May 27, 2020
By Dr. Howard Wetsman
The word “recovery” has been so effectively appropriated by 12-step programs that the two have become synonymous. As more medical professionals recognize addiction as a chronic illness, recovery has come to mean “recovering from the illness” in the same sense that patients recover from conditions like diabetes or cardiovascular disease. Thinking this way has led some professionals to label “real recovery”
as classic, 12-step participation without the aid of medication.
It’s easy to want recovery to have a neat definition that you can pinpoint, but labeling anyone’s recovery journey as real or otherwise benefits no one — especially someone who is trying to recover. Like addiction itself, recovery is a personal process that’s unique to each individual, and as long as he’s getting better, he’s recovering. Each person’s journey is his own and must be taken at his own pace. If doctors and loved ones don’t allow that, there likely won’t be any recovery at all.
People with Addiction Don’t Fit into the Same Box
For about 100 years, we thought of addiction as a moral failure
— a pattern of behaviors that everyone had the power to change. We considered addiction solely a drug problem
and consequently assumed that limiting drug use was the answer. And we misunderstood recovery, thinking a successful recovery should be within reach for anyone with the willpower to get better.
This mindset blames the person with addiction for his own illness. By doing so, our assumptions have led to dangerous stereotypes about addiction recovery:
Stereotype 1: “If you’re on medication, you’re not in ‘real recovery’; you’re in ‘medication-assisted recovery.’”
Those who believe recovery is only real if it’s done without medication ignore the fact that addiction is a brain illness, not a symptom of weak willpower. For many patients, medication is vital to help them find the balance they need to recover. This stereotype devalues their needs and can increase their likelihood of falling back into active addiction.
Stereotype 2: “If you’re not recovering the way I am, you’re not in recovery.”
When recovering from addiction, psychological support from peers is important, especially from those who struggle with the same illness. Because of our long-held (and erroneous) beliefs about addiction, many people believe there’s only one successful road to recovery and anyone who doesn’t follow it will never get better. But patients need to be able to recover in their own way.
Stereotype 3: “If you focus more on material things than on the spiritual aspects of life, you aren’t in recovery.”
It’s true that successful recovery requires a shift in thinking and priorities, but focusing on material things isn’t inherently negative. Many people with addiction don’t think about their basic needs — like food, shelter, clothing and transportation — until they begin to recover. It’s a sign of awakening, not weakness.
These stereotypes are damaging. When we tell someone with addiction that he isn’t doing recovery right, we risk generating feelings of inadequacy and failure. These same feelings are often what trigger addiction in the first place, and they can undo much of the patient’s hard work and worsen the illness.
No one recovers on our terms. They do so on their schedule, using methods that meet their unique needs. We must respect and support that individuality or risk driving someone back into the arms of active addiction.
If you or someone you know is struggling with addiction, find a treatment center that will successfully treat the brain illness, which involves being considered as an individual patient, not just an illness. This doesn’t mean the doctor will leave treatment options completely up to you; he’ll use his expertise to develop treatment plans
that address your specific needs.
Patient-centered treatment plans should define your goals for treatment, not the physician’s. There are several techniques to help people with different treatment needs get into and stay in recovery. Learn them all, and learn how to determine which techniques work best for which types of patients. As a result, you’ll already be prepared when your doctor presents your options.
Addiction isn’t one-size-fits-all. The same goes for recovery, so find a doctor who will meet you where you are and work to help you reach your goals. The term “real recovery” will only get in the way.
Dr. Howard Wetsman is an addiction medicine physician and psychiatrist living in New Orleans. He is the chief medical officer of Townsend Treatment Center in Louisiana and is a member of the board of the American Society of Addiction Medicine.