A comprehensive program for treating drug or alcohol addiction should be able to see the addict or alcoholic through the entire recovery process.
This needs to be from before the moment that they decide to get clean and sober (surrender) all the way to when they are living in long term recovery and are actively facing the long term challenge of complacency.
Such a program could be different depending on the individual. For example, take the example of an alcoholic who sobers up on the couch during a 12 step call, and then is led directly into AA meetings and sponsorship. Later on in his recovery he may eventually become a sponsor himself, and thus carry the message to other alcoholics. This might be one of the more “traditional paths” in recovery and it has certainly worked out this way for some people. Such examples might not have even been to detox or rehab at all, they simply sobered up under their own power (or with the help of their family and friends) and then started attending AA meetings as their primary source of recovery. It may not work for everyone this way but it has worked for some. It is one possible path.
Think also of two individuals who start in the same detox unit on their first day sober, and then ten years later where each of them will have ended up and what their recovery might consist of. If you happen to pick two individuals who actually make it to ten years of sobriety (long odds that both would have the same starting point and rack up that kind of longevity) you can bet that their lives and their recovery would look very different after ten years of continuous sobriety. One may be deeply involved in AA after all of that time, while the other may have drifted out of AA but has found another path to recovery, perhaps in a religious context. Or one of them might simply do their own thing in recovery and not claim any program at all any more (much like myself).
Nevertheless, our two sample individuals from above would both need to meet certain criteria and do certain things in order to maintain their sobriety over the long haul. Neither person is likely to see long term sobriety unless they attain certain elements such as:
* Full surrender to their addiction.
* A zero tolerance policy towards using addictive drugs and alcohol.
* The motivation to keep taking positive action on a cumulative basis (no backsliding!).
* A dedication to personal growth in search of building up real self esteem.
If one of those elements is seriously lacking in anyone’s recovery program then they are just going to make it that much more difficult for themselves to succeed in long term recovery.
Remember that our natural inclination as addicts and alcoholics is to relapse. In order to overcome this natural tendency we have to take massive action, and by that I mean that we need to make drastic changes and continue to keep making those positive changes on a regular basis.
I watched many people come into recovery while I was working in a residential rehab and detox unit, and many of them failed because they did not understand what they were up against and what was required of them. “Massive action?” they might have wondered. “What do you mean I have to take massive action? I just want to quit drinking or using drugs!”
And therein lies the biggest problem that most people face in recovery, and it can even affect someone years later if they are lucky enough to stay clean and sober for that long (given that they have not fully surrendered yet to their disease).
When you get to recovery, you have to be in a state of total surrender, one which allows you to make the drastic sort of changes that are required to be successful in sobriety. Those changes need to be drastic enough and consistent enough that they can carry you through to long term sobriety.
Because of the importance of your level of commitment to recovery, the moment of surrender is quite important as well. Most people who attempt recovery for the first time screw this up–generally at least once. I screwed it up twice before I got it right, and after working in a rehab for five years I realize that nearly everyone gets it wrong at least once.
The formula looks like this:
Partial surrender = total failure in recovery.
Full surrender = total success in recovery.
Pre-program planning and your moment of surrender
So before you can be successful in your recovery you must surrender fully to your addiction. There is not a whole lot of ways to describe this state of being, nor is there a clear path to tell someone how to reach this point of surrender. If there were a sure fire way to do it then the problem of addiction would be solved for the most part.
The problem is that the typical addict or alcoholic is going to be motivated entirely by pain. They are not going to take action to get clean and sober while things are going good in their life and everything is rosy. There is no motivation to go to rehab and throw their ego up on the table to be operated on.
On the other hand, if an alcoholic or an addict has suffered for many years and they have totally hit bottom and cannot imagine their life going on another moment because they are so sick and tired of chasing drugs and booze, then such a person has reached a state of what I would call “total surrender” and hopefully they will be ready to do anything in order to get help.
