In working with clients and their loved ones over the years, there is a reoccurring question that emerges at each initial contact with the Admissions department … Is Recovery from Drug Addiction Possible? In this blog, we will venture on a journey together into understanding the phenomenon of addiction and in so doing; answer this common question, which is often asked in very hopeful tone. There are many other questions hidden within this one such as:
• Do I dare to believe that things can be normal again?
• Is drug addiction treatment effective?
• Can addiction be treated successfully?
• Why can’t I get over it … others have?
• I am scared?
The list goes on but the strongest element is really a plea to “Fix Me/Him/Her”. Despite this initial anxiety, 91% of the clients that admit to Crossroads Centre Antigua successfully complete their treatment (Fig. 1). In this blog we wish to challenge our readers to open to their minds to re-conceptualizing the journey of an addict and in so doing reshape this common question through the lens of change.
Fig. 1 Crossroads Centre Antigua 2017/2018 Statistics
THE PROBLEMATIC NATURE OF SUBSTANCE ADDICTION
The United Nations Office on Drugs and Crime UNODC (2018) in its World Drug Report (2017) reported that about a quarter of a billion people around the world used drugs and of this 29.5 million people suffered from drug use disorders. Opioids were identified as the most harmful. Wakeman, Green and Rich (2014) liken the chilling global impact of addiction to the early years of the human immunodeficiency virus (HIV) and the rising death tolls from opioid overdose to AIDS death due to the HIV infection. This means that addiction like HIV is an international problem requiring multifaceted, cross-cultural approaches. The clients admitting to Crossroads Centre Antigua are from every part of the world and while we experience the cultural/national differences in their response to substance addiction and mental health disorders, the prevailing traumatic effect of the addiction on their lives is consistent regardless of their culture or nationality.
A big factor that perpetuates the problem of addiction is that many persons still struggle to understand how people become addicted to mind altering substances. For many people it is a moral dilemma that challenges their belief on human willpower. In this blog we emphasized the fragility and multilayered nature of humanity and motivation. Addiction and Recovery is not a matter of willpower. In reality substance addiction is a complex, chronic disease that requires a lot more than strong will and good intentions for recovery.
Addiction – Brain, Biology and Environment
Another factor driving addiction is that repeated drug use can lead to maladaptive changes in the brain that are erosive to the addicted person’s self-control, cognitive functions and ability to resist urges of continued usage. There are also many biological risk factors to be considered such as, genetic predisposition, ethnicity, gender, and other mental health disorders that when combined with environmental challenges, like poor economic status or history of trauma, compounds the problem of addiction further. Drug addiction is a relapsing, chronic disease due to these, and many other underlying factors, all of which increases an addict’s susceptibility of returning to use, even after years of abstinence.
Is Recovery Possible? And Does Drug Treatment Work? The answer to both questions is YES. Many recovering addicts have and continue to live fulfilled lives. Everyday they prove that Recovery is a reality. Everyday they utilize their Recovery Tools harnessed from treatment to make recovery possible.
What then is “Recovery”?
Here is where we challenge readers to look at the stages of change (Fig. 2), since recovery like change is a process without a definitive end. Rather it is a long life process.
Fig. 2 Stages of Change – Source: Elizabeth Hartney 2011
At Crossroads Centre, Antigua, we equip our clients with essential tools to enable them to take the actions needed to sustain their recovery. This action stage is challenging as it pushes clients to strip away their defenses and be honest about their lives. This is emotional and it mentally disrupts their previous maladaptive responses. The urge to relapse is triggered, but likewise the recovery process is ignited. Recovery and the possibility of relapse walk hand in hand. It is at this critical stage that we challenge clients to work through the discomfort and complete their treatment program; because in doing so, they become equip with tools to advance toward the maintenance stage. At Crossroads Centre 91% of our clients work through this challenge and complete their residential treatment program and begin their recovery (Fig. 1).
The optimal goal for all clients in the maintenance stage is to break the insanity and abstain from alcohol and other addictive substances. Many achieve this goal, while some still struggle and return to the cycle during a relapse. However, as with other chronic diseases such as diabetes, treatment for addiction does not provide a cure, rather it incorporates continual evaluation and modification based on developmental changes. As such there is always a struggle in doing daily what needs to be done. It is here that I pause to emphasize that relapse is not failure; rather relapse can be part of recovery.
