The Science of Denial

Rehab defined denial as a “sincere delusion.” Active addicts see alcohol and/or drugs as the solution, they rely on them as medicine to treat their emotional ills and get them through each day. They believe alcohol or drugs are necessary simply to feel normal and function, and because of the brain changes that take place as tolerance develops, that belief is true in the short-term (even while it’s fatally wrong in the long-term). So any suggestion that alcohol or drugs are the problem is unbearable because it challenges the assumptions that are the basis of their lives. Rather than face that truth, addicts deny it. They’re tragically wrong, but their belief in their need for drugs to survive is genuine. Although addicts may get glimpses of how damaging continuing drug use is, the prospect of living a drug-free life is so daunting and their denial is so deep, when cracks in denial develop, they don’t abandon it, they succumb to its fall-back position, delay.

Brain researchers posit a biological basis for denial. They say drug addiction is a form of toxic memory acting out. The depth of the psychological benefits of drugs is such a powerful emotional memory, addicts continue to believe drugs are essential even as the rewards lessen and the negative consequences escalate. Researchers say addicts suffer from a severe insight deficit that renders it difficult, if not nearly impossible, to recognize that their daily struggles are earmarks of addiction. Without perception, there’s no impulse for corrective action. This insight deficit expresses itself in addicts’ documented preference for short-term craving over longer-term consequences: they overemphasize immediate emotional needs, like the need for drugs to avert withdrawal, undervaluing more long-term, rational choices.1

But scientists have a long way to go before they fully understand denial. As one researcher acknowledged, “Deficits in insight …. and emotional awareness have largely been ignored in the field of addiction, despite the fact that this disorder is finally recognized as a disease of the brain, amenable to intervention and treatment.”2

In my experience, though, what addiction experts label an insight deficit is simply prioritizing need. No matter how nonsensical, no matter how controverted by actual facts, the belief that I couldn’t live today without drinking, even if it might kill me later today or tomorrow, was completely genuine and compelling.

For the next article in the Treatment series click here.

To return to the Treatment Science Menu click here

To return to the Treatment Menu click here.


1. An Anti-Addiction Pill?, New York Times Magazine, Jun. 25, 2006.

2. Denial In Drug Addiction May Be Explained As ‘Insight Deficit,’, November 17, 2008,


Subscribe to the Addict Science Newsletter


cover of A Whole Lot of Medicine

One Response to “ The Science of Denial ”

  1. […] of active addiction is denial, which means an addict thinks he or she does not have a problem. Addict Science states, “Active addicts see alcohol and/or drugs as the solution, they rely on them as medicine […]

Leave a Reply