The Cost of Misunderstanding: When Myths Kill
A mother watches her son struggle with opioid addiction for the third time. Friends tell her, “He just needs to want it badly enough.” She’s tried tough love, cutting him off, refusing to enable him. He overdoses alone in his apartment, afraid to call her because he doesn’t want to disappoint her again.
In Canada, over 47,000 people have died from opioid-related causes since 2016 (Public Health Agency of Canada, 2024). Behind each statistic is a person whose life might have been saved if the people around them—family, friends, even healthcare providers—understood what addiction actually is.
The myths we believe about addiction aren’t just incorrect. They’re dangerous. They prevent people from seeking help, keep families from offering effective support, and perpetuate stigma that kills.
According to the Canadian Centre on Substance Use and Addiction, only 1 in 10 Canadians with substance use disorders receive treatment (CCSA, 2024). One major barrier? The shame created by misunderstanding what addiction is and how recovery works.
It’s time to dismantle the myths. Here are seven beliefs about addiction that need to be permanently retired—and what the science actually tells us.
Myth 1: “Addiction Is a Choice” or “They Just Need Willpower”
The Myth
If people really wanted to stop using, they would. Continued use means they’re choosing drugs over their family, career, and health. They just lack self-control or moral character.
The Reality
Addiction is a chronic brain disease, not a moral failing (Canadian Centre on Substance Use and Addiction, 2024).
Here’s what actually happens in the brain:
- Substances hijack the brain’s reward system
- The prefrontal cortex (decision-making center) becomes impaired
- Neurotransmitter levels change, making normal activities less rewarding
- Physical dependence creates severe withdrawal symptoms
- Cravings become overwhelming physiological responses, not simple “wants”
Brain imaging studies show that addiction causes measurable changes in brain structure and function (National Institute on Drug Abuse, 2023). These changes affect:
- Judgment and decision-making
- Learning and memory
- Behavior control
- Stress response
Think of it this way: You wouldn’t tell someone with diabetes to “just try harder” to regulate their blood sugar. Addiction requires medical treatment, not moral lectures.
Why This Myth Is Harmful
When we frame addiction as a choice:
- People delay seeking treatment due to shame
- Families use ineffective “tough love” approaches
- Healthcare systems underfund addiction services
- Society criminalizes illness instead of treating it
- Insurance companies deny coverage for treatment
The truth is, while the first use might involve choice, addiction removes that choice through neurological changes.
Myth 2: “You Have to Hit Rock Bottom Before You Can Recover”
The Myth
People with addiction need to lose everything—job, family, home, health—before they’ll be motivated to change. Helping them before they hit bottom is “enabling” that prevents them from getting serious about recovery.
The Reality
Waiting for rock bottom kills people (Centre for Addiction and Mental Health, 2024).
The “rock bottom” myth is one of the most dangerous beliefs in addiction treatment. Here’s why:
For many people, “rock bottom” is death. Waiting for someone to lose everything before offering help means some people won’t survive to see recovery.
Early intervention is more effective (Canadian Journal of Addiction, 2023). The research shows:
- People who receive treatment earlier have better outcomes
- Brief interventions can be effective even before severe consequences
- Motivation can be built through treatment, not just before it
- Supporting someone doesn’t equal enabling
What Actually Motivates Change:
- Connection and support (not isolation)
- Access to treatment when ready (not barriers)
- Harm reduction approaches that meet people where they are
- Multiple attempts with learning from each experience
The Enabling vs. Supporting Distinction
Enabling means:
- Removing all consequences of substance use
- Making it easier to continue using
- Taking responsibility that belongs to them
- Ignoring the problem entirely
Supporting means:
- Maintaining the relationship
- Encouraging treatment
- Setting healthy boundaries
- Providing resources when they’re ready
You can do both: refuse to fund their addiction while still being emotionally present.
Myth 3: “If Treatment Didn’t Work the First Time, They’re Not Serious About Recovery”
The Myth
Real recovery means getting sober on the first try. If someone relapses or needs multiple treatment attempts, they’re not truly committed.
The Reality
Relapse is a common part of recovery, not a sign of failure (Canadian Centre on Substance Use and Addiction, 2024).
