Addiction is a medical condition that arises when an individual becomes physically, mentally, and emotionally dependent on a substance and is unable to stop taking it, even if they want to do so. Physical dependence on powerful drugs like prescription painkillers can occur without the individual craving the medication, but physical dependence and tolerance are two symptoms of potential addiction to a drug. Other symptoms include anxiety around doses, lying about taking the drug, stealing the drug or money for the drug, increasing the dose over time, and nonmedical use of other substances that can enhance euphoria associated with substance abuse.
One symptom of addiction is denial. This means that the person may not be aware they have a problem with the substance or that the problem is escalating in severity, or it may mean that the individual refuses to acknowledge they have a problem.
What Denial of Addiction Looks Like
Although many people enter treatment voluntarily for substance abuse or addiction, it is common for those entering drug rehabilitation programs to be in denial to some extent. They may refuse to believe they have problems with substance abuse at all, or they may refuse to acknowledge how serious the issue has become. Denial is often characterized as:
- Minimizing the problem
- Rationalizing the problem or the consequences
- Forgetting about the problem
- Self-deception about the extent of the problem
- Repression of the problem and its consequences
Some common beliefs that express denial of substance abuse include:
- Refusal to acknowledge addiction or substance abuse patterns
- Believing that “cutting down” or reducing the dose will help, rather than attempting sobriety
- Belief that a secondary substance, such as alcohol, is the problem
- Feeling that the drug problem has become so severe that the individual is beyond help from any treatment program
- Refusing to stay away from “friends” who enable substance abuse
Counseling during rehabilitation helps the individual learn more about their views on their substance abuse problems and what their specific symptoms of denial look like.
How Denial in Addiction Starts
Substance abuse and addiction do not simply appear out of nowhere. Although there are genetic and environmental causes of addiction that are beginning to be understood, the individual must be introduced to the substance in some way in order to trigger addictive behaviors. The situation in which the person develops their difficulty with substances can influence how denial looks.
- Legal drugs: Alcohol, tobacco, and a few other substances are very addictive but legal after a certain age. In the United States, adults ages 21 and older can drink alcohol, while tobacco is legal for use after age 18. States that are passing recreational marijuana laws also require people ingesting that drug to be 21 years old. However, some drugs, such as synthetic marijuana, do not have an age restriction because the substances are technically legal due to loopholes in federal and state drug laws. These drugs can be introduced casually through friends or family members who may use them recreationally, which can lead to substance abuse and addiction. If a drug is legal, however, it may not automatically be associated with danger or addiction; hence, those who are addicted to it may be in denial that a problem exists.
- Social connection: Getting a drink with friends after work, having a cigarette to look “cool,” and other methods of socially interacting around substances can lead to addiction later in life. Seeing friends or family enjoy intoxicating substances casually can make the drug appear more acceptable and less dangerous, and make it tough to admit that use can be problematic.
- Prescriptions: The opioid epidemic in particular, according to the Centers for Disease Control (CDC), is fueled by prescribing practices that allow people to receive intoxicating substances for short-term medical use. For example, a dentist may prescribe Vicodin for a few days after a person undergoes oral surgery, and this exposure to hydrocodone may lead the individual to become addicted to the narcotic. However, the drug was acceptable to use at first, since a doctor specifically told the person to take it, and this can make it easier for the person to deny that a problem is present.
As a person becomes more involved with a substance, their body will become more tolerant to and dependent on it, so this can lead to escalating use. Denial is often involved in escalation of substance abuse, as the individual justifies one more drink, one more hit, or one more pill.
How It Affects Loved Ones
Families and other loved ones are often drawn into the denial of a person who is struggling with addiction. There are many ways one individual’s denial of their problem can affect all of their loved ones, such as:
- Enabling others to begin abusing substances
- Asking others to make excuses for drug-related problems, such as skipping work or school
- Irritability or aggressiveness about symptoms, leading the loved one to question whether they accurately assessed the situation
Children, spouses, and parents may worry that they will lose their loved one if they confront the person about potential patterns of substance abuse. They may worry that they will lose other people in their family or somehow destroy the family’s safety. Their place in the world is threatened if they attempt to change their environment. Loved ones who fall into this scenario can put pressure on other members of the family or social circle to act in ways that perpetuate denial of the problem.
Family and friends want to believe the best of the people they care about. Unfortunately, this can be a negative factor when it comes to overcoming substance abuse problems, because the good aspects of the person struggling with addiction can be held up, as though to prove that the drug abuse issues are not that bad. Sometimes, family members may completely refuse, consciously or unconsciously, that there are any changes in behavior or obvious substance abuse problems.