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.

12 comments:

Thomas A. McDaniel said...

I was glad to encounter this great and greatly needed blog. I find it curious that there hasn't been a lot more comment.

"Recovery" is kind of a misnomer with regard to addiction, isn't it? One doesn't really recover from diabetes or COPD, one manages those health conditions.

Still, the word is too much in all the literature now to hope for any improvement in verbal accuracy. It's bad enough trying to define "alcoholism." And how about poor alcohol, with all those people who abuse it?

Anyway, I wanted to comment about what happens following detoxification of the addicted individual (detox). At present, a counselor or a treatment team or a predetermined program indicates a schedule of activities, classes, counseling, and attendance in support groups -- in varying combinations with varying emphases and for varying lengths of time. Support groups are almost invariably 12-step programs, since alternative groups have not been around long enough to have a track record (and had no famous Saturday Evening Post articles written about them). Activities run the gamut from picnics to movies. Counseling may be with psychologists or social workers. Classes may concentrate on cognitive therapy or behavioral modification techniques for the self, or on physical effects of the drug of choice. Daily schedules may be relatively full, but probably are normally relatively light, so as not to "stress out" our fledgling "recovering" addict/alcoholic.

My comment on this, and something I will write about in my own blog later, is that most counselors I have ever met, most social workers, most psychologists, and even most physicians ... do not even begin to be qualified to determine for any alcoholic or addicted individual, what continued treatment should entail. In the light of recent additions to scientific knowledge in the field, the treatment of alcoholism in particular should be on the cusp of incredible breakthroughs, one following upon the other in rapid-fire succession. But practice insists on continuing to trudge through the mud of the safely ineffective traditional treatment paradigms.

Sociologists ignore nutrition and biochemistry, pharmacology; physicians ignore the importance of social milieu and behavior. So in the world of treatment for the alcoholic, we have not a dichotomy, but bona-fide schizophrenia, and an effective "recovery" (management?) rate hovering somewhere below 20%, depending upon who is bragging at the time.

It's a state of affairs that could tend to make one mad enough to get well.

tudor alexandru said...

There is neither a single agreed-upon definition of recovery nor a single way to measure it. But the overarching message is that hope and restoration of a meaningful life are possible, usually through the help of a drug and alcoholic treatment center.

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Anonymous said...

One of the widely accepted treatments for drug or alcohol addiction is 12-step treatment process. The treatment of any drug addict starts with drug counseling followed by pre-intervention and intervention treatment. Then he is admitted to either inpatient or outpatient programs.

Anonymous said...

When we say “Recovery” it is something that recovers from illness such as diseases or addiction and this would be from treatment process. The most popular treatment is alcohol addiction which is a step by step process. In fact recovery could be out inpatient or outpatient.
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Anonymous said...

I am working the AA 12 steps, 7 months sober, finished (I hope)my step 3 tonight. Over 25 years I have had counselling of many types for depression, + medication and hospitalisation. I sought oblvion, escape.I have now found THE only program for recovery that has worked for me having really reach the bottom, I can only describe the experience so far as an opportunity to recover through self awareness and replacing the thought and behaviour patterns which define insanity, with ownership and amends but no more guilt, love and a sense of belonging. My only hope, belief in a higher power (after all alcohol is also one) that can restore me.

Sydney said...

Yeah, absolutely true that the drug addiction is crime however the peoples are using different types of drug in form of alcohol. Now a day it is a very critical issue for us. Mostly the youngsters are doing these such types of things. I think it should be banned as soon as possible otherwise it may create so many problems for our coming generations. Well I don’t think I am alcoholic or dependant - yet. But I am surely approaching that and would love to stop. I drink every weekend and sometimes 3 times during the week. I drink and party with friends, and when I am sober I am a bore and useless with women. When drunk I am confident, and a player! Id love to stop completely but I need to build my social skills and confidence when sober. Anyone out there ever been on the same boat and got out?. Great Post i look forward to reading more!
Sydney
Drug Intervention Illinois

Unknown said...

RECOVERY IS HOW WE LIVE ONCE THE DRUGS AND ALCOHOL HAS BEEN REMOVED SEE ONCE ITS REMOVED IT BECOMES CLEAR THAT THEY WERE NOT THE PROBLEM BUT SYMBOLS OF THE UNDERLYING PROBLEM AS ALCOHOLICS AND ADDICTS WE SUFFER FROM A MENTAL OBSESSION WHICH IS THE THOUGHT THAT OVER RIDES ALL OTHER THOUGHTS WE ALSO SUFFER FROM A PHYSICAL ALLERGY WHICH LEADS TO THE INDICATOR AND IT IS A PHENOMINEM OF CRAVING SEE DR SILKWORTH SAYS IN THE DOCTORS OPINION THAT WE DRINK BECAUSE OF THE EFFECT THE ALCOHOL PRODUCES SAME WITH WHY WE USE DRUGS,HE ALSO SAID THAT WE ARE DRINKING TO OVERCOME A CRAVING BEYOND OUR MENTAL CONTROL BINGO THERE IT IS SO NOW THAT WE ARE SOBER WE HAVE TO LEARN TO DEAL WITH THE REAL PROBLEM AND THAT IS US AND THUS RECOVERY FROM A HOPELESS STATE OF MIND AND BODY BEGINS WE ARE NOT CURED OF ALCOHOLISM IT IS A PROGRESSING ILLNESS BUT WHAT WE DO GET AS LONG AS WE STAY SPIRITUALLY FIT IS A DAILY REPRIEVE CONTINGENT ON OUR SPIRITUAL MATINCE IF WE OVER COME THE SPIRITUAL MALADY THEN OUR BODIES AND MINDS STRAIGHTEN OUT A COMPLETE PSYCHIC CHANGE SUFFICENT ENOUGH TO BRING ABOUT RECOVERY AND TOTAL ABSTINCE OF ANY AND ALL MIND AND MOOD ALTERING SUBSTANCES IS THE ONLY SOLUTION DOES THAT MEAN THAT JUST CAUSE I DRANK ITS OKAY TO DO SUBOXON?? NO IT DNT COMPLETE ABSTINCE MEANS COMPLETE ABSTINCE WELL I LOVE YALL AND THATNK YOU FOR ALLOWING ME TO TREAT MY DISEASE MY NAMES B AND IM AN ALCOHOLIC SOB 8-20-2008

Anonymous said...

what does dug in mean?

Salvage Yard Halfway House said...

Nice to read somebody's own story..