Alcoholism and drug addiction are not easy problems to fix. Traditional treatment methods are still evolving to an extent because we are still learning more and more about addiction and how it works from a medical perspective. In particular, addiction is now understood to be a disease of the brain and we are learning more and more about exactly how the reward centers work and so on.
Ultimately none of that matters to the struggling alcoholic or drug addict unless it can translate into real world sobriety. We want solutions. Understanding the problem and living a new solution are two very different things. Perhaps understanding the problem better can lead us to better solutions, but in the short term we all need a way to get help right now. Therefore we have to work with the solutions that are currently available to us in order to get the help that we need.
If you surrender and ask for help in the current environment then you will be exposed to current treatment systems. Our modern day understanding of recovery and addiction is mostly based on 12 step recovery. Traditional recovery solutions are almost always either 12 step based or faith based solutions. This is not necessarily good or bad, it just happens to be the current environment.
What is the disease of addiction, and how does traditional treatment attempt to fix it?
Addiction is defined in different ways, but from a recovery standpoint we can define it as someone who is using drugs or alcohol even when it is harmful to continue doing so. They would like to stop abusing substances but they cannot seem to do it on their own. The person needs help in order to stop.
If such a person finds that they can quit on their own, then they are not “addicted.” They do not have a problem. In my experience working in the treatment industry, the problem of addiction is defined mostly by whether or not a person needs additional help in order to stop drinking or using drugs. If they don’t need extra help then they are not an addict. If they do need extra help then this defines the problem. This is a bit simplistic and it really just measures the problem, but it is also a very useful definition in my opinion. If there is no problem then there is no problem! On the other hand if alcohol has ruined your life and you would like to be free of it then you need serious help.
Traditional treatment programs attempt to fix the problem of addiction with something of a replacement strategy. This is my opinion and just one way to look at the overall solution that is being presented in most treatment centers. Addiction is the problem and spirituality is the solution. Hanging out in bars or with other drug users is the problem and hanging out in daily AA meetings is the solution. Worshiping our drug of choice is the problem and the shift to a higher power and faith is the solution. In all cases we replace one thing with another. Again, this is not good or bad, it is just the current set of solutions. If you want to change your life then you need to eliminate old behaviors and introduce new behaviors. Hence, replacement. We replace the bad with the good. We replace negative actions with positive actions. I see traditional recovery as being a replacement strategy.
In traditional recovery the focus is almost always on spiritual growth and development. The idea is that if a person can develop spiritually then the rest of their life will fall into place. All things can be changed and healed through faith. This works well for some people but not for everyone. To some degree it is a mental trick in order to convince yourself that you can deal and cope with life rather than to turn back to drugs or alcohol. Again, this is not good or bad, it simple is the current solution. Traditional recovery attempts to motivate people spiritually.
What are the typical success rates with traditional treatments?
What is the success rate of spiritual based recovery?
It depends on who you ask, and exactly what you are measuring.
Let’s say that you have 100 random people who walked into a detox center or 28 day residential treatment program. Then 5 years later you track down those 100 people and find out how many of them have been perfectly clean and sober for the last 5 years without any slips or relapse. If you seek out this sort of raw data then chances are good that you will find a “success rate” of around 5 percent who stayed totally abstinent for the full 5 years.
Now some people who are measuring this will first ask the people: “Did you follow through with all of the treatment, all of the aftercare, and all of the meetings? Did you keep attending everything you were supposed to and do every little thing that was suggested to you?” And if the people say “no, not exactly” then they are not counted in the calculations. By doing this and selectively eliminating such people, some treatment centers are able to boast success rates of 40% or even higher. But if you just look at the raw numbers then it seems that most success rates run around 5% or so.
Also, someone might slip for a while but then go back to recovery, or they might relapse for a month but then try again, and do we count such people as a “success” or a “failure” in terms of our calculations? It is not an easy thing to measure. Obviously the gold standard is if someone attends treatment and then they never touch alcohol or addictive drugs again and remain 100 percent abstinent. It is also difficult to get accurate numbers based on the concept of shame and guilt. If a treatment center makes follow up calls then there is a strong tendency for people to under-report relapses. This has been measured in studies where drug testing is used along with follow up phone calls. The phone calls give a higher success rate but the drug testing tells a different story. So any success rates that you may read about from various treatment programs must always be taken with a grain of salt.