This is another characteristic of what it takes to make a successful recovery–the level of willingness. If the person says that they want to change their life but they put all sorts of limitations on how they are willing to get help, then they are probably not ready to change. The moment of true surrender will not have this tendency to fight for control, nor will it have any trace of manipulation left in the addict or alcoholic. They will simply say something to the effect of: “I need help. Show me how to live without drugs/booze.” This is the level of surrender that is necessary for success in recovery.
There are many elements that are important to an overall path in recovery. The starting point is surrender. Later on, more elements are needed in order to create long term sobriety, such as disrupting your life and your addiction, overcoming complacency, learning how to live without self medicating, and so on. But all of these additional elements that make up a successful recovery are not even possible if full surrender is not achieved FIRST.
This is why surrender is so incredibly important. Generally speaking, if a person starts to sober up but then balks at one of the next steps in their path (such as learning how to actually live a sober life) then it usually means that they did not fully surrender in the first place. They were still hanging on to the idea that they might be able to drink or use drugs like a normal person again some day, or that they might learn to control their use at some point, or whatever. Something held them back from full surrender and so therefore they do not follow through in their recovery.
Why detox is important
From a medical standpoint the detox process is very important and even necessary in some cases. Withdrawal from some drugs (including alcohol) can be dangerous, depending on how much the person has been using and how long they have been using the substance. In some cases a cold turkey withdrawal can be fatal. This can also happen with just plain old alcohol, without any other drugs being involved in the mix. Tragic that some people assume otherwise or that “hard drugs” are necessary to make a detox be dangerous. I have news for you: alcohol is a very hard, and harsh, drug in itself. Withdrawal from alcohol can be fatal in some cases.
But even beyond a medical standpoint and a safety standpoint, the need for detox is still quite pressing and important in recovery. Going through a real detox in a rehab facility helps to set you up for success in a few different ways. This is not to say that going to rehab and detox is a magic cure for addiction or alcoholism, because clearly it is not, and many people relapse after going through detox. But it still gives you a number of advantages, such as:
* More comfortable and safer withdrawal.
* Educational, you will likely learn about your addiction and start to learn about recovery as you are exposed to residential programming.
* Set up to leave detox to enter a residential program and start exploring recovery.
* Guaranteed clean time while you are actually in detox, giving you more confidence to stay sober in the long run.
It is definitely not a cure, but it is much better than doing it at home on your couch. There are all sorts of temptations when you are at home on the couch, plus you have no medical supervision and it could be dangerous to avoid drinking or relapse when you are at home trying to detox. At least when you are in a controlled detox environment you are guaranteed to get a few days sober under your belt while staying safe. This alone is worth something, and if it leads to more action in recovery (the other crucial elements that make up a successful recovery) then it is certainly worth the effort.
Disruption is the key…the only question is, how much do you need?
I recommend that most people who are struggling with drug or alcohol addiction to go to rehab or to seek treatment. There is a very specific reason for this and it is not because “treatment works” or because “they need to learn how to recover,” because while those are both partially true at least they are not the primary benefit that you get from rehab.
No, the primary reason to go to rehab is disruption, in my opinion. The addict or alcoholic is stuck in a pattern or a cycle of self medicating with drugs and alcohol, and they have structured their entire life around the getting and using of their drug of choice. It is all they do now and it is what they have come to have known. In order to have a chance at recovery they need to disrupt this pattern. In my opinion this is the primary purpose of rehab and treatment.
The addict or alcoholic checks into treatment and they generally go through the detox process first. Then they move over the residential treatment side of things and so they might stay in rehab for a week or perhaps up to 28 days. Of course the rehab or the treatment center is doing a few things to try to help them: teaching them about addiction and recovery, exposing them to 12 step meetings, guiding them directly with counselors and therapists, and so on. But in addition to all of that stuff, what rehab is really doing for the addict is it is giving them a massive break from their life of addiction. Their life and their cycle of addiction is being disrupted.
I tried this twice and failed at it because of two reasons really:
1) I was not yet fully surrendered to my addiction.
2) I did not choose a big enough level of disruption.
I believe that these two problems were closely related. Because I was not yet fully surrendered to my disease, I was not willing to choose a large enough level of disruption.
