We aim to improve the trajectory of affected individuals while supporting them towards a future of long-term recovery helping addicts recover and reintegrate into society productively with employment or another meaningful role in which they feel respected, valued, and supported by our community.
What is needed for recovery?
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To achieve recovery you need grit, stamina, the will to achieve and maintain active recovery.
It is possible to help facilitate the desire and support the stamina to achieve sobriety which is a significant hurdle and difficult to reach, much more so than remaining actively drug using. Once successful, being clean is harder than relapsing or continuing active drug use. However, only recovery will provide the opportunity for a rewarding life and true happiness. For this future, people affected by addiction must be inspired and believe a happy future is realistically attainable. To help an addict with recovery you need patience, respect, empathy, resilience, and tough love. It takes the village to support someone into recovery and sustained recovery. Remember that addicts are real people even if they do not act like it sometimes. Love them as people but don’t enable. To some extent, this is not possible. But after multiple rounds of being inadvertently used and abused, the victims of addicts can learn to curb enabling. Remember that people in active addiction are not in control of themselves. Do not take any irrational behavior as a personal insult. |
The Solution of Complete Abstinence
Virtually all addictive drugs cause some cognitive or emotional impairment with effects that last well after detoxification. Those who are able to achieve complete abstinence describe it as the deepest, greatest, most genuine happiness. These are the addicts in recovery who tend to integrate back into society most successfully, but because of the stigma of addiction, many people are not aware of who is a fellow addict in recovery around them.
Complete sobriety requires continued vigilance. There is no one solution for all addicts but for those who do embrace complete abstinence, the rewards are high. It is virtually impossible to sustain recovery alone. Peer support groups such as Narcotics Anonymous and Alcoholic Anonymous provide invaluable support, guidance, and a new path in life with effective drug abstinence. They inspired the individual to be the best human being possible, to recognize their flaws and to work always towards being a better person. These programs are often mistaken to be religious. In fact, they are led by spiritual principles and are not inherently religious. Religions can be applied but the programs are equally welcoming of atheists and agnostics.
Complete sobriety requires continued vigilance. There is no one solution for all addicts but for those who do embrace complete abstinence, the rewards are high. It is virtually impossible to sustain recovery alone. Peer support groups such as Narcotics Anonymous and Alcoholic Anonymous provide invaluable support, guidance, and a new path in life with effective drug abstinence. They inspired the individual to be the best human being possible, to recognize their flaws and to work always towards being a better person. These programs are often mistaken to be religious. In fact, they are led by spiritual principles and are not inherently religious. Religions can be applied but the programs are equally welcoming of atheists and agnostics.
The Solution of Medicated-Assisted Treatment (MAT)
Medicated-Assisted Treatment (MAT) is the best option to acutely stabilize an actively using person with opiate use disorder (OUD) and this is a wonderful resource for many situations such as when another medical problem requires acute compliance. For example, MAT can be ideal for an individual with endocarditis from IV drug use requiring IV antibiotics or for a cancer patient requiring any combination of time sensitive surgery, chemotherapy, and/or radiation therapy. Cancer care is further complicated by frequent need for pain management such that interventions such as combination buprenorphine/naloxone that interfere with the pain alleviating effects of opioids should not be used. This begs for the need of medical subspecialties understanding each other's interventions and care coordination between the substance use disorder at hand and the other medical concerns.
Beyond atypical situations of addiction in the face of multiple medical problems, MAT has a genuine role in today’s management of OUD. It has certainly brought a safer alternative to life in active addiction and unsafe practices. It has given individuals a stability and means to recuperate lost life, to be able to reintegrate back into their homes and society in a manageable way. It has been able to curb related overdoses and associated deaths, and has curbed criminal activity of theft and other acts of desperation to access drugs on street. It can also be a stepping stone for some individuals who may eventually seek complete abstinence.
Beyond atypical situations of addiction in the face of multiple medical problems, MAT has a genuine role in today’s management of OUD. It has certainly brought a safer alternative to life in active addiction and unsafe practices. It has given individuals a stability and means to recuperate lost life, to be able to reintegrate back into their homes and society in a manageable way. It has been able to curb related overdoses and associated deaths, and has curbed criminal activity of theft and other acts of desperation to access drugs on street. It can also be a stepping stone for some individuals who may eventually seek complete abstinence.
Improving What Works
An ideal complete abstinence program would include:
These programs do exist but quality programs are far and few between. The entire first year of recovery is a difficult one for addicts. They are slowly “waking up” and realizing thoughts, emotions, and senses that have been dormant during the entirety of active drug abuse which may be even multiple decades for some people. Most addicts do not have effective coping mechanism for stress since the fall back had always been repeat drug use. Typical adolescence maturation will not have occurred if the individual developed active addiction straddling this developmental period so it is common to have a 30 year old adult achieving sobriety after 15 years of drug use but with immature behavior that would seem more compatible for a 15 year old adolescent. Maturation will occur once sober but time and consistent support are needed.
- personalized taper and detoxification of the abused drug
- around the clock surveillance and support (more closely monitored in the first few weeks of recovery, but with a mandatory confinement in a supportive environment that is focused on recovery and not meant to be liken to incarceration)
- a maintenance phase of recovery that can be continued beyond the formal program
These programs do exist but quality programs are far and few between. The entire first year of recovery is a difficult one for addicts. They are slowly “waking up” and realizing thoughts, emotions, and senses that have been dormant during the entirety of active drug abuse which may be even multiple decades for some people. Most addicts do not have effective coping mechanism for stress since the fall back had always been repeat drug use. Typical adolescence maturation will not have occurred if the individual developed active addiction straddling this developmental period so it is common to have a 30 year old adult achieving sobriety after 15 years of drug use but with immature behavior that would seem more compatible for a 15 year old adolescent. Maturation will occur once sober but time and consistent support are needed.
Roadblocks to Recovery
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Legal Challenges
While a psychotic or suicidal person can be sectioned, without question, an addictive individual cannot even though they too are incapable of making rational decisions. There’s no established system to accurately assess an individual’s mental state as pertains to addiction. People in drug addiction are exceptionally good liars and the disease inherently can pull together the right front in times of need. MAT Abuse One significant problem of MAT that it is not well recognized by the medical community that the same medications used to help stabilize OUD patients are rampantly abused in the world of drug addiction. "Standard” doses are invariably inadequate for some individuals, especially for some users of many years. Care can be challenged by patient noncompliance, lying, and sometimes even belligerent behavior. A small increased dose above a stabilizing dose causes euphoria and individuals not committed to recovery may lie and essentially potentiate their active addiction this way. |
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