The Statistics:
- 40-60% of people in recovery experience relapse (National Institute on Drug Abuse, 2023)
- This is similar to relapse rates for other chronic diseases like diabetes (40-60%) and hypertension (50-70%)
- Most people require multiple treatment episodes before achieving long-term recovery
- Each treatment attempt provides learning that increases future success
Recovery is rarely linear. It typically looks more like:
Treatment → Progress → Relapse → Treatment → Progress → Relapse → Sustained recovery
What Relapse Actually Means:
- The treatment approach may need adjustment
- Additional support services are needed
- Underlying mental health issues require attention
- Environmental factors need to be addressed
- The person needs different strategies for managing triggers
It doesn’t mean:
- They’re not trying hard enough
- Treatment doesn’t work
- They’re hopeless
- You should give up on them
Why This Myth Is Harmful
When families and treatment providers view relapse as failure:
- People hide relapses instead of seeking immediate help
- Shame prevents return to treatment
- Support systems withdraw when people need them most
- Treatment centers discharge people instead of adjusting approaches
- People die because they use alone to avoid judgment
Professional addiction counselors understand that relapse is data about what needs to change, not evidence of moral weakness.
Myth 4: “Abstinence Is the Only Valid Path to Recovery”
The Myth
Recovery means complete abstinence from all substances. Any other approach is just “enabling” or “not real recovery.” Medication-assisted treatment is just replacing one drug with another.
The Reality
Multiple paths to recovery exist, and they’re all valid (Canadian Research Initiative in Substance Misuse, 2024).
Evidence-Based Approaches Include:
1. Abstinence-Based Recovery
- Complete cessation of substance use
- Often includes 12-step programs
- Works well for many people
- Requires strong support systems
2. Harm Reduction
- Meets people where they are
- Focuses on reducing negative consequences
- Can be a pathway to abstinence or an end goal itself
- Includes strategies like:
- Supervised consumption sites
- Needle exchange programs
- Safer use education
- Managed alcohol programs
3. Medication-Assisted Treatment (MAT)
- Uses medications like methadone, buprenorphine, or naltrexone
- Reduces cravings and withdrawal symptoms
- Allows people to stabilize their lives
- Evidence shows it’s the most effective treatment for opioid use disorder (Canadian Medical Association Journal, 2023)
Research shows that harm reduction approaches:
- Reduce overdose deaths by 37-66% (British Columbia Centre on Substance Use, 2024)
- Increase engagement with healthcare services
- Don’t increase drug use
- Often lead to eventual abstinence
- Keep people alive long enough to find recovery
The Truth About Medication-Assisted Treatment: Saying MAT is “replacing one drug with another” is like saying insulin is “replacing natural blood sugar regulation.” MAT:
- Prevents the euphoric highs and withdrawal lows
- Allows normal brain function
- Enables people to work, parent, and engage in life
- Reduces criminal activity related to obtaining drugs
- Decreases risk of infectious disease
Why This Myth Is Harmful
When we insist on abstinence as the only option:
- People avoid treatment that could save their lives
- Proven interventions are rejected due to ideology
- People die from preventable overdoses
- Treatment becomes all-or-nothing (increasing drop-out rates)
- We prioritize ideology over evidence
Recovery looks different for different people. The best path is the one that keeps someone alive and improving their quality of life.
Myth 5: “Addiction Only Affects Certain Types of People”
The Myth
Addiction happens to “those people”—people from unstable homes, lower socioeconomic backgrounds, with criminal tendencies, or weak moral character. “Good families” don’t have addiction problems.
The Reality
Addiction does not discriminate (Canadian Centre on Substance Use and Addiction, 2024).
