I’m forever grateful that within my lifetime, we’ve seen a massive destigmatization of addiction. Thirty years ago, when I was a kid, addicts were still far too frequently dismissed as losers, moral failures, and lost causes. These days, most people, at least in the United States, recognize addiction as a curable problem that has nothing to do with morality or a person’s character.
There used to be only a handful of public figures who were open about their addiction or sobriety. These days, it seems like every week, another celebrity gives an interview about how they overcame their alcoholism or drug use.
What I love about this is that it allows addicts to realize they aren’t alone, which in turn, encourages them to seek help. In my twenties, I was a heavy, daily drinker. It was the most isolating and lonely experience of my life. Meeting other alcoholics and reading about other people’s recovery stories gave me the confidence and support that I needed to get sober.
I went from feeling like all of my drinking problems were weird and unique to realizing that I fit into a series of very common patterns. This encouraged me because when I learned that other people had felt exactly the same as I had, but had managed to quit drinking, I understood that getting sober was possible for me, too. (Even though it didn’t always feel like it at the time!)
While this is all great, I do worry, however, that some people take it too far in the other direction. We’ve gone from a world in which addiction is a deep, dark secret, in which people assumed almost nobody was an addict, to a world in which I often hear the idiotic phrase, “Everyone is addicted to something.”
The reality is somewhere in the middle. In my experience, many non-addicts underestimate the number of addicts, while many addicts overestimate it. So what are the actual numbers?
A survey in the US, the 2024 United States National Survey on Drug Use and Health, found that 16.8% of Americans had a substance use disorder. If we narrow our focus to just alcohol, the number was 9.7%. (Source.)
This is a huge percentage of Americans, but it’s not “everyone” or even “most.” It’s enough that we should take it seriously, and it’s enough that we should realize how stupid it is for there to be a stigma around addiction. But it’s not so much that we should treat addiction as the norm. The truth is that addiction is still uncommon, and most people will never be addicted to anything during their lives.
Along these same lines, I think it’s also worth pointing out that most people don’t have a serious mental illness. That same survey found that while 23.4% of Americans had a mental illness, only 5.6% had a “serious mental illness,” meaning one severe enough to significantly impair their lives.
I mention that because many addicts also tend to overestimate the rate of mental illness in the general population. There’s a lot of comorbidity between substance abuse and mental illness, so when someone spends a lot of time with other addicts, they tend to think mental illness is more common than it really is.
The reason that I consider it so important to know these numbers is that it helps shape our response to these problems, both on a personal level and through policy. Addiction and mental illness are serious public health problems that need funding and support. However, that support needs to be targeted at the populations who really need it.
Too often, people conflate substance abuse and serious mental illness with far more minor problems. Watching a little too much TV is not the same as doing cocaine every night. Feeling miserable after the death of a loved one is not the same as major depression. The strategies that help with run-of-the-mill self-improvement will not work for overcoming addiction and will not cure mental illness.
If someone is suffering from alcoholism, my advice is to seek out other people who are recovering from an addiction to alcohol. (Or professionals who specialize in substance abuse treatment.) They are the ones who will understand the problem and how to best treat it.
I’d recommend against following generic self-help guides. All of the popular internet advice about motivation and discipline is more or less worthless when it comes to addiction. Addiction is a unique problem that plays by its own rules. We can’t overcome our drinking habit using the same strategies we used to start working out more.
I hope that as we move into the future, the stigma around addiction disappears entirely. However, I want it to disappear because people recognize the problem for what it is, and not because they water down the meaning of the word “addiction” until it no longer means anything at all.