Addiction is a complex illness, but that has not prevented simplistic portrayals of it in books and on the screen. While there are many myths about addiction that are propagated in fiction, there is one particular myth that sometimes even makes it into otherwise accurate portrayals of substance abuse. Unfortunately, it is a myth that can make addiction a whole lot harder to identify.
That myth is the idea that a person needs to use a substance every day or nearly every day in order to be addicted. We see this play out in fiction all the time. A character begins drinking every weekend. They then start to drink during the week on occasion. But they still aren’t considered to have a problem. Only when they need alcohol daily or even multiple times a day does the narrative consider them to be addicted.
This narrative is particularly prevalent in relapse stories. When a character relapses, they immediately begin drinking or using substances every day. However, this is often not how addiction looks.
Addiction vs Physical Dependence:
The portrayal of a person needing to use substances every day more closely resembles physical dependence. Physical dependence is when the body adapts to the substance and needs it in order to function. People with alcohol or drug dependence will use consistently and, if they want to stop, they will have to go through withdrawals. Where there’s physical dependence, there’s addiction.
But the opposite is not always true. While some addicts are physically dependent on substances, others are not. Addiction is reflected not just in the body’s reaction to a substance but in patterns of behavior.
Consider the following case.
Sally has a social anxiety disorder. She gets anxious before social gatherings and blushes and sweats her way through them. Afterwards, she feels a tremendous amount of shame. Gradually, she realizes that if she drinks alcohol beforehand, she is able to let go of her inhibitions and actually enjoy herself.
After some time, Sally is drinking before every single social gathering. She is unable to stop herself from drinking before meeting people. It is affecting her relationships, as she is unable to develop deep connections when drunk. It is affecting her work life as well, as she suffers hangovers regularly.
Sally is not physically dependent on alcohol. She can go days or even weeks without drinking, as long as she doesn’t need to meet people over that time. However, she is addicted to alcohol, as drinking is affecting her ability to function socially and maintain relationships.
Physical vs Mental Dependence:
Sally’s addiction is a type of dependence. However, it is a mental or behavioral dependence rather than a physical one. Her body does not require alcohol and she may not have much of a tolerance. But she depends on alcohol to get through social gatherings.
Many people in Sally’s position and their loved ones do not realize that there is an addiction. They can see that there’s a problem, but often delay getting treatment because they believe it is not serious enough. This is because of the idea that addicts need to use daily.
It is also reflective of how we approach mental and physical health issues. Whereas people are more ready to accept that physical dependence is a problem, mental dependence is seen as something that can be easily fixed. It is seen as a willpower issue rather than an illness.
We need to start seeing regular patterns of drinking and substance use as addiction, even when they are not occurring every day. Addiction is real even when the body is not dependent on the substance.