The Statistics Tell the Truth:
1 in 5 Canadians will experience a substance use disorder in their lifetime (Mental Health Commission of Canada, 2024)
Addiction affects all:
- Socioeconomic levels
- Education levels
- Professions (including doctors, lawyers, teachers)
- Ages (from adolescents to seniors)
- Family structures
- Geographic locations
- Cultural backgrounds
High-Risk Groups Often Missed:
- Healthcare professionals with easy access to substances
- High-achieving students using stimulants for performance
- Professionals using alcohol or prescription drugs to manage stress
- Seniors developing dependencies on prescribed medications
- Athletes using opioids for pain management
Risk Factors That Cross All Boundaries:
- Genetic predisposition (50-60% of addiction risk is genetic)
- Trauma and adverse childhood experiences
- Mental health conditions
- Chronic pain
- Social isolation
- Stress and burnout
- Easy access to substances
Why This Myth Is Harmful
When we stereotype who “addicts” are:
- Middle and upper-class families hide problems longer
- Professionals avoid seeking help due to career concerns
- Resources aren’t allocated to all affected communities
- People don’t recognize addiction in unexpected demographics
- Stigma prevents open conversations
The parent helping with homework might be struggling. The successful lawyer in court might be dependent on benzodiazepines. The elderly grandparent might be misusing prescription opioids. Addiction wears every face.
Myth 6: “Once an Addict, Always an Addict”
The Myth
Addiction is a permanent identity. People in recovery will always be “addicts” struggling daily not to use. They can never truly be healed or trusted.
The Reality
Recovery is possible, and many people achieve long-term wellness (Canadian Centre on Substance Use and Addiction, 2024).
What Research Shows:
- Over 75% of people who have experienced addiction eventually recover (Public Health Agency of Canada, 2023)
- Many people achieve decades of sustained recovery
- Brain changes from addiction can heal over time
- People in long-term recovery often show resilience exceeding general population
Recovery Outcomes:
- Some people achieve complete abstinence with no ongoing struggle
- Others manage recovery like a chronic condition with good self-care
- Many find that cravings and triggers significantly decrease over time
- People rebuild careers, relationships, and health
- Former users often become helpers, counselors, and advocates
Identity Beyond Addiction: While some people find the “recovering addict” identity helpful, others prefer:
- “Person in recovery”
- “Person with lived experience”
- Simply moving forward without the label
- Focusing on who they are now, not their past
The “always an addict” mindset can:
- Limit people’s sense of possibility
- Create self-fulfilling prophecies
- Prevent full reintegration into society
- Define people by their worst moments
- Ignore their growth and transformation
Why This Myth Is Harmful
When society sees addiction as permanent:
- Employment discrimination persists
- Housing applications are denied
- Custody battles are lost
- People internalize shame and limitation
- Recovery is framed as “managing disease” instead of healing
Recovery is not just about stopping substance use—it’s about building a life you don’t want to escape from.
Myth 7: “You Can’t Help Someone Who Doesn’t Want Help”
The Myth
Until someone with addiction decides they want recovery, there’s nothing anyone can do. You’re wasting your time trying to help someone who isn’t ready.
The Reality
Motivation is not binary—it exists on a spectrum and can be influenced (Centre for Addiction and Mental Health, 2024).
What We Know About Motivation:
- Motivation fluctuates daily, even hourly
- People can be ambivalent (wanting to stop AND wanting to continue)
- External circumstances can create windows of opportunity
- Professional interventions can increase readiness for change
- Connection and support influence motivation
Evidence-Based Approaches That Work:
1. Motivational Interviewing
- Helps people explore their own ambivalence
- Doesn’t require them to admit they have a problem
- Increases intrinsic motivation through guided conversation
- Used effectively even with “resistant” individuals
2. Community Reinforcement and Family Training (CRAFT)
- Teaches families how to influence loved ones toward treatment
- 70% success rate at getting unmotivated individuals into treatment (Journal of Substance Abuse Treatment, 2023)
- More effective than confrontational interventions or detachment
3. Harm Reduction Engagement
- Meets people where they are
- Builds trust through non-judgmental support
- Creates pathways to treatment when ready
- Keeps people alive until they’re ready for recovery
What You Can Do Before Someone “Wants Help”:
- Maintain the relationship (connection is protective)
- Learn about addiction and effective communication
- Set healthy boundaries without cutting them off
- Have resources ready for windows of opportunity
- Model hope and believe in their capacity to change
- Seek support for yourself through Al-Anon or counseling
Why This Myth Is Harmful
When we believe we’re powerless until they’re ready:
- Families give up prematurely
- People use alone, increasing overdose risk
- Windows of opportunity are missed
- Support systems disappear when most needed
- We underestimate our influence
The truth: Your connection might be the thing that keeps them alive long enough to find readiness. Don’t give up.