Then there is the idea that “for anyone who works the AA program (or any other program for that matter) and they put a true 100 percent effort into it and stick with it, the success rate is 100 percent!” Well of course it is. Part of the program is the assumption of abstinence. But this doesn’t prove anything to anyone. If you don’t drink and stand on your head for 8 hours each day you will stay sober too, but that is not necessarily very useful. If a program fails for 95% of people then this is your failure rate. You can’t discount the 95% because they “didn’t try hard enough.” Of course your success in recovery depends on your willingness and commitment!
What are the alternatives to traditional treatment methods? Are they effective at all?
There are ways to get clean and sober without going to AA or using traditional recovery methods.
However, there are no magic secrets and I am not suggesting that everyone avoid AA in order to try some technique that is much more effective. No such strategy really exists. Recovery is hard work, period. There are no shortcuts.
Of course there are alternatives. There are “secular programs” of recovery. There are groups that seek recovery that are simply anti-AA in nature. There are groups of people who use exercise and fitness as their model for recovery from alcoholism. There are people who use behavioral approaches and counseling or therapy as their solution. There are survival programs for recovery where you go live in the woods for several months. There are programs of recovery that are based on art and creativity. And you may evolve into your own personal brand of recovery and simply pursue a better life for yourself, taking positive action on a daily basis.
None of these methods are better or worse than AA necessarily. None of them have special magic that will vastly increase or decrease your rate of success.
A better question might be: What type of recovery program would yield the best rate of success among the general population? What program would best fit the majority of struggling alcoholics?
When people ask this question what they are really doing is asking a different question. What they are really asking is:
“What recovery program exists that can help to motivate the struggling alcoholic or addict?”
Think about this for a moment.
That is the real question that people are discussing when they talk about AA versus religious based recovery versus “Women for Sobriety” versus “Racing for Recovery.”
There are different recovery programs out there.
All of them try to do the same basic thing. They all try to help the alcoholic or drug addict to straighten out and live a sober life.
All of these programs may use slightly different methods. Or they might use radically different methods, it doesn’t matter. The point is that they all use total abstinence as the foundation for recovery, then you have to take action and build a new life somehow. That is recovery in a nutshell. You get sober, detox your body, then you have to TAKE ACTION in order to remain sober somehow. You have to do something. You have to change your life.
And when we are looking at the success rates of various programs, what are we seeing?
Are we seeing what program is more effective?
No, not really. All we are seeing when we look at success rates is how motivated the people were when they entered that program.
Here is a revelation for you:
The recovery programs themselves do NOT motivate people.
You can go to AA. You could go to “women for sobriety.” You could go to a religious based recovery center.
In the end it does not matter in terms of which one works better. They all work the same. Either you put in the work and stick to abstinence or you do not. There is no motivation that is better in one program over the others. The motivation must come from within.
This is what people miss. This is what most people do not understand. You cannot just design a better recovery program. You can’t take AA and somehow tweak it so that it works better. You can’t really make it much worse, either! The program is based on the assumption of abstinence. Get sober, do the work, rebuild your life. There is no perfect road map for this and there doesn’t need to be one.
You don’t need a better map.
You don’t need a better map to recovery. If your higher power could come down to earth and rewrite the 12 steps to make them more effective, it would not help you one bit.
Because the challenge is all internal. It is up to the individual to make the commitment to total abstinence.
All of the step work and the therapy and the higher power and all of these recovery strategies and techniques are just window dressing. They don’t really get to the heart of the matter, which is that the individual has to make this deep internal commitment to total abstinence.
That is the secret to recovery. That is the whole thing.
No rehab center or AA meeting or recovery program can ever make this part of the process any easier. They are not going to one day design a new recovery program that forces alcoholics to want to get sober.
Think carefully about that. There is no magic solution out there.
Don’t get me wrong here. I am not saying that AA is useless, or that recovery programs are a waste of time.
