One of the biggest barriers in committing to treatment for substance use disorder (SUD) is the idea that affected individuals are “addicts for life”. The phrase “once an alcoholic, always an alcoholic” is still dogmatically shared today, as a way to encourage recovering individuals to continue with aftercare or support group sessions.
Unfortunately, this thinking often leads to an unrealistic idea of what exactly is involved in recovery. In many cases, it may even turn a person with SUD off the idea of seeking treatment. After all, why bother if you can’t change?
It’s true that SUD usually leaves an unseen mark on a person. However, the same could be said for any traumatic or life-changing experience. Today, there’s evidence that shows SUD does not have to be for life.1,2 However, that does not mean that all people who progress or recover from SUD no longer face relapse risks.3,4,5,6
In this article, we’ll explore whether or not the idea of SUD being a lifetime illness has any merit. Contact us at Dallas Drug Treatment Centers to learn more about your options for SUD treatment in the Dallas-Fort Worth area.
Factors for Redeveloping Substance Use Disorder
As with many other mental health issues, substance use disorder is an incredibly complex illness that often has multiple direct and indirect causes. Not all these causes are necessarily going to be relevant for the entirety of a person’s lifetime.
However, other causes can permanently raise a recovered individual’s risk of relapse or developing a new SUD.3,4,5,6,8
Here are some inter-related factors that can influence whether or not a person redevelops an SUD after recovery:
A 2017 meta-analysis of studies involving SUDs and genetics found that genetics definitely does play a role in whether or not people develop specific types of substance use disorder.4 Because the genetic effects seem to depend on substance type, this seems to go against the conventional wisdom that a person who recovers from an SUD is immediately vulnerable to other SUDs or maladaptive coping behaviors.4,5,8
Additionally, it appears that at least some mental health issues that can lead to SUD are genetically linked. These genetic predispositions can be exacerbated by environmental factors that ultimately lead to an SUD as well.
In practical terms, this means that recovered individuals who are genetically predisposed to a specific type of SUD or a related mental health condition may continue to have a relatively high risk of re-developing SUD.4,5
Pre-existing Mental Health Conditions
Whether caused by genetics or external factors like traumatic events, mental health problems can continue to elevate one’s risk of relapse redeveloping an SUD after recovery.1,2,5 For this reason, mental health disorders that are co-morbid with SUD should be taken into account during and after treatment.
Living situations that heighten anxiety or contribute to trauma can lead to a higher SUD risk.4,5 Financial insecurity, the threat of violence, cultural and social norms, and the constant presence of people who are bad influences or cause negative feelings are just some of the things that can increase the risk of redeveloping or being unable to recover from SUD. These environmental risks may also worsen any existing genetic and mental health risks a person has.
Thankfully, environmental risks are among the most straightforward to mitigate. Moving away from a bad living situation or finding adequate social support will usually reduce or remove environmental SUD risks.1,5
Types of Substances Involved
While all SUDs are broadly similar, not all substances are as habit-forming for each individual. Genetics seems to play the largest part in determining whether or not a person will develop a habit for something. However, the specific substance’s so-called “potential for abuse” also plays a role.4,7
SUD Is Not Always Forever
Thankfully, the risk of redeveloping an SUD after recovery is lower than previously thought. A 2014 study provides evidence to suggest that people who have recovered from a SUD have less than half the risk of developing a new SUD compared to individuals who have not yet recovered.8
Additionally, people who have made a full recovery are unlikely to substitute their previous drug of choice with another drug. In other words, recovering the first time tends to make you highly resilient to developing another SUD.8
You Can Change
The available data so far suggests that drug and alcohol problems don’t have to be for life. The key, it seems, is to understand the ultimate causes of the specific SUD case and managing the relevant risks accordingly. When this is done properly, a full recovery and future resilience to habitual substance misuse are always achievable.1,2
If you’re interested in a holistic, personalized approach to SUD treatment and aftercare, it’s important to look at what different facilities and programs have to offer. If you’re in the North Texas area, you can call Dallas Drug Treatment Centers at +1(214) 935-2287 to discuss your treatment options.
- National Institute on Drug Abuse. (2020, September). Principles of Effective Treatment.
- National Institute on Drug Abuse. (2020, July). Treatment and Recovery.
- Mavrikaki, M. (2020). Brain Plasticity in Drug Addiction: Burden and Benefit. Harvard Health Publishing.
- Prom-Wormley, E. C., Ebejer, J., Dick, D. M., & Bowers, M. S. (2017). The genetic epidemiology of substance use disorder: a review. Drug and alcohol dependence, 180, 241-259.
- Mavrikaki, M. (2019). Your Genes and Addiction. Harvard Health Publishing.
- Grinspoon, P. (2018). Does Addiction Last a Lifetime?. Harvard Health Publishing.
- S. Department of Justice., & U.S. Drug Enforcement Administration. (2021). Drug Scheduling.
- Blanco, C., Okuda, M., Wang, S., Liu, S. M., & Olfson, M. (2014). Testing the drug substitution switching-addictions hypothesis: A prospective study in a nationally representative sample. JAMA Psychiatry, 71(11), 1246-1253.