Breaking Down the Myths and Realities of Substance Use Disorders

With the pandemic consuming over two years of our lives, the rate of substance use disorder has risen monumentally. From 20.4 million people ages twelve or older[1] to 31.9 million in 2022[2]; the isolation, the financial instability, and stress and trauma of living through a viral pandemic was a perfect environment for substance use disorder to increase dramatically.

Despite the prevalence of substance use disorders in America, there is still much misinformation surrounding them. Recovery Awareness Month, kicking off September 1, is the perfect time to revisit the myths surrounding SUD.

Myths vs. Reality

Myth #1: People who use or misuse substances are weak or have a character flaw.

Reality: Experts agree that substance use disorder is a brain-based disease.

Repeated use of substances can lead to changes in the brain. 

The brain is hard-wired to seek out pleasure.  When the brain releases dopamine (the chemical responsible as the brain’s “reward system”), the brain motivates itself to seek out the same behaviors, which causes reinforcement of behavior, including substance use.

When a substance is misused, the brain adapts. It creates a tolerance to the dopamine, requiring a bigger and bigger dose. This is what reduces the effect of the substance, causing many to consume more of the substance to feel the same.

In addition to the brain’s reward system, much of an individual’s biology, environment, and development impact the onset of substance use disorder. Biological predispositions may be rooted in genetics, gender, family history of SUD, and other considerations. Environment predispositions may include peer pressure, history of trauma, early exposure to drugs, stress, and parental considerations[3].

Myth #2: People don’t need medication or treatment. Willpower is enough.

Reality: While this can be true for some, research shows that a combination of medication and therapy can successfully treat substance use disorder.

Willpower sometimes isn’t enough.  Substance use disorders “hijack” part of the brain and can erode the ability of self-control, resistance, and good decision-making. This same reward center in the brain is responsible for survival—eating, sleeping, drinking water.

Many individuals benefit from treatment either with a licensed mental health professional or at a treatment center. Many treatment options include medication-assisted treatment (MAT). MAT is used to treat substance use disorders, as well as achieve recovery and prevent overdose.

Successful treatment is often holistic – combining MAT, counseling, and behavioral therapies. This combination has been clinically tested and retested to successfully treat these disorders[4].

Myth #3: Relapse = failure.

Reality: Recovery from SUD is a journey and a process. Setbacks on any journey are normal.

According to the National Institutes of Health[5], “Relapse rates for addiction resemble those of other chronic diseases such as diabetes, hypertension, and asthma.”

A return-to-use episode is very common for individuals in substance use recovery, especially within the first year. Many people find this experience motivates them further to commit to long-term recovery. It is not uncommon to have several episodes of return-to-use before an individual figures out their own unique path to long-term recovery.

While a return-to-use may feel disheartening, this experience can be used as a tool to help identify different environments, people, and stressors that an individual needs to avoid, while helping them know which new skills they need to work on to stay in recovery.

Myth #4: I can do this alone.

Reality: Social relationships are key to recovery, especially during the early stages.

Research has shown that “supportive relationships with caring family, partners, and friends—including individuals who do not use substance themselves—have proven to be helpful in abstaining and maintaining sobriety.[6]

Individuals with substance use disorders are known to have fewer social relationships than those without, due to the isolating nature of this disease. This population is known to experience higher rates of isolation, domestic violence, marital problems, and have fewer positive friendships or family relationships.

Research has shown that supportive relationships are crucial for all stages of the treatment and recovery process. These positive relationships have even been proven to be crucial to reaching long-term recovery[6].  Another finding[6] indicates that siblings of those with SUDs influence them most to stop using.

The Bottom Line

Recovery from Substance Use Disorder is a journey.

Now more than ever, we must adapt our strategies to combating SUD to reflect the challenges of addiction – not the myths. 

At CHESS Health, we collaborate with health plans, state and local governments, other public sector organizations, and individual providers to connect care across the continuum. Our offering helps to automate SBIRT (Screening, Brief Intervention, Referral to Treatment), achieve higher abstinence rates, reduce the risk of relapse, and lower the cost of care.


  3. Understanding Drug Use and Addiction DrugFacts | National Institute on Drug Abuse (NIDA) (
  4. Medication-Assisted Treatment (MAT) | SAMHSA
  5. How effective is drug addiction treatment? | National Institute on Drug Abuse (NIDA) (
  6. How Social Relationships Influence Substance Use Disorder Recovery: A Collaborative Narrative Study – PMC (