Does abstinence equal recovery? Certainly sobriety is the goal of most people who enter treatment. Most people celebrate their years of sobriety and consider that a marker of recovery. Certainly, length of sober time is something to be celebrated. But is it an end in itself?
Recently, the Substance Abuse Mental Health Services Administration published an advisory on the use of buprenorphine in the treatment of opiate use disorder (the new term for opiate addiction). A quote from Thomas McLellan and William White, addiction experts in England, was included in the advisory. It states in part “Neither medication-assisted treatment of opioid addiction nor the cessation of such treatment by itself constitutes recovery. Recovery status instead hinges on broader achievements in health and social functioning – with or without medication support. “
This isn’t a negative view of medication assisted treatment for opioid addiction. On the contrary, the advisory supports the safety and efficacy of medication assisted treatment (primarily use of buprenorphine/naloxone preparations) when used in a treatment setting with appropriate monitoring. The quote simply points out that taking medication alone does not really constitute recovery. I think that can be generalized to suggest that abstinence alone does not really constitute true recovery.
So what is recovery? Have you known someone who achieved abstinence but still seemed to have the same lifestyle they had before sobriety? Chaotic relationships, poor judgment, inability to hold a job – all symptoms of failure to really grow emotionally.
In my opinion, people who really recover from addiction have been able to finally figure out what their values are, what is important to them in the big picture of life. They get beyond daily frustrations, minor setbacks, dysfunctional family relationships because they have bigger goals.
They begin to think about what they believe in, what is important to them, and what contribution they want to make to mankind. Their worldview broadens beyond their day to day experience.
This may not be easy to achieve, especially for people who grew up in very dysfunctional families where the focus was on day-to –day survival. They haven’t had the luxury of thinking about life beyond their own daily existence, especially if they are still involved with their family.
That is really where therapy, sponsors, and group support can make a big difference. That is why most good medication assisted treatment programs insist on therapy along with the medication.
Certainly abstinence is a key element in recovery. You can’t have recovery without it. But true recovery is much more than that. What do you think constitutes recovery?