What is the ideal path for addiction and treatment in recovery?
Why do so many people who try to overcome their addiction ultimately end up failing?
How can we use the right approach in order to prevent relapse?
I have been in recovery for many years now and I have watched thousands of people try to recover themselves. A handful of them make it while the rest relapse. Many of those who relapse come back to try again later. When they do that, I have had the opportunity to talk with them to see what went wrong. These experiences are largely what have shaped my ideas. Not just my own experience (though that has been important as well), but also working in a treatment center and watching thousands of other people attempt to sober up.
Recovery from addictions requires two simple things: stopping, and staying stopped
When you break down the recovery process, it is easy to split it into just two main processes:
Stopping, and staying stopped.
Really that is all there is to it, if you look at it carefully.
You can go to detox and a 28 day program, for example, and once you check out of that facility you have officially “stopped.” You have quit using your drug of choice. You now have a month of sobriety under your belt.
At this point there is only one other task, one other process to master: “Staying stopped.”
Now if you want to get technical, I believe that the process of “staying stopped” should be split up into two different time periods (because they are so different).
The first time period is basically that first year or two of recovery. The time frame is not exact because different people spend a different amount of time getting stable in early recovery. But it is what I would label as being “early recovery” and it involves that first year or two after you have stopped drinking and using drugs.
This is a really challenging time period and most people relapse during this part. In fact the statistics indicate that over 90 percent of alcoholics who go to treatment will relapse within that first two years. So early recovery is a very important time period and I believe that you need a very specific strategy for this time.
That strategy could best be summarized as “overwhelming support.”
You need support during early recovery. Massive support.
My opinion is that it does not matter much where you get that support, so long as it is positive. In other words, you need support from people who are also sober and who will encourage you to remain sober yourself.
It is pretty hard to beat AA for this purpose. There are other ways to get support if you really don’t like the meetings, but this is the simple and direct path to support. (For example, you could get support in a church community instead).
Now after you have been sober for that first year or two and you have learned how to become stable in your recovery, the game changes a bit. So now you have stopped (via treatment and detox) and you have also managed to get a year or two sober and find relative stability in your life (through intense amounts of support).
In my opinion there is one more change that has to occur. You have to transition to sobriety “for the rest of your life.” For most people this will not consist of daily AA meetings (though they may still go once or twice a week, but probably not every single day).
Now the question is: Can your sobriety keep working for you if you drift away from this massive amount of support? Have you learned how to sustain your sobriety on your own? Is it even important to do so? Why not just stick with daily meetings for the rest of your life?
There is nothing wrong with going to meetings. But most people are not going to sustain it forever, at least not every single day. If you go do a survey of people at AA who have 10 years sober+ and ask them how many meetings they go to each week, the average is 2 or 3 meetings. So clearly they are not depending on meetings for their sobriety. They are doing something more than that in order to stay clean and sober. This is very different from that first year of sobriety where people try to go to meetings every single day and they are surrounding themselves with as much support as possible.
What I am suggesting here is that you should realize that there will be a shift in your recovery approach. Your strategy will evolve and change over time. You don’t have to beat yourself up for not attending 7 meetings each week when you have five years sober. Instead, you need to shift some of that responsibility for remaining sober on to your own shoulders. It is fine to still have support in recovery, but you will naturally shift away from having so much support as you mature in recovery. Plan for this. Realize that it is coming. And also recognize that the solution for this means that you have to take action so that you do not relapse as a result.
When you drift away from the massive amount of support that daily meetings provides, what do you need to do in its place in order to remain sober?
The answer is simple:
Personal growth. You have to push yourself to take action and make positive changes in your life, all on your own.
This is the key to long term sobriety.
The key to “staying stopped” is personal growth. You don’t get to stagnate and be lazy
You may have heard stories in AA about someone who had many years of sobriety (maybe even decades) and yet they suddenly relapsed.
What went wrong? How could this have happened?
Well, the truth is that they did not “suddenly” relapse. It had been building up for many months, probably for several years even, and they did not know how to fight against it.