What I mean by that is that I actually needed long term rehab in order to recover. That is what I needed. I needed to live in rehab for a year or two.
But the first two times I showed up to treatment, I was not willing to do that. I was appalled at that level of disruption (who needs to live in rehab for a year, that is like prison!) and so therefore I was not able to get sober at the time. I was not willing to do what it took (for me) in order to make the leap into recovery. This was a function of having not been fully surrendered yet to my disease.
So what I am saying is not necessarily that everyone who tries to get sober needs to go to long term rehab. This is not the case, and obviously many people do get sober without having to live in a rehab for two years. However, what this does mean is that every person who tries to get clean and sober needs to find the right level of disruption in their lives.
For some, this might mean going to AA every night of the week. Maybe they do not even need detox. This was definitely not me. I could not stop drinking on my own without suffering medical consequences, because I was so dependent on the booze.
Some people might just go to residential treatment for 28 days, and then leave and hit a few meetings each week and be just fine in their recovery. This was not me either. I could not do this because it was not enough disruption for my particular situation and my particular lifestyle. My problem was that I was still quite young and I had tons of friends that I used drugs and drank with and so if I tried to just hit a 28 day program and then return home I was going to be in big trouble. There was no way that I could get away with that little amount of disruption in my life because I just had too many friends who I liked to get drunk and high with. My whole world revolved around addiction and using drugs and alcohol. So it was silly to think that I could just go to rehab and then return back to my old environment and that I might be OK.
The counselors and the therapists that I spoke with in the 3 rehabs that I attended all knew this. I described my life and my situation to them and so at each rehab they always told me “you need long term treatment.” I did not believe them the first two times because I was not really surrendered to my disease (not fully anyway) and I thought they were just pushing more rehab on me because that was “what those people do” and that “they are just trying to make more money off me.” The truth was that those counselors knew that I was in big trouble if I tried to return home because my life revolved fully around addiction, and they knew how big of a trigger my everyday environment would be for me. And of course they were right, I needed a greater level of disruption, I needed long term rehab, and it was not until I finally went to long term that I was able to recover.
If you try to disrupt your life with treatment, and you fail, then you might need a more intense level of disruption.
How are you going to live a sober life without self medicating?
After you have surrendered, gone through the detox process, and then sought a way to disrupt your life, you still need to learn how to live your everyday life without self medicating.
This may be thought of as the “nuts and bolts” of recovery. This is why recovery is such a learning process. Because you must learn how to deal with every little thing in your life again without using drugs or booze.
For me this was a process that took years rather than months, but I am actually not the fastest learner in the world so perhaps your experience will be different. Luckily I was living in long term rehab during the first two years and so therefore I had a lot of support while going through the learning process. Of course this is no guarantee of anything, because most of the people that I lived with in long term treatment ended up relapsing (most while living there!).
In some ways I am still learning the “nuts and bolts” of the recovery process even after a full decade of continuous sobriety. It is said that we never finish learning. I believe this to be true. New learning experiences that I go through are really refinements of things I have learned in the past, and I gain deeper understanding. Usually these lessons have to do with communication and dealing with others and relationships.
Slaying the complacency dragon
The final piece of the recovery puzzle comes into play after you have gone through almost the entire process. We might outline this process up to this point as:
And here we are at the final piece of the puzzle, which I would label “fighting complacency” or perhaps “living in long term recovery.”
The final threat to your recovery is when you have “figured it all out” and you are now relatively stable in your recovery and the threat of relapse seems very distant.
It it in such conditions that some people become lazy, stop growing, and end up relapsing anyway!
We want to prevent this, obviously.
The key to preventing relapse due to complacency can be done in two ways (feel free to combine them):
1) Stay humble and realize that you are still learning, even after decades of recovery. Do this by focusing on the learning process. Recognize when you learn something, acknowledge it.
2) Push yourself to keep growing and making positive changes and learning new things in recovery.
This is how to slay the complacency dragon. It must be a proactive approach on your part because complacency creeps into your life in a very subtly, too much so to notice in most cases.