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Is Substance Use Disorder Incurable?

The idea that substance use disorder (SUD) is incurable is fairly widespread among laypeople and even some medical experts. What many of us may not realize is that there is a serious semantic difference between how regular people and most medical experts understand the word “cure”.

Unfortunately, this difference in how we understand what is and isn’t “curable” can sometimes be damaging. After all, why would anyone waste time getting treated for something that couldn’t be cured anyway?

The reason for the misunderstanding is very simple — as far as most clinicians are concerned, there is a distinction between being cured and achieving recovery. For laypeople, there may be no practical difference.

The difference between recovering and being cured

While being cured unambiguously means that the illness has disappeared completely, the term recovery implies something a lot less certain. You may have noticed that medical professionals rarely throw around the word “cure” unless it’s something that stops the illness for good.

As with many other illnesses, SUD affects different individuals in different ways. Many who have developed it may indeed, for all intents and purposes, be cured, to use the word as it’s commonly defined.

However, given what we now know about how brain plasticity and how drugs and alcohol alter the brain’s pathways, it can be difficult to say if these individuals are truly cured or there are some lingering effects that are not immediately obvious.

Most other individuals that have otherwise fully recovered from their SUD report intermittent mild cravings, sometimes for the rest of their lives. These cravings can be so mild and unnoticeable that they don’t make a difference in a person’s quality of life. Brain scans also usually detect some differences in recovered patients compared people who did not have SUD.

So the main consensus is that while SUDs tend to have a lifelong effect on individuals, they are treatable. The National Institute on Drug Abuse even goes as far as to be emphatic that individuals with SUD can be treated and that virtually everyone can make a recovery.

So while it’s debatable that cures can truly happen if substance misuse causes permanent changes to the brain, we know that people with SUD can fully recover and lead productive lives.

Does it matter that SUD might be incurable?

Not really. People recover from SUD all the time, and after finding the right treatment and support most of them will find their lives are no longer directly impacted by their illness.

While they may not be cured in a technical sense because their brains will still have undergone some changes, this simply does not matter for millions of people all over the world who have overcome drugs and alcohol. Given time away from substances, the brain will rewire itself to function mostly as it had before the disease.

Why is SUD hard to treat?

SUD changes the way the brain functions in a fundamental way, causing the affected person to feel discomfort when they cease using the drug. Further substance misuse tends to reinforce this maladaptive functioning, which makes it progressively more difficult for the individual to quit on their own.

Unfortunately, unlike other body parts that heal relatively quickly, the brain takes a very long time to recover from trauma. Even as new connections are made, the old ones that were reliant on drug use will continue to be in place and active for quite some time.

To make matters more complicated, people’s brains don’t always heal themselves in the same way. Some individuals may truly have an easier time, achieving full recovery in a few months. Others may spend the rest of their lives dealing with cravings for their drugs of choice.

Why this is the case is a subject of intense research. Genetics, upbringing, and the types of trauma experienced are just some of the factors that play a role in how susceptible a person is to developing an SUD and how difficult they might find it to recover.


The “incurability” of SUD is largely a semantics issue. While there is evidence that SUD leaves a permanent mark on people who experience it, this does not mean that they shouldn’t seek treatment. As with many other diseases, SUD can be effectively treated, even if no “cure” as such yet exists.

People with SUD can make full recoveries and become productive members of society, provided the right interventions are given. Whether one chooses to see this as being “cured” or not is mostly irrelevant.

Regardless of how severe an SUD case is, it’s almost certain that the worst effects could be mitigated. With enough time and the right set of therapeutic approaches, virtually every person with SUD can make a complete recovery.


If you or someone you love needs help with a substance use disorder, our team at Boston Drug Treatment Centers is ready to help. Contact us for a full listing of rehab and treatment centers in the Greater Boston Area.

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