As long as payoff is high and harm is low, an addict WON'T seek recovery


There is a simple truth when dealing with Addiction: As long as the payoff for using is of high value AND as long as the negative outcomes are either insignificant or meaningless, there is absolutely no reason for an addict to seek recovery. As a matter of fact, that same truth can be applied to any behavior, really. If a behavior provides a high value payoff without negative consequences, why change it? However, when it comes to Addiction, using a substance to those who don’t use seems dangerous and unhealthy.   Part of the job of an addiction counselor, in my opinion, is to help the addict “see” the adverse consequences of using a substance. It’s also part of the job to help friends and families “see” that to an addict, using a substance is valuable.

However, in reviewing certain cases I’m working, I can’t help but feel as though I’ve reached a stalemate. The reality is that the high value of using can’t be diminished and I can’t make any headway in presenting the harm the substance use causes. I’ve tried Motivational Interviewing, CBT, confrontation, and even resorted to begging – all to no avail. Plus, the friends and families of certain cases don’t understand how using a substance that is so clearly destructive can be valuable. It’s like I’m trying to grow snap peas in an asphalt parking lot.

Though the value and harm can have obvious meaning to people, that they don’t see both the same way has proven to be the among the hardest barriers to making headway in treating/educating people about Addiction. To the addict, using a substance is high value and the harm is low; to a non-addict, there is nothing valuable about using and it’s very, VERY harmful to use. These opposite perceptions are driving me nuts.

If we want to at least understand an addict, we have to understand that, especially in the cases where there’s physical dependence, an addict NEEDS to use. It’s as necessary as breathing. The harm is not nearly as meaningful as using; as a matter of fact, that’s where “rock bottom” comes from: The idea that the harm has finally “hit” an addict. But in truth, if everything stays the same in an addict’s life and there is very little negative consequences, there won’t be any drive to change. I’ve come to that point in a few situations and I guess it’s time to step aside and acknowledge the stalemate.