There is a growing understanding among medical professionals that the long-term, effective treatment of addiction starts with detox, but it definitely does not end there. According to a study conducted by the National Institute of Drug Abuse (NIDA), 30 to 60 percent of addicts also suffer from mental diagnoses including personality disorders, severe depression, impaired impulse control, schizophrenia, and bipolar disorder. For these individuals, addiction is not their only health issue—it is not even their major one.
In order to deal with the addiction, they must address their mental and behavioral health disorders in conjunction with treatment for addiction. This is the reason that going "cold turkey" rarely works.
Addictive Behaviors vs. Addictive Substances
It is no secret that soldiers in the field of battle during the war in Vietnam were very apt to be taking illegal substances, abusing alcohol or both. The Vietnam War was undoubtedly not the first or last war where this occurred. When the war ended, many stopped using and never went back, even though the substances they once craved are known to be highly addictive. When circumstances became more positive for them, they were able to get back in control of their addictive behaviors. It is reasonable to assume that the soldiers with prior behavior disorders not related to wartime did not fare as well.
Substance Abuse and Loss of Control
Abusing drugs and/or alcohol does lead to loss of control. Note that the word is "loss", not the absence of control. Drugs and alcohol do decrease the individual's ability for self-control. This does not render them powerless. Everyone has the ability to control their lives to a certain extent, but first, they have to want to. This includes understanding what led them to lose control and why they went down that path. It helps if they really believe their lives would be improved without the substance they crave. This brings up the question of quality of life.
If a substance abuser once had a happy life surrounded with love and threw it all away for drugs or alcohol, this person can come to the realization that they made a huge mistake and will at least consider going through the processes that will help them regain their former lifestyle.
On the other hand, if a substance abuser turned to drugs and/or alcohol to find a way to numb the trauma caused by a harsh life lacking in love and healthy attachments, the drug of choice for them may bring solace, at least temporarily. For them, attempting the difficult task of summoning up the control to deal with their substance abuse is not an issue, and, in fact, their lives may not improve by giving up the substance that helps them through the days and nights, horrific as they may be. This in no way means that such lives are worthless, only that they must be understood in the context of the discussion of control.
Control vs. Will
It is critical to understand the difference between "control" and "will." Will can be referenced to motivation, which is not the aspect of addiction involved in control. Control is about the capacity to make a choice. This is a major issue and not a semantic one, as the argument backed by many neuroscientists regarding substance abuse is that addicts suffer a decreased capacity to make appropriate behavioral choices, particularly concerning the addictive behavior of interest to them. If, for example, someone attempts to ride a bicycle, but repeatedly falls off, he doesn't currently have the skills or capacity to ride it. He does not lack the will or motivation to do so.
Myths surrounding addiction must be dispelled. Society stigmatizes addicts as a social group that is somehow inferior to other social groups. The fact is, addicts are not a "group." They are individuals with their own experiences, backgrounds, successes, and failures.