Recovery then is defined to reflect successful management of ones addiction. Dale-Perera (2017) consultant in the UK in her contribution to Recovery Plus: Best Practices invites readers to consider recovery in terms of an improvement in their quality of life, to engage in opportunities beyond the illness, to be an active member of society with the constant hope that one can have a fulfilled life and should not settle for less. The Substance Abuse and Mental Health Services Administration – SAMHSA (2012) shares this outlook and defines recovery as a “process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.” In both definitions it is clear that recovery is positive and enjoyable but with the possibility of relapse as we strive for positive change. Relapse or Recovery further appears tantamount to persons’ perception of their well-being and quality of life.
Recovery = Rebirth
In exploring “fear” with clients at Crossroads Centre Antigua, it is amazing that a frequently emerging fear is that recovery will not be fun. Recovery should be viewed as a rebirth, a chance to live a rewarding life not possible when using addictive substances. It is a life filled with clarity and unpolluted joy. If we open our minds to Dale-Perera (2018) and SAMHSA (2012) conceptualization of recovery, we realize that a big aspect of recovery is social re-integration into life and living the best life possible while making lifestyle changes to maintain abstinence. It is a chance to reinvent oneself, physically, mentally, spiritually and emotionally; a chance to be the best you possible or work towards this ideal. But in doing this re-birth we also need to be realistic that sometimes we stumble along the way.
The 12 Steps and Recovery
The 12 Steps program recognizes this reality. Step 1 is an honest acknowledgement that our addictive behavior has led to damaging results. This owned admission is the strongest evidence needed to support abstinence. However, while this primary step highlights abstinence, the other 11 steps provide guidelines on how to achieve this. Hence, as this blog emphasizes that recovery is about successful management, the 12 Steps traditions does likewise and provides management tools to achieve this. For example, Step 2 addresses the attainment of hope – a positive shift in the addicts’ perception, Step 3 initiates actions and Step 5 underlines the importance of support. All 11 steps are focused on lifestyle changes to maintain Step 1.
Recovery needs Nurturing
It is this understanding that has led us at Crossroads Centre Antigua to design our Continuing Care Programs such as Restore and Connect to acknowledge the fragility of human nature. It is designed to support recovering addicts who are stumbling. We believe that in addition to equipping clients with a tool kit to support abstinence; we also need to help clients envision a life that matters. This includes monitoring & identifying ways of enhancing their subjective wellbeing throughout treatment and afterwards. Rath and Harter (2014) posit that there is significant value in how persons perceive their lives and this impact on their willingness to stick to their long-term goals. In future blogs we will examine this idea closer with the support of feedback from our alumni. However, it is important to acknowledge here that if the test of a good treatment program is that it is holistic, then it stands to reason that proper management of recovery must also be holistic and defined by improvements in many areas of our lives, and this is reflected in the perception of our wellbeing. The recovery journey is not easy but Recovery is Possible.
Find a Treatment Center that shares your hope of recovery and supports you on this journey.
Jean-Machelle Benn-Dubois, PhD. LPC NCC ACS
Director of Admissions & Continuum of Care
Crossroads Centre, Antigua
Toll-Free from US or Canada: 1 888 452-0091
Toll-Free from UK: 0 800 783-9631
Direct to Antigua: 1 268 562-0035 Ext. 5024
Fax: 1 268 562-3278
1. Dale-Perera, A. (2017). Treatment of drug use disorders. In Recovery plus: Global best practices. Oct/November 2017 (pp. 12-15). UK: Boyd Powell Publications.
2. Rath, T. & Harter, J. (2014). Wellbeing: The five essential elements. Canada: Gallup Press.
3. Substance Abuse and Mental Health Services Administration (2012) Working definition of recovery. Retrieved from https://store.samhsa.gov/product/SAMHSA-s-Working-Definition-of-Recovery/PEP12-RECDEF
4. United Nations Office on Drugs and Crime (2018). World Drugs Report 2017. Retrieved from https://www.unodc.org/wdr2017/index.html
5. Wakeman, S. E., Green, T. C., & Rich, J. D. (2014). From documenting death to comprehensive care: Applying lessons from the HIV/AIDS epidemic to addiction. The American Journal of Medicine. DOI: 10.1016/j.amjmed.2013.12.018