addiction road to recovery cover

Road to Recovery signSeptember is Recovery Month. Those of us working in the UofL Physicians – Psychiatry Addiction Clinic want to acknowledge all of those suffering from the disease of addiction who are working hard in addiction treatment. We also want to remember the families who have been severely impacted by this disease. The path to recovery is different for each person. The goal is to get there one way or another. Also, recovery may not mean the same thing to one person that it does to another.

I’m frequently asked by colleagues, patients and family members why persons with this disease can’t just stop using.  I’ve compiled a list of reasons that hopefully will help with understanding how tough it is to just stop.

10 reasons why persons with addiction don’t just stop

  1. Once addiction is established, it’s a brain disease. Diseases don’t just go away. It would be great if we could just decide not to have hypertension or heart disease or cancer anymore. It just doesn’t work that way. Physiological changes have taken place in the brain that perpetuate the addiction. Craving for the drug is often so intense that the addicted person can’t get beyond it.
  2. Persons with addiction exhibit thinking that is “bottoms up” rather than “top down.” In other words, addiction “hijacks” the brain’s pleasure/reward pathway which is the limbic system, the more primitive part of the brain. The prefrontal cortex, the part of the brain in charge of logic, reason, and evaluating pros and cons of decisions, is no longer in charge.
  3. Persons with addiction often feel that some function is better than no function. They honestly believe that they cannot function day to day without the drug. They often mistakenly believe that they are functioning better than they really are.
  4. They fear withdrawal. Drug withdrawal is not just a mild case of the flu. It’s more like food poisoning on steroids combined with intense muscle cramps. Most persons with addiction will do anything to avoid it.
  5. They have experienced past traumas such as sexual or physical abuse or military combat trauma, and they are using the drug to try to deaden the pain. They are covering the symptoms of post-traumatic stress disorder.
  6. They can’t face the damage that their addiction has caused.
  7. They have no social support for sobriety. They have no family or friends who are sober. They don’t know what a sober life is like. They haven’t developed the skills to cope with the ups and downs of life.
  8. They have chronic pain, and fear dealing with pain without pain pills. Many of our patients in the clinic had no issues with addiction until they were prescribed opiates for chronic pain. That doesn’t mean, however, that every person who uses pain medications will become addicted.
  9. They don’t know how to access treatment, or they feel that they don’t have financial resources to do so. Many women have young children, and they are unaware of options for child care while in treatment.
  10. They no longer believe that they can get sober because they have failed before. They have lost family and friends. They have been told that they are losers, and they believe it. They have lost hope.

One of our most important jobs here in the addiction clinic is to restore hope. Once our patients begin to believe in themselves again, they are on the road to recovery.



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Colleen Ryan, M.D.

Dr. Colleen Ryan has been a psychiatrist for more than 30 years. She is a UofL Physicians provider, as well as an assistant professor of psychiatry for the University of Louisville School of Medicine. In these roles her responsibilities include outpatient treatment of addiction and general psychiatric patients, as well as teaching and supervision of psychiatry residents.

All posts by Colleen Ryan, M.D.
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