One of the more common catch-phrases within the addiction treatment community that I’ve head (and probably used) is, “Deception is the disease.” The reason it’s so widely used that it’s now almost cliché is that it’s an absolute true statement. What may be missed is why deception plays such an active role within an addiction. To me, there are two reasons why deception is the disease: 1) Substance abuser will do all they can to continue using their substance of abuse without any harmful consequences; and, 2) When drawing conclusions, the average person starts with evidence and then draws a conclusion based upon the evidence; however, a substance abuser starts with the conclusion: I must use and then build the case to use. These two reasons form the basis of the deception process because both require denial of reality.
A person who abuses anything, whether it’s alcohol or opiates or food, wishes to continue using the substance without any harmful consequences. For example, a cocaine user will only use cocaine on the weekends in order to avoid any problems with going to work during the week. Or, someone will drink to excess on the weekends because she needs to blow off steam from the week. As long as the substance abuser isn’t consciously feeling the harmful effects of their abuse, they can tell themselves and others that, “I’m doing ok, I have this all under control.” However, the odds are that they do not only use under controlled circumstances and, there are always harmful effects to abusing substances. Because, however, many harmful effects may not reach fruition for many months or years (such as cirrhosis or heart disease or loss of a job), substance abusers can deny those harmful effects and continue using their substances of choice.
The other reason, building the case to use often pre-empts all of reality. For example, a person may not be able to handle the way she feels when she’s alone, so she begins with, “I have to be alone, so I’ll take a pill to help me out” long before she even tries to understand why she hates to be alone. Some may call this building a case around using as excuse-making and they wouldn’t be entirely wrong. We all tend to start with our bias and then build evidence to support our bias, but within an addiction, the thought process is escalated to the point of not seeing the reality of the case-building. Plus, a substance abuser will often invent evidence to support their using in the absence of any real evidence.
Understanding these two reasons why deception is the disease is key to understanding addiction. Reality takes a backseat to the compulsive drive to use and harm and evidence mean very little to the substance abuser needing a fix.