A Better Way to Promote Recovery

By Tom Horvath, PhD, ABPP

Imagine that what people heard about addiction and recovery was roughly the following:

“It is a normal part of life for many people to experiment with the use alcohol and tobacco. Some people also experiment with marijuana, heroin, cocaine, psychedelics, and other substances, even though these substances are illegal. A portion of the individuals who use these substances will be come addicted to them.”

“What is addiction? All human beings have addictive behavior. We all act on desires (or cravings) for food, liquids, sex, and human connection. When these behaviors or other behaviors, or use of a substance, become excessive, we speak of addiction. Addiction is excessive involvement with anything. Any substance or activity which has a significant impact on emotional experience has the potential to become addictive for a particular individual.”

“Why do some people become addicted? If we had a definitive answer to this question we might also have highly effective treatment for addiction. At present there is no definitive answer or highly effective treatment for addiction. We do know that some individuals have a biological predisposition for addiction. We also know that many if not most individuals with this predisposition do not develop addiction. The interpersonal, social, cultural and environmental influences on addiction are probably more important than the biological ones. The good news is that, unlike an inborn biological predisposition, these other factors influencing addiction can be changed.”

“How does treatment work? Most helpful treatments focus on changing an individual’s thoughts and behaviors (thereby also changing feelings), as well as positively influencing interpersonal relationships and improving the individual’s environment. Because the positive impact of these treatments is limited, it remains crucial for the individual seeking to overcome an addiction to be fully committed to change, and focused on that project on a daily basis, at least initially. In fact, overcoming addiction occurs more often without any treatment or other outside support (such as a SMART Recovery or Alcoholics Anonymous meeting). This fact is more good news. We can think of recovery as the typical outcome of addiction, and natural recovery as the typical route of recovery. Individuals who seek treatment often have many additional difficulties, not just addiction alone. Treatment can help such individuals make progress in all areas of their lives, thereby increasing the likelihood of addiction recovery as well.”

“How do I know if I’m addicted? Although this question may seem like the place to start, it is actually an unhelpful question because it is all-or-none. It is more helpful to consider, how much do I have addiction problems? Only a few of us have no addiction problems. Some of us have significant problems, whether those problems are mild, moderate or severe. Only you can decide if the problems you are experiencing are big enough to make changes. People who have overcome addiction often say things like: ‘It just wasn’t worth it anymore. I was doing things I wasn’t proud of. I was losing what was important to me. I had become somebody different. It was time to make a change.’ ”

“If it’s time to make changes, for most people the place to start is cutting back.  It will likely not be easy to do so, but many people are successful with controlling or moderating their involvement. If within a few months (or sooner if you are having substantial negative consequences) moderation is not working, it may be time for abstinence.”

“If you have little or no success with reduced involvement, then it’s time to try abstinence. This route to recovery is harder at the beginning, but easier in the long run. When you abstain your cravings diminish almost entirely, generally within 90 days. When you do have cravings you can remember that they go away in seconds to minutes typically, don’t harm you while they last, and don’t force you to engage in your addiction. You still have a choice, no matter how strong the craving.”

“If your own efforts aren’t enough, try a mutual help group, treatment, or both. Before you make any commitments, read about recovery, treatment and mutual help. Recovery Options, by Volpicelli & Szalavitz, Inside Rehab by Fletcher, or Sober for Good, also by Fletcher, are good choices. You might also have an initial session with a local addiction professional, to find out what resources are available in your area. Before entering treatment, find an approach, and professionals, that look like a good match for who you are. There are two major approaches to mutual help. SMART Recovery is the best known of the self-empowering groups (“Discover the power of choice”). Alcoholics Anonymous and Narcotics Anonymous are the best known of the powerlessness/spiritual groups (“Made a decision to turn our will and our lives and will over to the care of God as we understood him”). If your situation is severe and urgent, residential treatment (inpatient) may be indicated. However, most individuals find outpatient treatment sufficient. There are also medications that may be helpful short or long term. Be prepared to spend some time determining the best combination of supports and services for you. There are as many paths to recovery as there are individuals.”

“What if I have the disease of addiction? Although you may be tempted to adopt the idea of addiction as a disease, there are many drawbacks to the idea. If you view addiction as a disease you may be able to persuade yourself that even though you have problems, you don’t yet have a disease. Therefore you may decide to do nothing, rather than work on changing. If you view yourself as having a disease, you may tend to give up just when you need to be working the hardest. Even if you decide that you have a disease, it does not mean that you need to give up hope or believe that the disease is untreatable or unmanageable. Remember you always have a choice about what to do with your hands, feet and the other parts of your body. Use your voluntary muscles to create a better life, not to relapse!”

“A life filled with purposeful and meaningful activity is the opposite of addiction. Such a life is available to anyone. Of course we all have limits. Not everyone will become famous or make lots of money. However, within your own world you can build relationships, make a contribution to the greater world, and enjoy life. It will be well worth the effort to create such a life, and to share it with others.”

At Practical Recovery we’ve been delivering these messages for a long time. We hope more professionals join us in making the public aware of them.