Choosing to enter a program in a drug treatment center is an important first step…
How to Build and Maintain a Solid Support System in Recovery
An estimated 20 million people are currently in recovery from addiction to alcohol and other drugs in the United States. They face myriad issues every day, any one of which can propel them headlong into relapse. Unfortunately, far too many of them will. Add to these numbers the estimated 22 million people who need treatment for addiction and the magnitude of the problem becomes even more significant. What can be done? Recovery experts say that building and maintaining a solid support system is crucial.
What is Recovery?
Many people mistakenly believe that recovery is simply a matter of abstinence. Get the addict to stop drinking, using, or engaging in addictive behavior – detox them – and they’ll be in recovery. If it were only that simple, we wouldn’t have the problems we do today.
The fact is that the field of recovery research is just beginning to grow. Treatment professionals and researchers now believe that there are many aspects of recovery, and there are numerous pathways to follow. There is no single solution that works for everyone.
While 12-step groups, such as Alcoholics Anonymous or Narcotics Anonymous or Gamblers Anonymous, for example, are the most common, there are really many ways to recover. Some individuals can be in recovery and also be in a maintenance program for their addiction. They may be sober, have good personal health, and be on a maintenance program, such as methadone or buprenorphine. This is a recent recognition, since previously it was believed that a person couldn’t be on a maintenance program and be considered to be in recovery.
Recovery is a process of change through which an individual achieves abstinence, as well as improved health, wellness and quality of life. It is increasingly being defined as long-term and wellness-centered. It involves an ongoing process of growth, self-discovery, self-change, and reclaiming the self. As such, recovery is shifting from a crisis-oriented, professionally-directed, acute-care approach with its emphasis on isolated treatment episodes, to more of a recovery management approach that provides long-term supports and recognizes the many pathways to wellness and health.
12 Principles of Recovery
The Substance Abuse and Mental Health Services Administration (SAMHSA) identifies the following 12 principles of recovery:
1. There are many pathways to recovery.
2. Recovery is self-directed and empowering.
3. Recovery involves a personal recognition of the need for change and transformation.
4. Recovery is holistic.
5. Recovery has cultural dimensions.
6. Recovery exists on a continuum of improved health and wellness.
7. Recovery emerges from hope and gratitude.
8. Recovery involves a process of healing and self-redefinition.
9. Recovery involves addressing discrimination and transcending shame and stigma.
10. Recovery is supported by peers and allies.
11. Recovery involves (re)joining and (re)building a life in the community.
12. Recovery is a reality.
The Importance of Healing the Whole Person
Simply detoxifying an individual and expecting him or her to go on to live a life of continued abstinence is both unrealistic and short-sighted. Just clearing the toxic substances from a person’s body does nothing to get at the many problems that may have contributed to the addiction in the first place.
For this reason, the whole-person approach to healing is now widely recognized as the most effective means of helping addicts to reach recovery. The whole-person approach to healing integrates all aspects of the individual’s life:
• Emotional well-being
• Physical health
• Spiritual peace
• Relational happiness
• Intellectual growth
• Nutritional vitality
Paths to Recovery
Studying paths to recovery, researchers have found that multiple paths exist. Some may find a single approach to be most effective, while others utilize a combination approach. Paths to recovery include, but are not limited to, the following:
• Natural Recovery – The individual uses no professional services or self-help. While this is rare, there are individuals who can make their own way toward healing. Generally speaking, such individuals are not chronic addicts or have less dependency on addictive substances. They also may not have genetic or biological predisposition or vulnerability to the addictive substance. They already have a good support system with family and friends and are highly motivated to become sober.
• Different Modalities – This path includes using various modalities and models of professional and specialty services, alone or in combination with 12-step or other mutual aid. It also includes psycho social and pharmacotherapy.
• Non 12-Step Mutual Aid/Self-Help – This path includes participation in organizations such as Secular Organization for
• Culture-Specific Approaches – Some of these include organizations such as Wellbriety/White Bison.
• Religion and Spirituality – For some, immersion into and reliance upon their personal spiritual and/or religious beliefs and ceremonies gets them on the path to recovery.
• Alternative Methods – These may be used alone or in combination with any of the above and include such alternative methods as yoga, meditation, acupuncture, and hypnosis.
What Recovery Means to the Person
Everyone in recovery has their own interpretation of what recovery means. For some, it’s as simple as the statement “I’ve got my life back.” A sense of being reborn, getting a second chance and an opportunity at a new life is very important to many individuals in recovery, and is often cited almost verbatim as such. Others cite being drug-free, having direction, self-improvement, achieving goals, more positive attitude, improved finances/living conditions, improved physical/mental health, improved family life, and having friends/support network.
Recovery-Oriented Systems of Care
The emerging model of recovery care recognizes that a systems approach is required. Coordinated support services are necessary using a chronic care model of sustained recovery management.
This model emphasizes post-treatment monitoring and support, long-term recovery-oriented (and stage appropriate) recovery education, peer-based recovery coaching, linkage to communities of recovery, and re-intervention when necessary. The emerging model includes ongoing support, peer networks, and auxiliary services as part of the overall addiction treatment plan.
The Recovery-Oriented Systems of Care (ROSCs) are designed to help individuals recover from substance use problems and disorders across their lifespan. ROSCs provide free and independent choices across an array of treatment and recovery support options. Services are provided in packages that are flexible and unbundled, and evolve over time to suit the ongoing and changing needs of the individual in recovery.
ROSCs provide the individual in recovery with access to a comprehensive array of services that are coordinated to provide support throughout the individual’s unique journey to sustained recovery. ROSCs include formal and informal community-based supports that are person-centered and build upon the resilience and strengths of individuals, families, and communities to achieve abstinence, health, wellness and quality of life.
