would have to do a hospital supervised stay to quit) – but very controlled – same level dosage for many years and it does help control my pain – I’m way beyond any “buzz” or risks of getting “high” – my wish is that there would be more research for chronic pain folks and the govt/politicians would remember there are legitimate people with real pain issue for which these types of medication do work – don’t throw the baby out with the bath water – help those that get addicted but remember us that are beyond “addiction” we are dependent on these medications to lead fulfilling, productive lives. I work, I own businesses, I pay my taxes….. please remember me and the thousands of others in this same spot!

Peter Grinspoon, MD
October 15, 2018

Agree! It is a complex discussion, addicted vs. dependent, and it’s true that if our government creates a crisis in untreated chronic pain by over-aggressively hounding doctors to not prescribe opiates, then they have just traded one crisis for another…

T. Gulbransen
October 15, 2018

Self-esteem very often seems [to my layperson view] to be the genesis of addictions. The thread above helps separate the lifelong role of self-esteem from substances’ physiochemical properties. Self-esteem may create the initial demand for mood-altering substances. The substance’s physiochemical properties then act in synergy with self-esteem. They can alter mood it in a healthy, albeit addictive way, e.g. endorphins from exercise or other public service altruism. Or substances can overtake one’s physiochemical controls. I agree with Dr Grinspoon that, while there may be lifelong behavior patterns, they alone do not indicate that all substances will be overwhelmingly addictive. Thank God for those who found clearer choices for how to alter moods.

Peter Grinspoon, MD
October 15, 2018

Thank you for sharing your interesting thoughts!

james stepsr
October 15, 2018

One requirement for sustained and expanded healing from recovery for the individual addict is subjective possession of self-knowledge about the prospect of one day returning to an ability to use intoxicants ‘recreationally.’ Hard won wisdom on that point is readily available, especially to anyone with legitimate experience in the recovery community.

Peter Grinspoon, MD
October 15, 2018

Thank you! (Our society is steeped in drugs and alcohol and, yes, anyone in recovery has to reckon with this difficult issue…)

Eric B
October 15, 2018

While the thought of using something you may have been addicted to or using it’s a close cousin to increase a happy moment, take the edge off or relax in normal life sounds appealing I think the risk outweighs the benefit if you’ve had a problem with addiction to anything. Furthermore, and the real topic and what a 12 Step program is about is that if you’ve tapped into a personal, conscious contact with a spiritual power and have helped others along your journey and enlarged our spiritual capacity and capacity to love, why would you want to risk it or quit participating in a 12 step program. I think people that have found a way out of the destruction of addiction and now that it’s better to think the program is no longer appealing are short on sight. Lack of logic with a sub-conscious agenda; blind spots exist for everyone. Tune into the frequency of the God of your choice; the God/spirit that is within and you will find your truth if you are truly seeking the truth. Much easier said than done but a pathway to true and lasting peace of mind; which what every human seeks. We are spiritual beings having a spiritual experience. To deny this is a rough path for sure.
Good luck to all.

Peter Grinspoon, MD
October 15, 2018

Good luck to you as well!

Lorie Eber
October 15, 2018

I think this is a very interesting subject and definitely worth exploring. I know people who struggle forever, but others who seem to get past it. My guess is that the ones who substitute or revert are those who have not gotten to the underlying issue that causes the behavior. I agree with you, we should not just assume everyone is addicted forever.

Peter Grinspoon, MD
October 15, 2018

Thank you for sharing your thoughts; it does seem to vary a lot person to person!

Monty Johnston
October 13, 2018

Strange lack of distinction here between other-direction and inner-direction.

Behaviors such as gambling, over- or under-eating, video game playing, Internet use, sex, work, religion, exercise, compulsive spending, etc., when done other-directedly, may well, for recoverING addicts, morph into bingeing, hang-overs, regret, failed swearing-off, increased tolerance, relationship damage, etc. Here we have weight training for chemical addiction.

To not caution that other-directed “abstinence” can safely include addictogenic behaviors in someone with no serious inner-directed experience is dangerous and irresponsible.