The Professional Reality: Working in Addiction Counselling
If these myths have opened your eyes to the complexity of addiction, you might be wondering what it takes to work professionally in this field.
Addiction counsellors in Canada are in high demand:
- 12,400 projected job openings in social and community services (including addiction workers) from 2024-2033 (Canadian Occupational Projection System, 2024)
- Growing recognition of addiction as a health crisis, not criminal issue
- Increased funding for treatment programs post-opioid crisis
- Expansion of harm reduction services
Canadian Addiction Worker Salary Ranges (2025):
- Entry Level: $40,000 – $52,000 annually (PayScale Canada, 2025)
- Mid-Career (3-5 years): $52,000 – $68,000 annually (Job Bank Canada, 2024)
- Experienced (6-10 years): $65,000 – $82,000 annually (Talent.com, 2024)
- Clinical/Supervisory Roles: $75,000 – $95,000+ annually (Government of Canada, 2024)
Where Addiction Workers Work:
- Addiction treatment centers (residential and outpatient)
- Community health agencies
- Hospitals and healthcare settings
- Correctional facilities
- Harm reduction services
- Employee assistance programs
- Private practice
Sources: Canadian Occupational Projection System, PayScale Canada, Job Bank Canada
Frequently Asked Questions
-
How can I tell if someone I love has an addiction problem?
Addiction exists on a spectrum from problematic use to severe dependence. Warning signs include:
Behavioral Changes:
– Neglecting responsibilities (work, school, family)
– Loss of interest in previously enjoyed activities
– Secretive behavior or lying about substance use
– Changes in friend groups or social circles
– Financial problems or unexplained need for moneyPhysical Signs:
– Changes in sleep patterns or appetite
– Unexplained weight loss or gain
– Deterioration in physical appearance
– Bloodshot eyes, unusual smells, tremorsPsychological Signs:
– Mood swings or personality changes
– Increased anxiety, depression, or irritability
– Defensive or aggressive when questioned about use
– Denial that there’s a problemFunctional Impact:
– Can they stop when they want to?
– Has tolerance increased (needing more for same effect)?
– Do they experience withdrawal symptoms when not using?
– Do they continue using despite negative consequences?If you’re concerned, approach with compassion, not accusation: “I’ve noticed [specific observations] and I’m worried about you. I care about you and want to help.”
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What’s the difference between physical dependence and addiction?
This is a crucial distinction often confused:
Physical Dependence:
– Body adapts to regular presence of substance
– Withdrawal symptoms occur when stopping
– Can happen with legitimate medication use
– Doesn’t necessarily involve compulsive use
– Example: Someone taking prescribed opioids for chronic pain may develop dependence but not addictionAddiction (Substance Use Disorder):
– Compulsive use despite harmful consequences
– Loss of control over use
– Continued use despite wanting to stop
– Life becomes organized around obtaining and using
– Involves both physical and psychological componentsYou can have physical dependence without addiction, and you can have addiction without physical dependence (some substances don’t cause physical withdrawal but are highly addictive psychologically).
Example: A chronic pain patient may need to taper off opioids to avoid withdrawal (physical dependence) but isn’t compulsively seeking drugs or harming their life (addiction). Conversely, someone with gambling addiction has no physical dependence but meets all other criteria for addiction.
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Is it possible to “cure” addiction or is it always a lifelong struggle?
This depends on how you define “cure,” and the answer is more nuanced than yes or no.
The Medical Model: Addiction causes lasting brain changes, so it’s considered a chronic condition like diabetes or hypertension. From this perspective, there’s no “cure,” but effective management leads to healthy, fulfilling lives.
The Recovery Model: Many people achieve full, sustained recovery where they no longer experience cravings, don’t think about substances, and have rebuilt their lives completely. For them, addiction is in their past, not their present.
