By KATHY MILES

Guest columnist

Last month, in an overdose response training held at Centre College, a young man in long-term recovery shared his life story. It included growing up in a loving home, with a long list of academic and athletic opportunities and achievements, followed by the development of an addiction that led to being arrested and homeless.

After more than one treatment experience, he described saying to his homeless self that he would try it again, even though he had not been successful at recovery up to that point. It was not a decision based on lots of hope for change, but a little. He did go to treatment again, and today is completing a Ph.D. and is a nationally recognized addiction recovery speaker.

Embedded in his story is the question many ask about recovery. How many times does it take? His story also holds the complicated and less than satisfying answer — it varies from person to person, and it depends upon a variety of factors. Recovery would be so much easier if a “prescription” for recovery could be written, and if followed, no relapses would be a guarantee.

What we have instead, is some knowledge of what works and what doesn’t work in treatment, a growing recognition of the importance of family and community support for people in recovery, and the need for still more research to better answer these questions.  

Not too many years ago, U.S. treatment staff were trained in viewing people with addictions who wanted to return for more treatment as manipulative, and part of a “revolving door” culture. This belief system was a part of our culture’s lack of understanding of substance use disorders, and was deeply ingrained in the criminal justice system. Sadly, it also permeated the life of so many American families with loved ones suffering from addictions.  

We know now that recovery is a process, rather than an event, and that having options in place that meet a variety of individual needs is what works best. We know that some people are more motivated by external pressure to enter recovery, such as homelessness or threatened loss of a job. Others seem to respond to an internal experience, reflected in the phrase, “sick and tired of being sick and tired.” 

We know that a specific religious approach to treatment works best for some, and not for others. We know that some people enter long-term recovery without going to residential treatment — they may become part of a mutual support group like Alcoholics Anonymous or Celebrate Recovery, or they may seek outpatient counseling.

We now know that many people respond positively to forced treatment — such as court-ordered treatment. As a result of this fact, we have seen an increase in drug courts and laws like Kentucky’s Casey’s Law, which allows family members to seek mandated treatment for their loved ones who won’t get help voluntarily.  

We also understand that mental health issues, such as depression and anxiety, complicate treatment and recovery, and often contribute to more episodes of treatment for substance use disorders.  Medication-assisted treatment for opioid use disorders has been shown to be effective for many, and has saved lives.

A large study of U.S. adults in long-term recovery was reported in the Drug and Alcohol Dependence Journal in December 2017. Researchers asked people to self-report how many times it took them to enter long-term recovery. Their answers ranged from 0 to 100, with 50% needing only 2 attempts, and the average being 5. These results support our understanding of there being many paths to recovery.

It’s imperative, of course, that treatment professionals keep up with the growing body of research on addiction. Good programs incorporate new evidence-based research into what they do, and train staff in best practices. But, there are other people who should understand what the experiences of millions of Americans in recovery tell us.

Judges, law enforcement, policy-making elected officials, primary health care providers and insurance company decision makers should incorporate current understandings of treatment and recovery into their daily work and policies and procedures.  

 

Some might ask about the people still in active addiction. No matter what the research says about treatment and recovery, don’t they have a primary responsibility to make the changes necessary for their own health, and the well-being of their families?

Absolutely. Good research and good systems of care aren’t sufficient for individuals to change complicated diseases. Personal responsibility and courage to make lifestyle, relationship, and spiritual changes, are also necessary.

It just makes a huge difference in recovery outcomes when the right supports are in place.                                                                                                            

 

Kathy L. Miles is coordinator for the Boyle County Agency for Substance Abuse Policy Inc.