The reason that they did not know how to defeat that relapse is because it did not attack them directly. It was not as if something bad happened in their life and then they reacted to that and drank over it. That is how we think of relapse in early recovery.
In long term sobriety, things are different. You are much more stable in your sobriety and you are not going to just drink suddenly when something bad occurs. Your typical triggers no longer pose an immediate threat to you like they did when you had 90 days sober. You are more stable than that now.
But there is another threat that most people do not really understand. They may grasp the concept but they have little defense against it and they do not know how to fight it.
That threat is one of complacency. You can get lazy in your recovery efforts without even realizing it. You can get too comfortable in recovery and then relapse has a way to sneak up on you.
This can happen “to the best of us” in recovery. It can happen to nearly anyone. And there is only one way to prevent it, one strategy that completely defeats the threat of complacency.
That strategy is one of personal growth.
If you are experiencing growth in your life today–real growth–then relapse is impossible.
The presence of real personal growth is a powerful shield against the threat of relapse. If you are engaged in making positive changes, right now, today, then you cannot possibly relapse at the same time.
Why would you? You are too excited about the positive changes that you are actively making. So you would not sabotage that by drinking alcohol or taking drugs. There would be no reason to do so.
Abstinence is a platform for personal growth. Once you become stable in your recovery, you have this foundation that is your sobriety that allows you to pursue better things in life. But you have to actually make use of that platform, you have to take positive actions and start making positive changes, or you run the risk of losing that platform.
Therefore the ideal path in recovery can be outlined like this:
1) Stop. Go to detox and residential treatment for approximately 28 days. Stop using your drug of choice.
2) Stay stopped during the first two years through massive support. Find people who can help you stay sober, each and every day. Reach out for help. Find support.
3) Transition to personal growth. Learn how to push yourself to take action and make positive changes to improve your life. Keep doing this until you die.
The last step never ends because the threat of complacency never goes away entirely. You cannot just sit around and wait for complacency to strike you and then react to it. If you do this then you will be too late and you will have already relapsed. The key then is to take a proactive approach. This means personal growth. This means that you push yourself to always be improving your life and your life situation.
Various programs such as religious recovery or AA are simply methods of inspiring personal growth. All else is just details
So what do you say to someone who insists that they have found the one recovery program that actually works.
This has happened to me many times in my journey. I meet someone who is in the process of recovery. They are usually within the first year or two when they confront me with this argument. And they are so excited because they have been struggling for their whole life to overcome their alcoholism and drug addiction. They have tried and failed many times using various different programs and strategies.
Now suddenly they are clean and sober! It is working for them. They have discovered a program that seems to work. And so they are convinced that this is the one true recovery method, and everything else that they tried before in life was all useless junk. So they go around and try to convince others that whatever they are doing is the one true method of recovery, and that anyone who is following a different program is in serious danger of relapse.
I have met many people who are in that exact situation and have that exact same message for people. They believe they have found the one true program for recovery.
The truth is that this person has experienced a sudden success in recovery because they finally reached a point of total surrender. It had nothing to do with the program that they are using now and everything to do with timing.
The timing was finally right in their life. They finally hit bottom, surrendered, and broke through the last bit of their denial. So they were ready to get sober.
At that point, nearly any recovery program would have produced good results for them. Because they were finally ready.
All they needed to do after surrendering was to:
1) Stop drinking and using drugs (detox).
2) Find support (be it through church communities, AA meetings, group therapy, religion, etc.)
3) Transition to personal growth.
At the point that you meet such a person you can be confident that they are somewhere in between “stopping” and “finding support.” But they are nowhere near the third point on that list which is to evolve in their recovery to the point where they maintain sobriety based on their own personal growth.
So here is a key point that this example helps to illustrate:
Programs of recovery such as AA or even religious communities can help to inspire change and they can offer support, but they are not magical and they do not have mysterious powers that can eliminate addiction. There is no secret formula that can do that. No one has a monopoly on beating addiction. No one has a secret path that makes it easier to overcome addiction. There are really only three key principles that I have outlined here and I keep harping on: Detox, support, and personal growth. That’s it. You need to stop, find support, and then learn how to embrace positive change and personal growth. There is no mystery.