What Research Shows:
– Brain changes from addiction can reverse over time with sustained abstinence (National Institute on Drug Abuse, 2023)
– Many people report that recovery becomes easier over years, not harder
– Some people naturally “mature out” of addiction, especially from alcohol
– Long-term recovery (5+ years) is associated with high quality of life and low relapse ratesThe spectrum of recovery experiences:
– Some people manage recovery actively throughout life
– Some people find the first year difficult, then rarely think about it
– Some people experience occasional cravings but manage them easily
– Some people completely rebuild their lives and identify more with their present than their pastBottom line: Whether you call it management or healing, long-term recovery with high quality of life is absolutely achievable for most people.
-
How can I support someone with addiction without enabling them?
This is one of the most challenging questions families face. Here’s the framework:
Support Means:
– Maintaining emotional connection
– Expressing love without conditions
– Offering resources and treatment information
– Being present during recovery attempts
– Celebrating progress, no matter how small
– Educating yourself about addiction
– Getting your own support (Al-Anon, therapy)Enabling Means:
– Removing all natural consequences
– Providing money that will be used for substances
– Making excuses to employers, family, or authorities
– Taking on their responsibilities indefinitely
– Protecting them from experiencing the impact of their choicesThe Key Distinction: Support empowers change. Enabling prevents the person from experiencing the reality that might motivate change.
Practical Examples:
Instead of: Paying their rent so they don’t become homeless (enabling) Try: Offering to help them apply for treatment or housing programs (supporting)
Instead of: Calling their employer to make excuses (enabling) Try: “I love you and I’m here when you’re ready for treatment, but I can’t protect you from consequences at work” (supporting with boundaries)
Instead of: Cutting them off completely (abandonment) Try: “I won’t give you money, but I’ll buy you groceries” or “I’ll pay for treatment but not rent” (supporting with boundaries)
The hardest truth: Sometimes supporting someone means letting them experience discomfort that might motivate change, while ensuring they know you still care and will help them get treatment when ready.
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Where can I get professional training in addiction counselling?
Vancouver College of Counsellor Training (VCCT) offers a comprehensive Addictions Worker Certificate designed to prepare you for this challenging and rewarding career.
Program Highlights:
Duration: 24 weeks (6 months)
Format: On-campus or distance education—flexible for working adultsComprehensive Curriculum:
– Personal & Professional Development of the Counsellor: Ethics and self-awareness
– Clinical Counselling Skills: Core competencies for effective practice
– Substance Abuse Counselling: Understanding addiction, assessment, and intervention
– Specialized Approaches to Substance Abuse Counselling: Advanced techniques and special populations
– Introduction to Family Counselling: Family systems and addiction
– Pharmacology for Counsellors: Understanding how substances affect the brain and body
– Introduction to Cognitive Behavioural Counselling: Evidence-based treatment approaches
– Group Process & Support Skills: Facilitating recovery groupWhat Makes VCCT’s Program Different:
Evidence-Based Training:
– Learn both abstinence and harm reduction approaches
– Understand the neuroscience of addiction
– Master motivational interviewing techniques
– Practice trauma-informed careReal-World Focused:
– Taught by practicing addiction counsellors
– Case studies from actual treatment settings
– Skills you’ll use immediately in the field
– Understanding of Canadian addiction treatment landscapeLearn more about our Addictions Worker Certificate.
The people struggling with addiction in your community deserve counsellors who understand the science, challenge the myths, and believe in the possibility of recovery. That counsellor could be you
The Bottom Line: Myths Kill, Truth Heals
Every myth about addiction creates barriers:
- Barriers to treatment
- Barriers to support
- Barriers to recovery
- Barriers to compassion
When we understand addiction as a complex brain disease influenced by genetics, trauma, environment, and choice—rather than a moral failure—we can finally respond with effective interventions instead of judgment.
The people in your life struggling with addiction are not weak, unmotivated, or morally deficient. They’re experiencing a medical condition that hijacks the very brain circuits needed to overcome it.
Recovery is possible. Treatment works. Lives can be rebuilt.
But first, we have to stop believing myths that prevent healing.
Remember: Behind every person with addiction is a story of pain that led them there. Your compassion, not your judgment, might be what keeps them alive long enough to find recovery.