From the On Our Mind archives:


     "The issue with addiction is that most people who use drugs do not get into deep trouble with them.  Many people get better without ever going to treatment or attending self-help groups.  Those are not the people I see in treatment programs. I work with people who are not only addicted to substances, but are using them because, at least in the beginning, they helped the person cope with something really big, like co-occurring mental health issues or trauma.

      I think the stats are that 91% of people who use a drug don't develop a substance use disorder.  For that other 9% there seems to be a switch that gets flipped in their brain. Is that a disease? Probably more like a predisposition, an underlying issue, or both.

      As for isolation vs. the rat park, research has shown, that if a treatment program is nice to people they tend to stay, and if they stay, they tend to get better.  The longer someone is engaged in treatment, the better their chances of maintaining long-term sobriety. If their family engages in treatment of their own, the better loved one’s chances are of maintaining sobriety. If they begin to hang around with healthier people, they tend to do better. But the problem is that until that caused someone to use substances in the first place is addressed, people will continue to struggle.

     So what causes addiction? As best we know, it is a bio-psycho-social problem/illness/disease/condition.  It seems to have many causal factors and many of these lead to isolation.  Depression, anxiety, school problems, family issues, poor self-esteem, etc. may lead to isolation.  So while a nice rat park may help many people who use drugs, it may not help those who have the whole bio psychosocial thing going on. 

    Addiction is complicated but treatable.  If there was only one solution, there would be only one book about it. Or one type of treatment."

   Abby Dean, LICSW, MPH

   April 12, 2017