Recovery, A Broad Concept:
Exploring multiple pathways to recovery is not just a consideration; it's imperative.
By definition, recovery means a return to a normal state of health, mind, or strength.
When we talk about addiction recovery, the definition is also the same. However, many people have a preconceived notion when they think about what recovery is, and what others’ recovery should look like. Often, recovery is thought of as complete and total abstinence from any drugs and alcohol.
The definition of recovery is a working one. Substance Abuse and Mental Health Services Administration (SAMHSA) defines recovery as a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.
Abstinence from all drugs and alcohol is not a requirement for recovery. Despite this, it is often what many providers utilize as the preferred treatment modality. Simply put, abstinence may not always be the choice for everyone, or may not be possible for everyone, right now, or ever. People seeking recovery from their drug and/or alcohol use may have attempted abstinence. After all, it is the most traditional and common solution recommended; it is practiced by nearly all substance abuse treatment programs and the majority of 12-step self-help programs.
So, if you are unable to succeed at an abstinence-based model, what do you do now?
Do you continue using drugs or alcohol in a way you see as problematic, or are there other options?
“Two roads diverged in a wood and I – I took the one less traveled by, and that has made all the difference” - Robert Frost
Medication Assisted Treatment (MAT) refers to medication used in addition to other behavioral therapies and counseling. MAT can be helpful in sustaining long-term recovery and is most often used for persons with an opioid use disorder, however can also be used for those with alcohol use disorder, and is being explored for those with other substance use disorders.
Click here to learn more about the different types of MAT and if MAT may be a useful tool for you. Safe Project: MAT
Harm reduction is a concept that does not require complete and total abstinence. Harm reduction is a set of strategies and ideas aimed at reducing negative consequences associated with substance use. These negative consequences may include but are not limited to: health concerns, death, incarceration, motor vehicle accidents, conflict with family, employment, etc.
The primary idea in harm reduction is meeting a person where they’re at not turning people away for their inability or lack of desire to conform to a specific idea of recovery. Some people that started utilizing a harm reduction model may choose abstinence, however, this is not necessarily the goal. The goal, again, is to reduce the consequences associated with drug use.
Here’s a scenario:
Someone acknowledges their use of heroin is problematic. They have overdosed multiple times, have been arrested, and are having major conflicts at home with their family. Due to missing excessive days, they recently lost their job. They use marijuana and occasionally drink alcohol. Recently they have tried to stop using heroin on their own, however withdrawal has been very difficult. They reported that marijuana has been helpful in managing their cravings, as well as some mental health symptoms. They report no interest in discontinuing marijuana use at this time. They seek treatment from a traditional treatment center. The treatment center explains that complete and total abstinence is a requirement of the program. The person leaves the assessment, feeling defeated. From the recommendation of a friend, they attend a Narcotics Anonymous meeting and are also told that total abstinence is the basis of the program. They leave the meeting feeling they are unable to get the help they are looking for.
Now, someone looking at this scenario may think that this person should be abstinent from all substances. However, if we utilize the Multiple Pathways to Recovery approach, which implies that recovery is broad and that many routes can get you there, who are we to judge another person’s pathway? What could happen next if we only utilize an abstinence based model? The person is unable to get the help they are seeking and is likely to continue the pattern of behavior that they know, so naturally they continue using heroin and run the risk of dying from an overdose. Now what? If we are able to help others enter their own pathway to recovery, we are much better able to prevent severe consequences.
Simply put: Dead people can’t recover. Harm reduction saves lives.
Here at NJ Recovery & Wellness, we support multiple pathways to recovery. We support various approaches and will collaborate with you to identify your goals and the way you would like to reach them.
Clinician & Harm Reduction Advocate - Jess Barrows, LCSW, LCADC