Monday, February 12, 2007

What Does Recovery Mean?

In the addiction counseling world, "recovery" is the word most often associated with successful treatment. But we also hear that someone has "recovered" from alcoholism or that someone has just entered a "recovery program" for drug addiction. Those "in recovery" often refer to themselves as "recovering" from their addiction. So what do these variations on the word "recovery" really mean?

In Alcoholics Anonymous (published in 1939 and known as "The Big Book"), the word "recovered" refers to an AA promise: If a person applies the principles of the program, the desire to drink will be removed -- and will remain removed -- if the person continues to participate in the recommended program of recovery.

So in Alcoholics Anonymous, the term "recovered" has significance beyond simple abstinence. Its extended meaning relates to the essential psycho/social/spiritual changes that must occur in the life of the recovering person. AA stresses that abstinence alone is "but a beginning." The alcoholic must be willing to fortify his recovery by taking responsibility for past mistakes, repairing relationships, developing a commitment to spiritual principles and helping others.

While the continued maintenance of sobriety is best served through attendance and commitment to AA or NA (Narcotics Anonymous) meetings, treatment programs play a vital role in the early stages of recovery.

These programs should offer access to detoxification services for those needing assistance with the symptoms of withdrawal. Because many drug addictions pose health hazards during withdrawal, the professional addiction counselor must first assess these risks. Physical withdrawal from cocaine, for example, is terribly uncomfortable because of cravings, but it is generally not dangerous. However, withdrawal from alcohol or benzodiazepines (Valium, Xanax and Ativan) can be life-threatening and must be closely monitored. Opiate (heroin and Oxycontin) withdrawal is physically less dangerous, but painful symptoms make it nearly impossible to successfully withdraw without medical intervention.

But detoxification alone only readies the individual for the next step in the healing process: treatment. While many addicted people and their families believe that a few days in a detox center will cure them, without continued treatment the vast majority will quickly relapse.

So, following detox, a counselor must determine the level of treatment needed. Choices include intensive outpatient (three to five days a week), short-term residential treatment (30 to 60 days), or long-term residential treatment (more than 60 days). The decision is based on the individual's duration of addiction, drug type, physical status, home environment, family support system, and access to other necessary resources, such as AA or NA meetings. Once the level of care has been determined, an individualized treatment plan is instituted, which outlines the course of treatment and expectations of both the treating facility and the client.

A final segment of treatment provides an aftercare program that allows the client to continue receiving services as long as necessary to ensure continued sobriety. Addiction is a devastating disease, and while the physical body may heal quickly, the healing of relationships takes much longer. On-going counseling and attendance at AA or NA meetings offer the newly recovering person the best opportunity for continued success.

The aftercare plan also should outline what actions will be taken in case of relapse. Relapse is a reality with any addiction, and relapse prevention services are particularly beneficial to recovering addicts as they work toward reintegration into their families, jobs and community. Family members and other concerned persons also should develop a relapse plan. Handled appropriately, relapse actually can propel an addicted individual into stronger commitment toward recovery.

The recovery model developed by Alcoholics Anonymous is alive and active today. Effective professional treatment programs strongly recommend active participation in Alcoholics Anonymous, Narcotics Anonymous, and related family groups of Al-Anon and Alateen.

The concept of recovery as expressed in the program of Alcoholics Anonymous offers the hope -- and promise -- that if a person follows the directions outlined in the program, his problem with alcoholism (or any drug addiction) will be "removed." To be sober and free of the desire to use alcohol or drugs is the great promise of recovery.