Assessing addiction-recovery success by how many consecutive days a person is sober is like measuring type II diabetes-treatment success by the last time an individual with this condition sipped a Frappuccino or ate a piece of cake.

24 Hour recovery tokenIf somebody relapses after, let’s say, five years of sobriety, is that person now a newcomer needing to pick-up a “white chip” to acknowledge being one day into recovery? Has that individual really regressed back to square one?

Irrespective of one’s pathway to recovery (AA, SMART Recovery, religion, treatment facilities, etc.) we do not view this scenario as a “white-chip moment.” Assessing substance use disorder (SUD) from the singular perspective of “days sober” distorts the nature of recovery and often leads to shaming and stigmatizing further the already stigmatized population of those with SUD. The inverse is also true—it is a faulty inference that somebody with five years of sobriety must be “more recovered” than somebody with two years or even somebody with two months. We look forward to the day when the broader recovery community views substance use disorders in a more refined context than “black and white”—this change of perception will likely lead to better outcomes (demonstrated empirically by assessing the many indicators of recovery) than the singular-variable (days sober) “old paradigm.”

The person that relapses after five years of recovery still likely experienced five years of varying degrees of struggle, confusion, overcoming adversity, wisdom gathering, and self-discovery. With this example, we must recognize that the individual remained committed to living a life of recovery for 1,825 days—this is a monumental triumph in and of itself. If this individual then relapses for, as an example, a two-week period, it does NOT invalidate or lessen that person’s recovery. Often, the “relapser,” can transform that obstacle into the pathway for an even deeper level of self-development and an increased ability to serve others navigating a similar situation.

It is often significantly more damaging for others in the recovery community to “assign” this person back to the “role of a newcomer” in a way that disregards all the individual’s growth and accomplishments while reinforcing the rigid ideology that recovery is defined by, singularly, the abstinence of substances. Aligning with the mentality that the guy with five years of recovery “threw it all away,” we believe, directly correlates with more pronounced addictions, more overdose deaths, more misguided stigmatization, among other negative consequences to the individual and to the “SUD cause.”

To allow the relapse to move from “a tragic mistake” to “an opportunity for growth,” generally requires self-reflection, uncovering the lessons contained within the relapse, and NOT being swayed by others’ “narrative” of the relapse (no matter how much sober time such individuals may have). This approach and perspective on relapses can facilitate transitioning the conversation to focus on new perspectives gained rather than having lost something.

Some potential questions to develop new perspectives include:

  • What were the main factors that led to my relapse and how might I navigate these same factors in the future?
  • What can I preserve the recovery capital I had established prior to the relapse?
  • How might I process potential feelings of shame and guilt so that I can return to my recovery practices with a renewed sense of vigor?

We believe that recovery is defined by the presence of a new and improved way of life. This perspective on recovery can be (and is) demonstrated empirically via “measuring” the individual’s changes across multiple dimensions through time. The particulars of how to develop and implement such a process is beyond the scope of this blog post—yet a subset of the changes measured (via numerical scales) relate to areas like:

  • Substance use; urges to use; craving frequency
  • Interpersonal relationships
  • Psychological and medical issues
  • Personal confidence and feelings of hope
  • Life satisfaction
  • Achievement of goals; resolution of problems
  • Willingness to ask for help

This type of approach to assessing recovery is already being done effectively by a subset of stakeholders dedicated to advancing our collective understanding of substance use disorders. As such, our priority is advocating alongside of thought-leaders like the non-profit Shatterproof  and Substance Abuse and Mental Health Services (SAMHSA)—which defines recovery a containing:

“Dimensions [of recovery] that are meaningful to people in recovery, scientists, clinicians, and other stakeholders . . .” the multidimensional aspect “implies change, with the main elements of a reduced relationship with substance use (either abstinence or significant reduction) and improvement in a person’s quality of life.”

So, in practical terms, what is recovery? Our perspective is that recovery is more about changing in ways that allow us to feel free and capable of being our best versions of self than singularly achieving freedom from the compulsion to use substances addictively. Said differently, if progress has been made relative to the many underlying causes of the addiction (maladaptive behaviors, undeveloped coping skills, underlying mental health issues, etc.), even before abstinence is achieved, that represents being on the pathway to recovery. This belief system stands in stark contrast to comments many in early recovery receive, such as “you simply are not ready yet” or “you must not want it badly enough.”  These comments, even if they are helpful to some, are more often damaging to many.

Going further on this idea, consider that we may have, as a community, developed a streamlined definition of recovery that deprives people of the ability to create individual paths and lead self-directed lives. Consider that by telling those in recovery that relapse, “once an addict, always an addict,” and treating the relapse as a travesty, we have placed a judgement onto these individuals that is not actually backed by science, statistically significant data, or even reflective of that person’s reality. The concepts of “once an addict, always an addict” or “relapses should be punished” (for example, demanding the person who relapsed to find a new provider for SUD treatment or a new sober home) became biproducts of a “culture of recovery” popularized more than 80 years ago. Can you think of other medical conditions that have anchored to “knowledge” from so long ago because of tradition or the perception that considering new, scientifically validated perspectives on recovery to be, for many, blasphemous?

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