How Individuals Can Sustain Recovery
Individuals need access to creative structures they can use when stresses arise that may cause them to relapse. These include having friends to call that can offer support and encouragement, developing a circle of non-drinking, non-using friends, and possibly having the right kinds of places to live.
In other words, those in recovery need to develop new connections. They need to find new friends that are clean and sober – to reduce the temptation for them to fall back into their old habits. They often need to change their location, to get out of the environment where they used to use, or lived with other individuals who continue to use. They need to pay attention to their spiritual development, possibly through meditation or prayer or introspection.
Some chronic, hard-core addicts – someone who’s been drinking for 20 to 30 years – cannot simply go through a 28- or 30-day program and come out with any likelihood of remaining clean and sober. They need a transitional phase, a place where they have continued support, counseling, education and other services to help them get to a point where they can re-enter society and have a hopeful chance at recovery. For these individuals, a half-way house or sober-living home may be this transitional step.
Many individuals need to learn how to do a resume, how to present themselves during a job interview, how to fill out a job application. The half-way house or sober-living home helps promote long-term stabilization.
Every recovering addict has different needs. All require a solid support system while they build upon their strengths in recovery. They may need to find a job, a new place to live, or to get back their relationships with family and friends.
Peer pressure is something that addicts are familiar with. When they were using, peer pressure may have been a factor in their
addiction. Recovery experts now recognize the benefit of peer pressure in recovery as well. This is the core of the 12-step groups: positive peer pressure helps keep the individual in sustained recovery.
Factors that help individuals sustain recovery include:
• Family Involvement – Persons that are in recovery need the emotional support and stability of the family. Some family members may need to be involved in family treatment, in order to build and sustain a healthy environment for the individual in recovery. This is one of the strongest factors affecting a person’s ability to maintain their treatment – to stay clean and sober.
• Personal Connection – The individual must be able to develop and maintain a strong personal connection with at least one therapist or counselor (or caregiver).
• Treatment Type – There are many different types of treatment that the person in recovery may be involved in – from replacement therapy (involving the use of prescribed drugs) to cognitive behavioral therapy (CBT), among many others. If a treatment type doesn’t feel right, the individual should continue to explore other treatment types and programs until they find the right fit.
• Personal Motivation – You have to want to be in recovery – and to remain in recovery. This often involves making hard choices, especially in early recovery.
• Outside Support – There are many types of outside support that may be required, including that from an employer. For example, the support of the employer in paying for a major or portion of treatment often means the difference between an addict’s being able to sustain recovery or falling back into relapse.
• Other Organizations – Whether faith-based or community-based, involvement in other organizations plays an important part in an individual’s sustained recovery.
Available Recovery Services
If you are in recovery, avail yourself of counseling (individual or group) and other behavioral therapies. These are considered critical components of an effective recovery program.
For many persons in recovery, medications are an important part of their overall treatment program. If you are prescribed medication – perhaps to help reduce or eliminate cravings, help with depression or anxiety – take it exactly as prescribed by your doctor. Recognize that these medications may take some time to work (antidepressants and anti-anxiety medications), so keep taking them to allow them time to begin to show improvement in your symptoms.
Join and participate in 12-step groups such as Alcoholics Anonymous (A.A.) (//www.aa.org/?Media=PlayFlash) or Narcotics Anonymous (NA) (//www.na.org/) or others. These 12-step groups are not affiliated with any sect, denomination, politics, religion, institution or organization. Many have separate groups for women. It’s been proven effective to participate in such groups during and following treatment. So, just because you went through treatment doesn’t mean that you stop going to 12-step support groups. In fact, your sustained recovery may depend upon your ability to draw upon the support of others who understand your situation.
Tips to Prevent Relapse
Sometimes it’s useful to have a condensed version of what to do to help prevent relapse. The following tips may be helpful:
• Select a treatment program that offers a variety of continuing care services – and actively utilize them.
• Find a recovery support group and stay actively involved with it.
• Involve your family members in family support groups and activities. These include groups such as Al-Anon (the family component of Alcoholics Anonymous) (//www.al-anon.alateen.org/english.html), Nar-Anon (affiliated with Narcotics Anonymous) (//nar-anon.org/Nar-Anon/Nar-Anon_Home.html), Gam-Anon (affiliated with Gamblers Anonymous) (//www.gam-anon.org/), and others.
• If your home environment is not conducive to continuing recovery, investigate moving to one of the growing communities of recovery homes.
• Recognize that you need to become an expert on your own addiction, and take responsibility for it.
• Learn techniques and strategies to help you when you feel the cravings or urges to use – so that you won’t revert to substance use during difficult or challenging times.
• Learn how to manage the tendency toward negative thinking. Use cognitive training or the help of others.
• Learn effective techniques to deal with conflict. This may involve the use of coping strategies or backing away, taking it down a notch, so that conflict does not escalate into heated arguments – and the potential for relapse.
Getting Back to Recovery After Relapse
If you do slip, it’s not the end of the world. It should not be looked upon as a failure, lack of willpower or courage. It happens. What do you do? You get back on the road to recovery. Get back into a supportive environment where you’ll have a much better chance of stopping the relapse and getting back on track with your recovery.
It’s also vitally important that you talk with others who have also undergone a relapse and come back from it. They know what you’re going through and can offer encouragement, support, recommendations and a non-judgmental ear – something you definitely need during this painful time. They can help provide you with coping tools – things that worked for them and have worked for countless others – so that you’ll be able to prevent relapse from happening again. Most of all, they will help you to understand that relapse is not unusual, it is preventable, and you can develop your ability to prevent it in the future.