Sow, what?, is eveything “with no basis in scientific evidence” false? This article is a risky opinion piece.

Peter Grinspoon, MD
October 14, 2018

Thank you for your interesting comments. I appreciate your concern and your opinion though I do believe that the addiction and recovery field has suffered incalculably form a lack of treatment “with no basis in scientific evidence” and am eager to see modern life saving treatments used uniformly in the addiction treatment industry and community.

Terry Goldman
October 11, 2018

Back around 1910, a physician wrote a book about narcotics, alcohol and smoking addictions. He found smoking to be a dangerous addiction leading to lung cancer. He also claimed that some people “aged out” of heroin addiction. If correct, this suggests an even more positive conclusion than presented here — the neurochemistry can change to get past the addictive condition. Now if we could only figure out how to actively change it, we would have real ‘cures’.

David C Arndt, M.D.
October 10, 2018

As a surgeon and long-time methamphetamine addict who is now in my 15th year of recovery, I found Dr. Grinspoon’s editorial to be of considerable interest.
My use of “recreational” and mood-altering substances had catastrophic effects on my life and the lives of those around me. I cannot imagine a circumstance where I would find it prudent to use any mood-altering substance again.
I suppose my question to Dr Grinspoon is: “Why would using anything after having struggled with a SUD be desirable?”. If dinner without a glass of wine feels difficult, perhaps this is a sign that one’s recovery is not a solid as one might have thought. If this is the case, perhaps the solution is not to find a way to justify drinking the wine…

Holly Attutis
October 15, 2018

I agree with everything you are saying…

Carla
October 15, 2018

Thanks for the comment, Dr. Arndt. My brother started at a young age with drinking, went through rehab for alcoholism but fell later for cocaine and opiods, a wide range of drugs. Multiple rehabs did not help. Only at 50 when his underlying dual diagnosis was treated and he had a stay in jail has he been able to stay sober. He says it is not worth the risk, and “denial is not just a river in Egypt.”

Etta elliott
October 15, 2018

I am now 83 years old! I have had an anxiety disorder most of my life, which the Drs treated with zanex for many years. Then they changed it to clonipen years ago, and now generic brand called clonazepam 1mg. which works well. But I don’t like the idea of being addicted to anything. I kicked my addiction to pain meds years ago which I was given for arthritis. I did not know for a long time that the pain meds, or the zanex was addictive. The dr. Writes my prescription for 3per day of clonazepam now, however, I have never taken but one half pill nightly. Recently I decided to quit that, but easier said than done. I have been cutting back for some time and making one third of one pill do me each night. I can’t seem to completely quit it!! Could you someone please suggest something off that I can replace the clonazepam with? Thanks!

Ger
October 15, 2018

It is not that dinner without a glass of wine is difficult. For some of us, we have dinner maybe 5 nights a week without a glass of wine. But we may like to enjoy a glass or two over a special occasion dinner, without going over the top with it! I am so glad I tried that again, many years into my so called “recovery”. It makes life more enjoyable for me.

Peter Grinspoon, MD
October 15, 2018

Hi David! (our fathers were classmates in medial school…). That’s the whole point: some people find it difficult to enjoy that glass of wine, and others don’t. Obviously, if you have any difficulty, you should avoid it like the plague. But, in fact, many (most?) people don’t have trouble, decades later, using, say, a drug that is much less addictive than meth (e.g. cannabis) in an entirely different class of substances. The people in this category wouldn’t necessarily need to fall into the “abstinence for eternity” category. In rehab, they teach that “a drug is a drug is a drug” but, as you know, that is mindless nonsense…in any case, congrats on your recovery!!!

