for Paste Magazine

Addiction is an issue that impacts almost everyone in some way. I’ve been in recovery from alcoholism/addiction since January 2008. During that time, I’ve gone through ups and downs but have fortunately managed to stay sober. I’ll be answering a reader-submitted question about recovery every other week (information on how to submit below). I’m not an expert or mental health professional, just a sober person offering advice based on my experience and the research that’s available.

This week, I’m talking about addiction’s shades of gray—if being addicted to one substance means you’ll be addicted to all of them, and if anyone ever grows out addiction altogether.

Dear Katie,

Is it possible to grow out of addiction? And if you are addicted to one substance, are you necessarily going to be addicted to all substances? I know people who used to have a cocaine problem and now abstain from drugs but drink moderately. I’m thinking about quitting drinking but my sober friends say that also means I need to quit smoking pot. I’m not a heavy pot smoker at all, but I do smoke sometimes. I’m not quite ready to say I’m an addict, but if I am addicted to alcohol, does that mean I will also be addicted to marijuana?

From, Wondering

Hi Wondering,

Sometimes the questions that seem the most straightforward have the most complicated answers. This is one of those questions. Some people will answer this question differently but, well, you asked me, so you get my answer. Explaining this requires a little background information, but I’ll try to keep it brief.

In the most recent version of the DSM (the manual that all psychologists use to make a diagnosis, etc.) the term “addiction” was changed to “substance use disorder.” This revision was made to acknowledge the reality that people can go through periods of exhibiting signs of addiction to a substance without necessarily being Addicted To All Things Forever. The notion that once an addict, always an addict, is born from the accepted-but-controversial disease theory of addiction. I’m not going to go into the various theories behind addiction and my thoughts on them, but suffice it to say, addiction is not a zero-sum game for everyone. There are people who exhibit behaviors consistent with a substance use disorder and are later able to use that substance or other substances in moderation. A number of studies have demonstrated that, in the United States, substance use increases in late teens and into an individual’s 20s, and then later decreases. Anyone who has spent time on a college campus can likely attest to this. Still other studies have noted that some substance users who initially decrease their substance use after a period of time might increase their use again later. (continued)