No Two Addictions Are the Same


By David B. Bohl
Originally published on his website, David B. Bohl, on February 4, 2019

Addictions, like snowflakes, have one thing in common – they are all absolutely unique.

The intricacies of a snowflake pattern can be an easy metaphor for the intricacies of human experience when it comes to trauma, addiction, resilience, success or failure. What makes one person reach for alcohol to deal with her social anxiety makes another person become a public speaker to conquer that fear.

A fortunate child growing up in a household filled with love, attention and given lots of opportunities to develop academically might not thrive at all, might drop out of school, and might become addicted to pills. Why? Too much prosperity? Some traumatic event at school? Or something that another person would consider trivial, like being made fun of at a party? Another sibling from the same family can go on to become a successful psychologist, a parent to a bunch of happy kids, but then will suddenly crumble in her 40s and start drinking. Why? Did something happen in her childhood that only surfaced when she reached middle age? And reversely, a woman who grew up in a single-parent household, surrounded by addiction and abuse and poverty, grows up to become a successful entrepreneur who enjoys wine but only as far as vintage goes and only by a glass.

The point I’m trying to make is that there’s really no way to predict what will turn someone into a person with substance use disorder and what will make another immune to it. For this reason, we cannot also make false and stigmatizing assumptions about groups of people who “tend” to suffer from greater incidence of problems such as addiction. We cannot develop any kind of sure formula that will help us identify those who might be more prone to addiction than others – this is not to say that research, and especially genetic research, should be ignored, as there seems to be a genetic component to addiction, but we cannot assume a child will grow up to suffer from substance use disorder even if both parents have had it. Sure, the child will have a greater chance of developing it, but she might also completely skip that genetic sequence and be entirely resistant to her genetic “fate.” I know of two sisters who came from the exact same environment and who would score high Adverse Childhood Experiences, and one of them has struggled with addiction for more than two decades where the other one has never gotten more than a little tipsy at a party (and, frankly, says, hates the effect that alcohol has on her).

It is only natural for humans to want to know the cause of illnesses, and especially something like addiction – so widespread a problem that it is now considered an epidemic. We think that if we know the cause, we will be able to eliminate it. That’s what we’ve done with infectious disease. Maybe there is a way to vaccinate people against addiction? Probably not. I tend to believe that substance use disorder is a condition so complicated that the physical element is just one of its many components – for those reasons I am skeptical about medication used to eradicate it. I don’t believe we’ll ever come up with the right formula because there are so many targets to aim for.

In his book In The Realm of the Hungry Ghosts, Gabor Mate talks about how we simply cannot compare each other’s pain or capacity to endure suffering. He writes, “People who have overcome severe addictions deserve to be celebrated, and they have much to teach, but their example cannot be used to condemn others who have not been able to follow in their foot steps.”

As an addiction specialist and someone who also suffers from it, all I know is that studying and working with addiction is a lifelong process and that there aren’t any easy answers. We are constantly learning, because, when it comes to addiction, we know a lot about how little we know.

Parallel UniversesDavid B. Bohl, author of the memoir Parallel Universes: The Story of Rebirth, is an independent addiction consultant who fully understands the challenges faced by so many who seek to escape from, or drown their pain through, external means. His story offers hope to those struggling with the reality of everyday life in today’s increasingly stressful world.

You can visit his website here: David B. Bohl.

Through his private practice substance use disorder consulting business, Beacon Confidential LLC, David provides independent professional consultation, strategic planning, motivation and engagement, care coordination, recovery management and monitoring, and advocacy services to individuals, families, and organizations struggling with substance use issues and disorders.

9 Responses

  1. Pat N. says:


  2. Joe C says:

    Amen to Pat’s ‘amen.’

    I saw this on David’s site and retweeted it. The caution about chronic-uniqueness is overblown. Yes, it’s not helpful to compare at the cost of identifying; yes, the narcissism of small differences does more to encourage our addiction than recovery. This I can say, delayed my recovery. But submission to a uniformed solution isn’t the best approach either. One addict talking to another can’t be replicated into (effective) cookie cutter formula.
    Addicts are difficult people to be patient with but no one felt threatened by my bad attitude. Sometimes they’d smile, say, “Maybe your right,” pause and ask, “So, would you like me to pick you up for the meeting tomorrow?”

    Before the 1976 pamphlet “Do you think you’re different?” came out, the working title was “So, you think you’re different.” That said more about our bad attitude than the newcomers. We wisely changed it.

    • David says:

      Joe C, there are so many variables, we are all unique, though our maladaptive coping mechanisms, consequences, and symptoms may not be. Identification of these is what pulls sone of us into these fellowships. Finding solutions and philosophies that suit us us often why we stay.

  3. Steven V. says:

    I had found out that the latest research on addiction/alcoholism had concluded this fact only a few years ago which is exactly what the author of today’s article is saying. When I told some people this, I was met with plenty of skepticism. This proves the belief that if I do exactly what you or the “100” (original members of AA) did, I will NOT necessarily get the same results as you or others got. One cannot take a “cookie cutter” or “one size fits all” approach to recovery. Really and truly different things work for different people. The unique set of factors that contributed to my addiction are unique and therefore my job has been to search for the sets of different things that will work for me. Each of us experiences different degrees of severity of this disease/disorder/illness or whatever you want to call it. We are not all the same! Thank you David!

    • David says:

      Thank you Steven V. The long walk into the woods of alcohol addiction is uniquely long and winding. Why would we think the walk out would be a straight line exactly like how someone else has done it?

  4. Dave J says:

    Thank you, David! An intelligent take on addictions. How rare. Over the years I have been told by a couple of AA friends that my kind of sobriety would probably get them drunk and my rebuttal was that half of their “character defects” were probably my hobbies. Of course being a smarty pants essentially accomplishes nothing but it sure as hell feels good. The snow flake analogy is great – one could even remove the word snow. lol.

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