About 46% of people who once had an issue with drug or alcohol use achieved sobriety without formal treatment or assistance, according to a study published in Drug and Alcohol Dependence. The study found that addiction issues are common, with 9.1% of participants in a nationally representative survey reporting they had recovered from an addiction.

The study undermines some popular beliefs about addiction, particularly that all individuals recovering from addiction must see themselves as “in recovery” or seek inpatient treatment.

Many Pathways to Sobriety

The study began with a nationally representative survey of 39,809 people. Researchers followed up with 2,047 participants who answered in the affirmative to, “Did you once have a problem with alcohol or drugs but no longer do?” Some participants responded to follow-up questions incompletely or in ways that suggested they had not actually had an addiction. This left 2,002 responses to analyze. [fat_widget_right]

Slightly more than half (53.9%) of people who recovered from an addiction said they sought help to become sober. The most popular path to sobriety was through self-help groups like Alcoholics Anonymous. Around half (45.1%) of people in recovery used these programs to get sober. Medical treatment was another popular option, with 27.6% using some form of treatment in either inpatient or outpatient settings.

Recovery support services, such as faith-based programs and sober housing, helped another 21.8% of respondents become sober. About 37% used multiple forms of assistance to get sober.

The remaining 46% of respondents did not use traditional treatment or support to get sober. Just 46% of people who were once addicted to drugs or alcohol reported viewing themselves as “in recovery.” Many addiction treatment programs encourage people with substance abuse issues to see themselves as in recovery for a lifetime.

Authors of the study argue that this suggests there are many ways to achieve sobriety. Treatment providers might need to reconsider the way they talk about addiction and the way they encourage people in recovery to view themselves.

Who Seeks Treatment for Addiction?

The study also analyzed factors that correlate with seeking formal assistance to get sober. People who abused substances at an earlier age, who abused several substances, who were involved with drug courts, and who were diagnosed with a substance use or mental health issue were more likely to seek assistance to get sober.

People with opioid addiction were more likely to seek help, while those with an addiction to cannabis were less likely to pursue assistance.

References:

1. Almost half of those who resolve a problem with drugs or alcohol do so without assistance. (2017, November 01). Retrieved from https://medicalxpress.com/news/2017-11-problem-drugs-alcohol.html
2. Kelly, J. F., Bergman, B., Hoeppner, B. B., Vilsaint, C., & White, W. L. (2017). Prevalence and pathways of recovery from drug and alcohol problems in the United States population: Implications for practice, research, and policy. Drug and Alcohol Dependence, 181, 162-169. doi:10.1016/j.drugalcdep.2017.09.028

Think you know about relapse prevention? Answer “true” or “false” to the following questions:

1. If you stop the use of a mood-altering substance and then begin using again, you have relapsed.
2. Relapse can be avoided with willpower and self-discipline.
3. You have to hit bottom before you can get better.
4. Thinking about relapse will make it happen.
5. There are positive addictions.

The answer to each of these questions is false.

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Myth: If you stop the use of a mood-altering substance and then begin using it again, you have relapsed.

Reality: Relapse is a process with identifiable signs and symptoms that occur over a period of days, weeks, or months, not a matter of hours or minutes. The goal is to identify your signs and to train others to recognize them so they can help you interrupt them.

Relapse also cannot occur until you acknowledge there is a problem and take active steps to correct it. Often a person’s “clean date” and “sobriety date” are different. Many people report they initially stop using because of external pressure from parents, family, the legal system, or health reasons. It is only once you stop using the substance AND make the choice to do something different AND implement appropriate lifestyle changes that you become sober.

* * *

Myth: Relapse can be prevented with willpower and self-discipline.

Reality: Willpower and self-discipline are important parts of recovery, but are only two components. You need knowledge of what is happening to you, especially because the first phase of relapse often is denial. This is significant because if you are pretending there is no problem, willpower will do nothing to change your unhealthy behavior.

You first need to acknowledge the presence of a problem. You need information on what to do when you are in the relapse process, and you need a support system to confront your denial and help you get healthy again.

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Myth: You have to hit bottom before you can get better.

This is why it is so important to have a prevention plan in place, rather than just an emergency action plan. It is easier to prevent a crisis than to resolve one.

Reality: The belief behind the concept of “hitting bottom” is life has to be at its worst possible point before a person will take the steps to get better. The reality is you need to recognize you are experiencing some symptoms before you will seek help. It’s the same as recognizing a symptom like a fever or a sore throat before going to see a doctor.

But too much pain is not healthy. Your goal is to recognize the symptoms of relapse and get help before your situation gets bad again. This is why it is so important to have a prevention plan in place, rather than just an emergency action plan. It is easier to prevent a crisis than to resolve one.

Remember: A relapse isn’t just about using a substance. It is a signal something in your recovery is not working. Going through the relapse process can be a powerful experience of learning what not to do, identifying areas you need to work on, and reinforcing the attention that goes into recovery. The hope is to decrease the frequency, duration, and impact of a relapse.

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Myth: Thinking about relapse will make it happen.

Reality: The opposite is true. If you do not think about the possibility of relapse, you are likely to place yourself in higher-risk situations. Think about why you fasten a seatbelt. When you click it, do you assume you are going to be in an accident? No, you do it to protect yourself, just in case. The same concept applies to paying attention to your environment and the choices you make concerning mood-altering substances. You need to be aware of your thought processes so if a risky situation does come up, you are better prepared to deal with it. If you do not think ahead and practice self-awareness, you can be caught off guard and make an impulsive decision that might not yield the best results.

On the flip side, if you are thinking about using and see only the good things about it, this indicates a problem. While you may have had fun while under the influence, your misuse of substances did become a problem in your life. The hope is when you do reminisce, you will recall the negative things that happened as a result of using. Forbidden thinking is not healthy because it tends to increase your cravings. A realistic weighing of the pros and cons relating to substance use tends to yield better results.

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Myth: There are positive addictions that can be used to deal with negative ones.

Reality: There are no positive addictions. You may believe you can substitute healthier behaviors for negative ones. You may think it is better to smoke cigarettes than marijuana or to attend hours of mutual support meetings instead of spending hours in a bar. However, all addictions are harmful in some way. They usually indicate a loss of control and imply that the substance or behavior has taken over your thoughts and actions. Actions that might normally be considered healthy—such as going to church, exercising, and eating better—can have unintended consequences if taken to extremes.

If you cannot manage life without the behavior, it is a problem. The new, less destructive behavior is often covering up some other preexisting problem that needs to be addressed. The goal for healthy living is balance. Without it, some area of your life is likely to suffer.

For help with an addiction or substance use, contact a qualified counselor in your area.

References:

1. Gorski, T. T., & Miller, M. (1989). Mistaken beliefs about relapse. Independence, MO: Herald House.
2. Larimer, M. E., Marlatt, A. G., & Palmer, R. S. (1999). Relapse prevention: An overview of Marlatt’s cognitive behavioral model. Alcohol Research and Health, 23(2), 151-160.
3. Turner, C. (2017). Can I keep drinking? How you can decide when enough is enough. New York, NY: Morgan James Publishing.