Do Addictions Last a Lifetime?

Does my prior opioid addiction put me at risk or protect me?

I am currently 15 years into recovery from my harrowing yet ultimately successful battle with opioid addiction. The unfortunate story which culminated in my being raided in my office by the state police and the DEA, being charged with three felonies for bogus scrips I had written, and losing my medical license for three years has been thoroughly documented in my memoir, ‘Free Refills: A Doctor Confronts His Addiction.’

As a physician, I had numerous specific risk factors for an addiction. To start, my job as a doctor in training was extraordinarily stressful. It included profound sleep deprivation, first as a medical student, then as a resident.

No matter how compassionate a person one is, it is hard to care about anything, or to think clearly, when you’ve been up and working under duress for thirty hours.

And the stress didn’t cease when I finished my training: In my time since residency, practicing as a primary care doctor has become untenably bureaucratic and anxiety-provoking for a variety of reasons that have been documented (such as in this blog I wrote, ‘Why is it so challenging to find a primary care doctor?’)

I also was contending with an out-of-control home life, trying to care for two small children while contending with a hostile and incoherent marriage. I had ready access to prescription opioids – my ‘Free Refills’. It was a perfect storm for an addiction to settle in. I am lucky to be alive, to recover, and to help others with their addictions.

Ever since my recovery fifteen years ago, I have been fascinated with several related questions: is there truly such a thing as an "addictive personality"? Do people substitute addictions?  Do addictions last a lifetime?

The myth of the addictive personality

The deceased writer and television personality Anthony Bourdain was criticized by some people in the old-school recovery community for using modest amounts of alcohol and cannabis, on his show, decades after he quit heroin and cocaine. He was criticized for not being a good recovery role model and for putting his recovery (and, by example, the recovery of others) at risk. Are these valid criticisms? Can an unhappy youth who was addicted to cocaine and heroin in their early twenties safely have a glass of wine with dinner or a puff of weed at a party, decades later?