Is willpower enough to overcome an addiction?

What we know today is that the “Just Say No” campaign of the 1980s may have been a good strategy to help some people prevent drug use, but it is a complete failure for those already addicted.

Addiction  (photo credit: LAURIE MCADAM/ MCT DIRECT)
Many people do not understand why an addict cannot just “will” away his or her addiction.
When scientists began to study addictive behavior in the 1930s, people addicted to drugs were thought to be morally flawed and lacking in willpower. Those views shaped society’s responses to drug abuse, treating it as a moral failing rather than a health problem, which led to an emphasis on punishment rather than prevention and treatment.
The belief in the role of willpower to change addictive behavior is still widely held by many individuals, particularly by people who know little about addiction. In some countries, the society’s response to drug use is so severe that it is punishable by death.
However, thanks to Western science, our views today and our responses to alcohol and drug addiction and other behavioral addictions have changed dramatically.
What we know today is that the “Just Say No” campaign of the 1980s may have been a good strategy to help some people prevent drug use, but it is a complete failure for those already addicted. Moreover, the limits of willpower to stop addictive behavior can be described in the meaning of the term. Addiction is derived from a Latin term for “enslaved by” or “bound to.” Anyone who has struggled to overcome an addiction – or has tried to help someone else to do so – understands why.
All addictions share certain common features: craving for the object of addiction, loss of control over its use, continued involvement with it despite adverse consequences, susceptibility to relapse and strong denial that one is in fact addicted. Consider the following examples of clients that I treated where willpower alone was unable to help them stop their addictions.
Sue, age 52, a tobacco addict for 35 years, wanted to stop smoking and came to me for help. Similar to 70% of tobacco-dependent people, Sue wanted to quit smoking, but she could not. Her willpower to quit did little to help her kick the habit. Yossie, age 29, has been addicted to Internet games and pornography since his teen years. He had been in treatment for several years, including a residential addiction center. He has been in treatment with me for about one year. Although he has made some progress, Yossie still relapses. Whenever he sits in front of his computer, his craving to stay in front of it for long stretches of time and play games or enter porn sites often overpowers his will to refrain.
Scientists now understand that an addiction is a brain disease and that is why willpower alone cannot help someone to stop his/her addiction (National Institute of Drug Abuse). For many years, experts believed that only alcohol and powerful drugs could cause addiction.
Using neuroimaging technologies, current researchers have shown that the brain activity of alcohol and drug addicts is very similar to the brain activity of people who are addicted to other pleasurable activities, such as gambling, shopping and sex.
Experts posit that addictive behavior is reinforced and conditioned by its overstimulation of the same neurochemicals – dopamine and endorphins – that are produced when we eat, drink, play or have sex. The difference is that drugs, alcohol and certain behaviors overstimulate and flood the brain’s reward system.
While genetics and some traumatic experiences may play a role in our understanding of why some people are vulnerable to addiction, once an addiction takes hold, it has a life of its own that exceeds and overpowers the person’s desire or willpower to cut back. This is the true meaning of being out of control.
Although willpower fails terribly for addicts trying to stop their addiction, there is another side to the willpower story. In reality, the person’s initial willpower is a crucial component in getting someone to stop his/her addiction and it is essential for any real change to take place. Willpower in recovery means that the individual wants to stop his/her addiction but does not know how to do so. It is the central underpinning of motivation. If he/she is not motivated, the individual addict has no chance to stop. Therefore, addiction counselors always check a person’s level of willpower to determine how motivated the individual is to undertake an attempt to quit. Willpower and motivation to recover from addiction go hand in hand.
There is somewhat of a paradox in the significance of willpower in the recovery process. Although very strong willpower cannot stand alone as an answer to stop an addiction, without that very same willpower, an addict will be unable to succeed in the long road to recovery. An addict is ready for help when he/she truly faces the reality of being out of control, powerlessness over the addiction, recognizes the limitations of his/ her willpower to stop an addiction and has the strong motivation to start the recovery process. 
The writer is a marital, child and adult cognitive-behavioral psychotherapist with offices in Jerusalem and Ra’anana.;