7. Cocaine. Cocaine is an episodic-use drug. It is one moreover associated with certain lifestyles - at one time (if not now) people in the financial industry and entertainment fields - and more often younger people. Studying long-term users of cocaine, Ronald Siegel found most moderated, controlled, or quit their use over time. Patricia Erickson and Bruce Alexander surveyed the research and found that fewer than 10 percent of cocaine addicts continued their addictions for substantial periods. After cocaine use peaked in the 1980s, most middle-class users quit (although use in inner cities continued some time longer). Remarking on this phenomenon, David Musto concluded: "The question we must ask ourselves is not why people take drugs, but why do people stop." He surmised that people with fewer resources had less to counterbalance their addictions.
6. Alcohol. Alcohol is the addiction most written about, both in scientific literature and as recounted in personal memoirs. Alcoholics Anonymous members swear AA is the only way to recover; treatment experts claim alcoholism is inescapable without treatment. But epidemiological research does not find this is true. The National Institute on Alcohol Abuse and Alcoholism in 2005 published the results of its National Epidemiologic Survey on Alcohol and Related Conditions. NESARC conducted 43,000 face-to-face interviews with a sample of Americans about their lifetime alcohol and drug use. Among these, 4,422 were classifiable at some point in their lives as alcohol dependent (or alcoholic). Somewhat more than a quarter had received any kind of treatment (including in an emergency room, attending AA, etc.). Among the large majority who went untreated, fewer than a quarter drank alcoholically at the time of the interview. Most (about two-thirds) of this group continued drinking non-alcoholically.
5. Valium. In general, drugs used for pacifying purposes (which are usually depressants), taken regularly over long periods of time, are hard to quit. This holds for sedatives, sleeping pills, barbiturates, and tranquilizers. Several best-sellers have been written about the difficulty in quitting Valium (benzodiazepine tranquilizers): Barbara Gordon's I'm Dancing as Fast as I Can and Betty Ford's The Times of My Life. A prominent New York City newscaster, Jim Jensen, recounted in Peoplehow he readily quit cocaine but couldn't get off Valium: "Valium withdrawal soon plunged him into a massive depression that left him unable to eat or sleep. It took two more months in two hospitals for him to regain his mental and physical health." Ah, but Americans love these drugs, need them to survive - although in good part they have been supplanted by antidepressants.
4. Heroin. Powerful analgesics, taken regularly, are difficult for many (but not most) people to quit. After all, most of us have had intravenous supplies of narcotics in the hospital, followed by prescriptions for powerful analgesics when we went home. What is remarkable is not so much that heroin can produce serious withdrawal for some, but how variable this syndrome is and how comparable it is to other depressant and painkiller drugs and analgesics (like Vicodin and OxyContin), which are the fastest growing drugs of abuse and today are taken by the majority of illicit narcotics users and overdose victims. So much has been written about heroin withdrawal, it is mainly worth noting that when people quit the drug with little difficulty (as the major league ballplayer Ron LeFlore did when he entered prison and took up baseball) it is simply considered impermissible to describe or portray this aspect of their stories.
3. Cigarettes. In ratings by cocaine and alcohol addicts, smoking is regularly cited as the more difficult drug to quit, generally on par with or more difficult than heroin. Nonetheless, more than 40 million living Americans have quit smoking. While impressive, this still only represents about half of all of those ever addicted to cigarettes - although a higher percentage of those in higher socioeconomic groups have quit. When I speak to recovering people at addiction conferences I ask, "What is the toughest drug to quit?" By acclimation, the audience shouts out, "cigarettes" or "smoking." I then ask, "How many people in this room have been addicted to cigarettes but are now off them?" Half to two-thirds - often hundreds of people - in the room raise their hands. "Wow," I enthuse. "And how many have used any kind of therapy - medical or a support group - to quit?" Never have more than a small handful done so.
2. Potato chips. I use potato chips, of course, to stand for all kinds of alluring but fattening foods. These comfort foods, which deprive more Americans of life years than any other substance, are inextricably integrated with our own lives, and with the lives of all Americans. Although overweight is disapproved and regularly lectured against, it still doesn't have the stigma of drugs, alcohol, and cigarettes, so that hidden (and not so hidden) food addictions are more readily tolerated. That gastric bypass surgery is growing so rapidly shows that this is the substance addiction people find hardest to quit, even those for whom it causes serious, life-threatening health conditions. In fact, we will never resolve our massive food addictions in the United States, but we hope to come up with medical cures to prevent their negative effects, as if we would succeed by simply deciding to let smokers continue to smoke noncancerous cigarettes.
1. Love. Ah, love is the hardest addiction to quit. It certainly causes more murders and suicides than any other addiction. And if you think people miss smoking, consider what people are like when they break up with long-time lovers or get divorced - even when they hate their spouses! (See the response to this post, "My divorce has left me . . .") On the other hand, we read frequently about people who totally sacrificed their lives to a lover who betrayed them or otherwise destroyed their psyches, yet who still didn't quit the relationship - what is the answer, after all, when an abuse victim is asked why they simply don't leave an abusive spouse? "Because I love him, and can't live without him." I regularly counsel spouses of substance abusers about this.
Don't despair, however, no matter what your addiction is. The large majority of addicts give up every kind of addiction. So can you. That most people do it, one way or another, tells you that it lies within your power.
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