This is the first article in a series of posts about addiction and recovery and the stages that make up the recovery process.
We could break up the stages in many different ways, such as “short term and long term recovery” or “detox and long term,” but here I have decided to break the stages up into 4 different parts (in order to provide a good amount of detail about each one).
Those 4 stages are:
1) Disruption and detox.
2) Early recovery.
3) Transition and personal growth.
4) Long term sobriety.
Those are just arbitrary stages of the recovery process, nothing official or anything. Just the way that the stages break down the best in my own way of thinking.
For me, the typical time frame breaks down like this (at least for me, your experience may be different, but probably will not be vastly different):
1) Disruption and detox = 0-14 days.
2) Early recovery = 14-365 days.
3) Transition and personal growth = 1-5 years.
4) Long term sobriety = 5 years and beyond.
Of course those are all rough estimates when it comes to the time frames, and it will obviously be unique for various people in recovery. For example, I still feel like (looking back) that I was in a transitional phase when I was between 1 and 5 years sober, whereas some other people in recovery may have matured or progressed much faster than that. I was still seeking out my own path and do not feel like I was in “long term sobriety” when I had 4 years of sobriety. I was still transitioning to something else at that point, still seeking a path, still finding my own way and experimenting quite a bit with new ideas.
So you can watch for more articles about the other stages of recovery as I have outlined them here, but this one in particular is going to deal with detox and the idea of “disruption.”
Why disruption is necessary
Disruption is necessary because addiction contains plenty of inertia on its own. In other words, an addict or an alcoholic left unchecked is just going to stay stuck in their pattern of drug or alcohol abuse. If nothing changes, nothing changes.
Indeed, addiction is defined by the fact that you are not just going to stop using your drug of choice out of your own free will….you will not just wake up one morning and accidentally forget to go chase down more drugs or booze. You will not slowly drift away from your addictive behavior just on a random whim or by mere chance. And yet many addicts and alcoholics who are trapped in denial often think of their life situation and their disease of addiction in these very terms. They will actually think to themselves “oh, I know this disease is killing me, I will probably wake up one day and feel like walking away from it all, and start making healthier choices.” The addict may hang on to such an idea just to help justify their current behavior (which is to abuse drugs or alcohol).
Drug addiction and alcoholism carry plenty of inertia with them. An addict or alcoholic who is in the habit of self medicating will have a very strong tendency to keep self medicating. Overcoming this tendency is incredibly difficult and that is why we have such elaborate options for treatment (28 inpatient rehab, 2 year long term treatment centers, daily AA meetings for years on end, etc.).
The intensity of various treatment options (such as living in long term rehab) should give you a strong clue as to the level of disruption that is needed in order to overcome an addiction.
The amount of disruption you need is usually proportional to the intensity of your addiction. Not necessarily how long you used or in what amounts you used, but the extent to which you depended on your drug of choice in order to deal with reality. Of course the longer you have used for the harder it is going to be to disrupt the addictive pattern, but even some kids who have only used for a short time will find it extremely difficult to transition to a new way of life.
How much disruption do you really need?
You need enough disruption to successfully stop using drugs and alcohol and to start dealing with life on “normal terms.” This means that you have to be able to function in your everyday life (outside of treatment) without resorting to self medicating.
This can be easily tested based on a progression of treatment options. In other words, do what most humans will choose to do anyway–start with the least disruptive treatment option first and then keep working your way up in intensity until you find something that is effective for you. (Try to convince someone to do otherwise is probably not effective anyway).
So what does this mean in the real world? It means that as soon as you identify your drinking or drug problem, you should try to address it in the least disruptive way possible.
No one who recently developed a drug or alcohol problem would say “ooh, ooh, I know! I should go live in an inpatient rehab facility for two full years! That will surely fix my problem!” No one will say this if they have only had a drug or alcohol problem that just recently developed over the last few months or even years.
No, what most humans will do is to start out with LESS disruption, not more. So they might say something more like “OK, maybe I do have a small drug or alcohol problem. I will go see a therapist for an hour and talk this over.” Notice they are not even committing to regular therapist appointments just yet. All they want is to invest a single hour of their time to further diagnose their problem. At this point they are still probably thinking in their head that they can talk a therapist into the idea that they don’t really have a problem at all. “AA meetings? Inpatient rehab? Detox? Are you kidding me? I just drink a bit much here and there, that’s all!” To such a person, long term rehab sounds like a prison sentence. Forget it.
So we tend to seek the least amount of disruption that we can get away with.
I personally did this in my own recovery journey, opting for therapist visits and then later a short stint or two in inpatient rehab before realizing that I needed a much more serious amount of disruption in my life if I was going to break free from addiction. Eventually I accepted the idea that I needed long term rehab.
Does this mean that everyone needs long term treatment? Of course not! It just means that you need to find the right amount of disruption in order to fix your problem. Most people start with the least amount of disruption because doing otherwise is far too damaging to the ego. People will not tend to admit that they need help as a general rule, so it is quite normal to see people minimize their disease and try to seek the least disruptive solutions for their life. If they agree to more intense treatment (like inpatient or long term rehab) then this is an admission that they need serious help, and the person will feel like it is a weakness. In reality they are not weak for knowing this or suggesting it, but their ego will not see it that way. Their ego will fight for them to avoid major forms of treatment (disruption).
