What is recovery?
In the substance misuse ‘world’ we talk about recovery all the time because this is what we and individuals using alcohol and other drug users mostly strive to achieve. The actual term means different things to different people and that is okay, because each person’s recovery journey is unique and individual to them. When you hear people say they are ‘in recovery’ this usually means that they are recovering from substance use (be careful, it can mean recovering from other things too!- like an operation).
I hate to tell you this, but there is no clear definition of recovery!
Recovery in the general sense is defined as, ‘a return to a normal state of health, mind, or strength’. Okay, so if we can define ‘normal’ then we might be onto something, but this implies there was a baseline ‘state of mind’ that we can aim to return to. What if there wasn’t? What if someone has always needed help and never quite got it? According to our National Drug Strategy,’ up to 70% of people in community substance misuse treatment also experience mental illness’. I’m not sure whether this is as a result of their substance use or that substance users have not been diagnosed or have self-medicated with their particular substance instead of getting treatment for their mental health. What I do know is that this figure is extremely high and suggests that people cannot get the help they need while using substances.
Does it help us not having a definition? Not really. We do need to have an idea of what it means so that we can support our loved one’s to achieve it!
The Substance Abuse and Mental Health Administration (SAMHSA) in the U.S.A. offers this definition:
“Recovery from alcohol and drug problems is a process of change through which an individual achieves abstinence and improved health, wellness and quality of life.”
This is a pretty good example of a definition.
There are a couple of points I would like to make.
1. Firstly, notice ‘abstinence‘ is stated here. This is the ultimate, but not the only, goal of recovery. Cutting down, having a bit at the weekend or any of those type of suggestions are more than likely going to be unsuccessful with problematic drug or alcohol users. an individual’s recovery journey is their own so abstinence cannot be forced on them.
Why do you think abstinence is preferred?
Well, if substance use is a symptom of something else such as masking pain or other problems, or is down to genetics or environment, cutting down is not going to alleviate the cause. Substance use may be a symptom of one of these things, so, in order to address those problems, your loved one ideally needs to be sober. If they are not, then this work can still be undertaken providing their use is stable.
An example of this in my work has been with clients who have both substance misuse and mental health problems (this is called Dual Diagnosis). In order to support someone with mental health problems, they ideally need to be sober, so that an accurate assessment of their mental health can be made. If they are under the influence, then this is not always possible. Then, it’s a case of establishing whether the substance misuse has caused or increased mental health issues or that the substance user has been self-medicating with substances because of their mental health. Do you see what I mean?
Harm Reduction is an alternative way of supporting substance users who might not want to stop or reduce their use, but can learn to use safely. For example, injecting drug users can access needle exchanges for clean needles that reduces the risk of infection. Or, a drinker might slow down their pace, make sure they have eaten and have nothing planned the next day.
2. The second point is about ‘improved health, wellness and quality of life’. Giving up drugs or alcohol is not the end of a substance users journey and cannot be done in isolation. In fact, addiction is a chronic relapsing condition, which means that it is unlikely that your loved one will give up on their first attempt and not have a lapse or a relapse. Don’t despair at this though, because every attempt brings them closer to recovery.
In order to be well and lead a quality life, what do we need?
We need people to help and support us, we need to address all areas of our lives such as relationships, home life, finances, physical, mental and emotional health, parenting, our ambitions and goals in life. This is called a holistic approach or supporting someone with their whole self. This doesn’t mean that you have to do all this work! This is your loved one’s journey.
It is important that you understand as a family member or friend that your loved one’s first step to recovery is being open to getting support and then, get treatment. Rehabs and other substance misuse services are well placed to undertake this work and will complete a full assessment with your loved one when they access treatment.
Recovery communities are often peer led support groups or communities which are led by people in recovery themselves. In these groups, people support each other by sharing their experiences of their own drug or alcohol use and can also help the community in which they live. Some of these communities are accessible online as well as face to face groups. There is so much variety of this type of support such as AA, NA or Smart Recovery so have a look and see what’s out there in your area and online. This type of support is fantastic following a period in rehab or detox. Some people attend them alongside treatment in their own community. Many people in recovery will continue to attend groups for ongoing support from people who have been through the same situation as themselves.
With all the information around addiction and recovery in mind. Why is it important to help families to recover too? I’ve worked as a drug and alcohol practitioner for over ten years. I started working in prisons with young offenders who were there because of drug or alcohol related crimes. I worked with some fantastic young men who had so much potential. Some never came back but many did. Why? Because they were going back to the same environment, the same family, the same problems, the same peers, and coming back to prison with the same issues I had supported them with the last time they visited.
Substance users must learn to maintain their changes and the recovery in the environment in which they live, particularly following rehab, as they often go away for treatment. Families are vital in supporting the recovery of a substance user, whoever they are and from whatever background. It is you who are spending most time with them and it is you that can influence their environment. Changing the environment is the thing that is going to influence your loved one to change. Please note that I am not implying that your are responsible for your loved one’s substance use. This responsibility lies with them, but you can influence their choices.
You need help too! It is you that is experiencing your loved one’s substance use as well as they. You need help to meet your own needs and to help you recover from your loved one’s choices. This will take time and I can show you how.
To summarise then, we know there is no clear definition of recovery. The recovery journey will bring different challenges and benefits to different people. What we do know is that it is about overcoming the symptoms and consequences of drug or alcohol use. The starting point is accepting help, then working on cleansing the body of a substance. This is where recovery begins. The next part of the process is to explore the reasons why an individual has been substances problematically and unpick these. These issues can then be worked with, hopefully resulting in long-term abstinence from substance use. We should expect lapses and possibly relapse as addiction is a chronic relapsing condition. We know that finding other alternatives to find pleasure works and also finding a sense of purpose in life can help to create a new life journey for loved one’s and their families.
We also know that very few people are successful in this journey alone.
Recovery, in my opinion, is where we feel comfortable in our own skin.
I can help!
If you are living with a loved one’s drug or alcohol use, I can help you.
My service, The Vesta Approach, supports families affected by a loved one’s substance use. You can access confidential support from me wherever you are in the world. I will help you to get your loved one into treatment and lead a better life. I offer face to face sessions in the Manchester (UK) area. You can also get help via Skype and an online group therapeutic programme.
I share lots of great information and advice on my Facebook page.
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See you next week,