More than 46 million people in the U.S. alone live with substance use disorder. Unfortunately, only about 6% of them get the treatment that they need. These numbers tell us important things. First, there is likely someone you know — a friend or a colleague — who lives with a substance use disorder. And second, they may be suffering in silence.
This October, for Substance Use Awareness Month, we’re focusing on clearing up some of the common myths that might increase stigma and get in the way of support. Misinformation can stop people from acknowledging the problem and getting the help they deserve. Substance use is a health issue, not a moral one. The more we understand, the more we can respond with compassion and connection.
Here are 5 myths about substance use, and the truth behind each.
Myth #1: You can tell just by looking at someone if they struggle with drug or alcohol abuse
One of the biggest misconceptions about addiction is that it’s obvious — that you can tell just by looking at someone that they abuse drugs or alcohol. This myth is often based on stereotypes about how someone “should” look or act if they’re dealing with addiction. But substance use disorders don’t always show up the way people expect.
Many people who live with addiction appear to be doing “fine” on the outside. They might be working full-time, taking care of their families, and going about their daily routines. That doesn’t mean they aren’t struggling privately. Others may show signs that are subtle or easy to misinterpret.
Assuming you can spot substance use disorder by their appearance alone can lead to judgment, discrimination, or missed opportunities to support someone. If we want people to feel safe enough to open up, we have to start by letting go of the idea that we can always “just tell.”
Myth #2: If you can still hold down a job, then you don’t really have a problem
A lot of people with substance use disorder still go to work every day. That doesn’t mean they aren’t suffering — it just means they’re managing to keep things afloat.
But the pressure to “keep it together” can also make it harder to ask for help. People may worry about losing their job or facing stigma from coworkers or leadership if they seek support. In some workplaces, it may feel unsafe to talk about substance use at all.
That means someone in your workplace could be living with substance use disorder — even if everything looks fine on the outside. Leaders should be trained on warning signs, like frequent absences, sudden changes in behavior or performance, or signs of physical or emotional distress. It’s also important to create a work culture where people feel psychologically safe enough to ask for help.
Myth #3: Only “hard” drugs are addictive
People tend to associate addiction with substances like heroin or methamphetamine. But legal substances, like alcohol and marijuana, can also be addictive — and they’re more widely accessible.
Alcohol use disorder is actually one of the most common types of substance use disorder in the U.S. According to recent data, nearly 28 million people live with alcohol use disorder. Cannabis use disorder is also on the rise, especially among young adults. Prescription medications — including opioids, stimulants, and benzodiazepines — can also lead to addiction when misused.
It’s important to recognize that addiction isn’t about how serious a drug looks on the surface (which is often just a reflection of legality and how stigmatized it is). The criteria for substance use disorder is about how it affects your life, your health, and your ability to function. Just because a substance is legal or socially accepted doesn’t mean it can’t cause harm.
Myth #4: Addiction is just about a lack of willpower
This myth is not only wrong — it’s harmful. It keeps people stuck in shame, and it discourages them from getting help.
Addiction is not a character flaw. It’s not a moral failure or a reflection of who you are as a person. It’s a serious health condition that changes the brain, especially in areas that are related to motivation, reward, and decision-making. Once a person develops substance use disorder, stopping isn’t just a matter of trying harder. The brain becomes literally wired to seek out the substance, even when the person wants to quit.
That doesn’t mean there’s nothing you can do about it. Brain conditions like substance use disorder are treatable. But most of the time, it takes a lot more than willpower. People with substance use disorder need and deserve professional treatment. That might mean entering a treatment program, working with a therapist, joining a support group, or using medication to help manage withdrawal or cravings.
Myth #5: People are never really able to walk away from substance use — they always relapse
Many people do relapse during recovery. But that doesn’t mean that substance use disorder isn’t treatable. Relapse doesn’t mean failure, and it definitely doesn’t mean recovery is impossible. It’s usually just one step in the journey.
Relapse is a common part of the recovery process, and for many people, it’s something they experience more than once. But a relapse doesn’t erase all of the progress someone has made. It can be an opportunity to adjust the recovery plan and figure out what needs to be done differently in order to succeed.
Plenty of people go on to live healthy, meaningful lives in recovery. But to achieve recovery, people need to have access to treatment. And to have more accessible treatment available, we need more awareness and education.
Substance use disorders are treatable. People can and do recover. But to get there, they need support — not shame.
As an employer, you can play a big role in helping to reduce stigma and create workplaces where people feel safe to get the help they need. That might mean encouraging someone to talk to HR about medical leave, giving them a confidential referral to your company’s EAP, or just creating an open and safe workplace culture.
At MINES, we’re here to help. Our employee assistance program provides confidential counseling for substance use and other mental health concerns. We also offer support for families and workplace trainings that build more compassionate organizational cultures.
To your wellbeing,
The MINES Team
