There are Many Definitions of Recovery – Which One is Right for You?
Recovery is recovery is recovery – Isn’t it? Isn’t recovery the same thing for everyone finishing rehab? Aren’t we all talking about the same thing?
Actually, we’re not. There are many definitions of recovery, depending on whom you talk to. And it’s important to know which definition of recovery fits the end product you have in mind when you are choosing a rehab.
The way a group defines recovery will shape the services that group feels should be delivered to an addicted person. So the exact definition of recovery being used is a very important starting point that can be used to evaluate a program or approach to recovery.
Let’s take a look at some of the ways recovery is defined by government agencies, researchers or other professionals.
The Substance Abuse and Mental Health Services Administration (SAMHSA)
Their definition is: A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.
SAMHSA further elaborates on this definition in their publication Principles of Recovery. They recommend addressing all these aspects of a life in recovery:
- Health: Overcoming or managing one’s disease(s) or symptoms—for example, abstaining from use of alcohol, illicit drugs, and non-prescribed medications if one has an addiction problem
- Home: A stable and safe place to live
- Purpose: Meaningful daily activities
- Community: Relationships and social networks that provide support and more
SAMHSA’s materials make it clear that for it to be successful, addiction recovery must address many aspects of life. It should not be limited to whether or not a person uses and craves drugs or alcohol.
This seems like a good guideline to me. What do you think?
Medication-Based Treatment (MAT)
Many professionals are firmly in the camp that believes that addiction recovery for those addicted to opioids must include medication. Specifically, that medication should contain methadone or buprenorphine as a replacement for the opioid itself.
The opioid in this formula (methadone or buprenorphine) maintains a level of this drug in the person’s bloodstream. The person stops using their drug of choice—heroin, OxyContin, hydrocodone, whatever—and they do not go into withdrawal. Their cravings are to some degree reduced.
Some people take advantage of these changes to seek counseling or support so they can maintain an honest and productive lifestyle. Other people try to add other drugs on top of their medication because of the desire to get high or to blot out the problems of life which still exist. One young woman taking Suboxone said, “That obsession to use never went away.”
A person in favor of this method of treatment will object—sometimes with great ardor—to any claim that a person on methadone or buprenorphine is not “sober.” They’ll claim that prescribing methadone or buprenorphine is a method of achieving recovery. But is it?
The answer is not so simple.
These drugs can be used as a pathway to sobriety. Medication-assisted treatment does allow a person to normalize their lives, to stop committing crimes to get money for drugs. They can often find employment IF they comply with their medication schedule and don’t seek other ways to get high. After all, sedatives, stimulants like cocaine, plus alcohol and marijuana are still available to them. But just because it's excepted, can it really be called recovery?
Perhaps the saddest thing about medication-assisted treatment is that in too many cases, this is all the help some people get. Their recovery consists of relying on an addictive drug. A program that actually rehabilitates their ability to live a fully drug-free life is not made available to them.
Should MAT Alone Be Enough?
Not according to SAMHSA. “Medication for [opioid use disorder] should be successfully integrated with outpatient and residential treatment.” Not dispensed without concern for how this person can rehabilitate their body, mind and soul.
If relying on this addictive drug was as good as treatment could possibly get, then perhaps MAT alone could be acceptable. But maybe it’s not as good as it gets. Let’s keep looking.
The Journal of Substance Abuse Treatment
In 2007, this journal published an article from William White, a researcher and addiction counselor. Mr White strove to define recovery and whether or not abstinence was required to truly be in recovery.
His answer was a bit complex so I’ll reword it in simpler terms. To be in recovery, you should be in sustained abstinence from a drug to which you previously met the criteria for addiction.
“addiction scientists have generally defined recovery from illicit drug dependence in terms of problem resolution rather than the absence of drug use.”
He further states that “addiction scientists have generally defined recovery from illicit drug dependence in terms of problem resolution rather than the absence of drug use.” For example, there would be a “reduction of drug use, criminal involvement and unemployment.”
Is this a good definition for recovery? Using his definition, a former heroin addict could be validly in recovery while using marijuana and drinking alcohol daily as long as he wasn’t using enough to get addicted and he kept his job. Maybe that definition falls a little short.
American Society of Addiction Medicine
This group finally addresses dependence on any addictive drugs during recovery. In 2005, they published a statement saying that a person is in a state of recovery if they have “reached a state of physical and psychological health such that his/her abstinence from dependency-producing drugs is completed and comfortable.”
That’s starting to sound like a more common-sense definition. Would you agree?
So What Constitutes Recovery at a Narconon Drug Rehabilitation Facility?
Good question. On the Narconon drug rehab program, the focus is truly on rehabilitation. Each person should be able, by graduation day, to create a fully abstinent life for themselves. They should not need to rely on any mood-altering drug. (Of course, if they have medical conditions that need medication they should follow their doctors’ recommendations.)
They should be capable of overcoming life’s ups and downs without self-medicating with alcohol, marijuana or other drugs. This is not to say it’s always easy to cope with ups and downs, but they should be able to succeed without relapsing.
Because most people consider an enjoyable life to be one in which they can achieve their goals, being productive and progressing towards one’s own goals are important parts of recovery. To help a Narconon graduate make this progress, the abilities needed are taught in the life skills component of the Narconon program.
What about that “obsession” to use drugs the woman taking Suboxone mentioned? A graduate from the Narconon program is not plagued by cravings so severe that they can’t be resisted. Many people finishing an early step of the program, the Narconon New Life Detoxification, talk about how this sauna-based detoxification step relieves the worst of their cravings—sometimes they have no physical cravings at all.
The Narconon program is designed to rehabilitate a person’s ability to enjoy an abstinent life. He or she should graduate with the skills, self-esteem and freedom from the trauma of the past to be able to live a forward-looking life. A life without drugs or alcohol.
For those of us affiliated with the Narconon program, this is what recovery looks like. We want everyone who once suffered the desperation of addiction to achieve this freedom.
That’s why treatment that begins and ends with medication may be selling people short. Those people deserve the ability to wake up fresh and drug-free every day.
It could take a long time to get to the point that every addicted person can achieve this result, but a belief that being drug-free is the only acceptable result of treatment is the starting point to achieve that goal.
Sources:
- https://store.samhsa.gov/system/files/pep12-recdef.pdf
- https://www.ncbi.nlm.nih.gov/books/NBK424846/
- www.ncbi.nlm.nih.gov/books/NBK424856/def-item/glossary.gl1-d42/
- https://www.nytimes.com/2013/11/17/health/in-demand-in-clinics-and-on-the-street-bupe-can-be-savior-or-menace.html
- http://www.hngnews.com/lake_mills_leader/article_57e6a062-d90e-5880-8ef1-e6995a314cd4.html
- https://medicine.yale.edu/edbup/quickstart/TIP_63_338482_42801_v1.pdf
- https://www.researchgate.net/publication/5955477_Addiction_recovery_Its_definition_and_conceptual_boundaries
- https://doi.org/10.4324/9781315227221
- https://www.narconon.org/drug-rehab/life-skills.html
- https://www.narconon.org/drug-rehab/new-life-detox.html
- https://www.narconon.org/drug-rehab/objectives-course.html
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