Peter Grinspoon, MD
October 15, 2018

Hi David! (our fathers were classmates in medial school…). Thanks for your comments. That’s the whole point: some people will find it difficult to enjoy that glass of wine, and others won’t. Obviously, if you have any difficulty, you should avoid it like the plague. But, in fact, many (most?) people don’t have trouble, decades later, using, say, a drug that is much less addictive than meth (e.g. cannabis) in an entirely different class of substances (e.g broadly speaking, a downer vs. an upper). The people in this category wouldn’t necessarily need to fall into the “abstinence for eternity” category. I believe that concept was never evidence-based in the first place, came from AA in the 1930’s, and may well be out-dated. In rehab, they teach that “a drug is a drug is a drug” but, as you know, that is mindless nonsense. In any case, congrats on your recovery!! I’m really happy for you.

Bob Shoemaker
October 10, 2018

I have but one experience and that was my father. He was heavily addicted to tobacco all of his adult life. Sometimes 3 packs or more per day. When he was in his early 60s he was at Mayo clinic He was told that he needed to cut down his smoking. He and my mother were driving home. As they crossed a bridge over the Mississippi River he opened the car window and through a cigarette butt out. He said, “I cannot ‘cut down’ but I can quit”. He did. That was the last butt he ever had to dispose of. Returning home “No smoking” signs went up in the front hall of their house and in his car. Never having smoked my self I took that cue and posted “no smoking” signs in my office. Dad quit –period. Sadly it was a little late. He died as a result of lung cancer about ten years later. My children, his grandchildren, are non-smokers as are their families.

Peter Grinspoon, MD
October 11, 2018

That’s a fantastic story; thanks’s for sharing. A lot of people find it easier to just quit than to just cut down…

David
October 15, 2018

I quit smoking as a 40 year old after smoking for 25 years. The interesting part of my story was I quit smoking during my time as a marketing representative of a leading tobacco firm. Considering I had free cigarettes/tobacco at my disposal, tells me anyone can do it particularly today with the cost associated with smoking. I resigned from the company some 6 months later as I couldn’t promote something I never believed in myself. I just wish weight loss was as easy!

Stephen C Row
October 10, 2018

I lost three family members to addiction – my mother to alcohol, one sister to alcohol and cigarettes (She died from COPD) and another from a combination of pills and alcohol. I stopped drinking 33 years ago, nine months after my mother died. I stopped relatively early – as a young child (8 – 15 years old), watching my mother go through DT’s (three times), hallucinations, convulsions, and physical and emotional abuse of all of us children and my father – I didn’t need to experience these things to know that my own drinking, if I continued, would probably lead to these terrible extremes. Of course I never talked about this while a student at Harvard. I also found rowing – a very healthy “addiction” – helped me overcome my own depression, hypomania and ADHD. For me, the question has never entered whether I can imbibe in a glass of wine now and then. I don’t even want to consider it. I too often watched my mom try a glass of wine at a family celebration only to relapse into full-blown alcoholism and be carted off on Christmas eve to detox, wake up in the morning as a child to a house filled with shattered dishes, blood, Christmas trees in the front yard, neighbors gossiping about mom’s running half naked through their yard, etc., etc. I am not religious about this abstinence; it’s just a risk I choose not to take. And for what? Is the pleasure of a glass of wine worth the hassle and risk? For me, NO!

Peter Grinspoon, MD
October 11, 2018

Congrats on your recovery! I can see how, if it runs so deeply in your family, that it makes sense to not even consider opening Pandora’s box!

Ger
October 15, 2018

You sound like an immensely strong person, and you are ver definite in your decision not to risk addiction. I completely understand why and would agree with that – the risk would be so horrendous I cannot imagine enjoying any substance you feel would take you down that very sad and difficult road. Well done on your choices – they make perfect sense.

Peter Grinspoon, MD
October 15, 2018

Sounds like you’ve figured out what works for you, which is what is most important of all!

phillip Bettin
October 8, 2018

If you have a primary SUD with certain drug, why would anybody want to role the dice that they won’t develop an addiction to another one, or that use of another drug won’t lead then back to their “drug of choice”. It would seem prudent to refrain from all mood altering chemicals. I’m sober over 36 years. Headed for a12 step meeting right now. Phil 😊

Peter Grinspoon, MD
October 11, 2018

You absolutely can’t go wrong with a ‘better safe than sorry’ approach! Congrats on your recovery.

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