All of these programs out there that attempt to guide people through recovery are always based on these fundamentals. They all involve stopping and detox. They all involve some sort of support system where the alcoholic can identify with other alcoholics and learn from their experience. And if the programs are good then they will not leave you hanging their in early recovery, but instead will attempt to teach you how to pursue personal growth in your life so that you can thrive in long term sobriety some day.
Ultimately this last bit is really difficult to teach. Perhaps this is they the rate of relapse seems to be so threatening. After people burn out during the “support phase” of recovery they do not always have the tools that they need to make it through long term sobriety. Those tools can be summarized as being personal growth and individual motivation. You have to get excited about life and about making positive changes, then you have to keep doing it.
There is a cycle in long term sobriety between accepting what is in your life, and seeking to make positive changes. The threat is that you will practice acceptance and start “coasting” in recovery and you will thus get lazy. This is what can lead to relapse eventually. If you stay plugged in to your support system this can still happen if you are not actively preparing for it. In other words, some people who are in long term recovery and are still attending AA meetings can still fall victim to relapse, even though they still had the support in their lives.
This gives way to the idea that, at some point, support is no longer enough. We become stable in recovery and we sort of “outgrow” the support. It is just there. But our addiction is still in the background, trying to figure out ways to make us relapse. So the real challenge is if we can engage with that support (such as by sponsoring people and working with newcomers in recovery). Or we can move on from the support system and find our own path in recovery, one in which we challenge ourselves to keep making personal growth.
It is almost as if you reach a point in recovery where you have to start taking action again. Early recovery required lots of action, but after you are stable in your sobriety you sort of get to a point where you no longer have to work as hard. Recovery becomes easy. This is a warning sign! This is a red flag. If recovery is easy then you are not working hard enough. Even though you may be staying sober, you still need to push yourself in order to make positive changes. Abstinence is not the end game, it is merely a platform for personal growth. If you don’t use the platform then you will lose it. There is no reason to stay sober if you are not making use of your sobriety. This is how complacency works. It sneaks up on you and you will never see it coming. No one can possibly see complacency coming, it is just like denial. If you are aware of the threat then you can take positive action and fight against it. If you are not aware of the threat then you may fall into a dangerous pattern where you become vulnerable.
The ideal path is the one that works for you. This may or may not include formal programs of recovery, but it definitely includes personal growth.
Some people will argue that lifelong attendance in recovery programs is the best solution for them.
This may be true. I am not trying to discourage anyone from attending a program for life.
What I am cautioning you against is the fact that you may get lazy in long term sobriety, regardless of what you are doing as far as programs.
Therefore you need to look at your life and the positive changes that you are making, and ask yourself: “Is this enough?”
My theory is that you need to be excited about the changes you are making and excited about what is unfolding each and every day. If you never get this feeling then you need to crank things up a notch and start taking more positive action. Get a goal and strive for it. Make it an exciting goal. Figure out what you want to do in order to be happier and healthier in recovery. Then start taking action.
You may still cling to a recovery program, and there is nothing necessarily wrong with that. The key is that you are not getting lazy and complacent in whatever it is that you are doing.
There are many paths to recovery that might work for you. But if you are on a path and you stop growing and stop making positive changes, then you need to find a way to shake things up. If you stop growing for too long then eventually you will relapse. Personal growth is the key.
Why so many people fail in early recovery from addiction
People fail in early recovery for 3 main reasons:
1) They never stop. They never get help to stop. They never go to detox or treatment.
2) They stop but then they fail to embrace support. They don’t find a supportive environment that can help them through the first few years.
3) They fail to transition to personal growth. They stay stuck in the “support phase” forever. They don’t make the leap to long term sobriety.
Make sure that you do all three things. Stop. Find support. Seek personal growth.
The rest is just details. Those are the fundamentals.