By all means, take action and get help. Go to AA. Go to rehab. Go to detox. Find a recovery program, any program, and get to work. Get busy rebuilding your life. Take action. Take massive action.
My point is that it doesn’t matter. Any program based on abstinence is going to be roughly the same as the others. They all depend on commitment and willingness of the individual. This is 99 percent of the equation. The actual steps, the tactics, the strategies, the instructions for the person in recovery….that is just a minor detail. That is 1 percent of the solution.
So don’t get too worked up over success rates, or which program you should follow. They are all the same because they all depend on this one thing, and that is the commitment to total abstinence. There is no way to dress that up or fake it. You either want to be sober or you don’t. And if you don’t and you have not surrendered fully then there is no help for you right now other than to go back out into the world of addiction and get some more pain. Alcoholics are motivated to change based on pain and misery and suffering. No pain, no change. Because change is hard.
How to take steps to fix your own drug addiction and get help
Just do it.
There really is not much to say other than to just do it.
Get on the phone. You want a piece of wisdom, that is it right there. Pick up the phone and call a treatment center.
The phone weighs a million pounds. You may be drunk right now or using drugs and you feel stupid calling up a rehab.
Don’t feel stupid. Making such a phone call is the smartest thing you could ever do.
For sure, it is the smartest thing that I have ever done. And in fact I did not even lift the phone up myself, nor did I talk on it. My family did. They called for me.
I only agreed to get help. I nodded in agreement and said that I would get help. I agreed to go to rehab. I agreed to go through medical detox, to stay overnight in a facility that would supposedly teach me how to stop drinking alcohol.
And it worked. Even though I had been to rehab twice before and relapsed, it finally worked. I had to go to rehab 3 times before it finally “clicked” for me.
But don’t get caught up on the numbers. I knew a guy who lived in long term rehab with me and he was on his 19th trip to rehab. He later died of a drug overdose.
I know other people who went to treatment once and have never drank or used drugs since.
The key, as I mentioned above, is personal commitment. They say that you cannot get sober using willpower alone. This is both true and false. You still need a ton of willpower. You need to make a massive commitment to yourself, bigger than any commitment you have ever made before in your life. And this takes willpower.
But then you use that commitment and energy to make positive changes. And you ask for help. You seek guidance and wisdom. This is how early recovery has to be. If you have all the answers yourself then you may as well go drink again. Because that is where we always end up when we rely on our own ideas.
In early recovery you need to get suggestions from other people. You need to take advice and follow it. For the struggling alcoholic, they have been avoiding this solution for a long time. They have avoided taking advice and tried to do it all by themselves.
It hasn’t worked. Has it?
It did not work for me either until I became willing to let go. I had to let go and embrace the idea that if I followed directions that it might actually make me happy. And the miracle is that this worked. When I finally surrendered and got out of my own way, I was able to become happy in sobriety.
The actual program or treatment method did not matter much. My own methods for sobriety have evolved drastically over time. My recovery today is nothing like when I first started.
Why you should not obsess over which treatment type you use
You need to do what works for you.
We can break this down into a simple process for early recovery.
The order should be roughly:
1) Surrender. You cannot drink successfully any more. You have tried. Give up. Surrender.
2) Ask for help. Ask a professional for help. Go to detox. Go to rehab. Get professional help. Do not obsess over “who has the solution.” The solution is abstinence. The rest is just details.
3) Follow through. In other words, pay attention to the details. On one hand they are not important (because different programs will work for you), but on the other hand you should pay attention to the details and follow through. This is a seeming contradiction but in reality it will all work out.
In other words, ask for help and then embrace the help you are given. Knowing full well that a different recovery program could save your life as well. There is more than one way to live a spiritual life.
Most of all you should be grateful. If you can stay grateful in your recovery journey then you are well protected from relapse. Therefore the fundamentals of recovery are:
1) Surrender and asking for help.
2) Taking action and following directions.
3) Practicing gratitude.
Nothing more is really required for a lifetime of sobriety.
What about you, has the traditional method of recovery worked for you? Have you tried any alternatives? What has your experience been? Let us know in the discussion forums. It only takes a second to register!