Why detox is necessary
For most people in recovery from addiction or alcoholism, a medical detox is necessary in order to be safe and get off to a good start in recovery. The problem for most people is that the discomfort of withdrawal combined with the psychological addiction to their drug of choice becomes too great for them to overcome on their own.
Detox in a proper medical facility or rehab is actually very easy, and is also mostly painless. The medical professionals in drug detox units are trained to keep you safe and at least somewhat comfortable. They do not want to see you suffer, for the most part (there may be some bad rehabs out there but most of them try to do a good job and keep you comfortable).
Detoxing from some drugs (including alcohol, which is just another drug btw) can be dangerous or even fatal in some cases. This is the biggest reason that detox is so important. But even aside from the health/safety factor, you need detox in order to set yourself up for success in recovery.
Detox is simple but necessary. You purge the drugs and the chemicals from your body, and you do so in order to become stable without having to put any more chemicals into your body. Once you achieve this stability, your only real job is to maintain it. Detox is just a drop in the bucket compared with ten+ years of sobriety. Your real challenge in recovery is “relapse prevention.” Detox is actually the easy part (provided you do so in a rehab center or medical facility).
If at first you do not succeed, seek greater disruption
As mentioned above the key is to seek greater disruption if you do end up relapsing. Whatever you did in the past did not work for you. It failed to keep you clean and sober and so therefore you need to try something different.
People in traditional recovery use this idea all the time. They are fond of saying “insanity is doing the same thing over and over again and expecting different results.” Well, I have seen some people in recovery who came back to the same inpatient rehab over a dozen times. Seriously, over 12 visits in the 5 years that I worked in a detox unit. At some point you kind of want to say to these people “Isn’t it time to try something different?”
Some people fall into a pattern of relapse. They keep going back to the same disruption, only to fail over and over again. What is the point of doing this if you keep getting the exact same outcome? Try something different!
For me, this meant going to live in long term rehab, a solution which turned out to work for me (finally!). Up until that point I had only done short inpatient rehab, counseling sessions, and the occasional 12 step meeting. Nothing worked until I became willing to seriously change the level of disruption in my life. When I went into long term treatment I also quit my job (which was a huge trigger for me) and eliminated all of my old friends.
The advantages of inpatient treatment
I needed the advantages that only inpatient treatment could provide for me. The level of disruption that I needed in my life was very great. Previously I had tried to break free from my addiction in certain ways but found that I could not do so under my own power. I needed much more help and I needed a way to disrupt all of my patterns and behaviors. Treatment was the answer for me because I could not make enough of the required changes on my own without a lot of help.
They say that the environment is not the solution, and that simply changing geography is not going to cure your addiction, but I found that this was at least partially untrue for me. I needed a serious amount of disruption in my life and so part of that was in getting away from my job, all of my old drinking and using buddies, all of my old friends who used with me, and so on. I could not do this by simply attending a few meetings each week and not changing anything else. If I had kept the same job and the same set of friends then I would never have been able to become clean and sober.
Obviously this will vary from person to person and also depend a bit on age. If you are 65 and trying to get sober then you might not need as much disruption in your life. On the other hand if you are under, say, thirty years old and your life revolves around using drugs and alcohol with a huge circle of peers, then you are going to need some serious disruption in your life in order to fully break free. It is not just geography but also the social landscape of our lives that can keep us trapped. I had to abandon nearly 100 percent of my peers in order to get a fresh start on life in recovery.
Disruption is the start of your journey
Most people who try to recover on their own attempt to skip the step of disruption and go straight to the whole “living in recovery” phase of their lives. This almost results in failed recovery and repeated relapse while the person tries to avoid biting the bullet and choosing a treatment that is more disruptive. So instead their lives are disrupted even more by repeated attempts at sobriety in which they keep failing and relapsing.
You have to get this step right in order to make any sort of long term progress in recovery. You have to start out your recovery on the right foot by laying a strong foundation in the beginning. Detox is just a starting point but it is also necessary for any lasting recovery to take place.
Stay tuned for the next article where we will look at the next stage of recovery, which is typically made up of about the first full year of a person’s recovery journey. This is a time that is chock full of learning and growing pains. It is not easy and a huge amount of people end up relapsing in this second stage of recovery (like I said, detox is actually pretty easy).
So in reality when you are choosing your level of disruption what you are really doing is figuring out just how much professional help you are going to need in order to get and then stay sober. Getting sober is actually the easy part (just check into detox!) and staying sober is actually the hard part. The first year in particular is very challenging and therefore the vast majority of people in early recovery end up relapsing within the first year, and most of them end up relapsing within the first 30 days of leaving rehab.
Therefore the amount of disruption that you choose can be the difference between whether you make it through these first few critical stages of recovery or not.