How is recovery success defined?

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By Dr. Raul Rodriguez The Pineapple Contributing Writer Successful recovery from addiction can be defined in a number of different ways. Most people think of “clean time” when grading sobriety, but there is much more to it. Physical health, mental health, emotional health, spirituality, relationships, and happiness are all essential elements of global recovery success. Having a global perspective is critical. If you do not look at the big picture, you will miss something important. Ignoring any major facet of life will usually create problems that could have been prevented. To be perfect in every facet is not realistic, but to achieve some measure of improvement is. Betterment in one dimension will spill over and make progress in other dimensions easier. The desired effect, of course, is a decreased rate of relapse. The relative rate of relapse is a much more meaningful statistic than simple “clean time”. Simply counting the days of chemical abstinence may give misleading information about a person’s overall progress. To suddenly stop relapsing once and for all, without even a single unintentional setback, may be an unrealistic expectation for most. Some become unreasonably discouraged by a relapse that they really were not prepared to prevent. They see it as yet another failure and experience hopelessness. That is precisely the time when they must persevere. Most long-term success cases work through short relapses early in the recovery process. These relapses are typically shorter, minimally enjoyable, less frequent and not premeditated. A person who has a “slip” but has otherwise demonstrated global progress is in a more favorable position than someone who is fully abstinent but has not changed any other aspect of how they live. The degree of change in how someone lives their life will often determine their degree of recovery success. Positive changes result in decreased stress levels over time. Avoidable conflicts are avoided and unavoidable conflicts are managed more effectively and with less distress. Stress is a natural trigger for relapse so the less, the better. Improved self-care preserves gains in physical and mental health, which in turn protects against relapse. These positive effects of healthy living become increasingly more prominent over time. This beneficial effect of recovery is indisputable. A controversial topic in many recovery circles has been whether or not people on Suboxone qualify as being in recovery. Many 12-step groups believe those individuals are not in recovery. The medical community and many other non- 12-step recovery groups believe otherwise. The answer to this question lies in the very fundamentals of recovery. Is an individual experiencing intoxication or some other form of maladaptive reinforcement from the use of Suboxone? If the answer is “yes” then the person is not sober. If the answer is “yes” for any substance, or behavior for that matter, then the person would not qualify as being in a state of recovery. The addictive process is largely based on reinforcement of bad behavior due to the way the “addiction center” in the brain responds chemically to those behaviors. When there is no intoxication or maladaptive reinforcement from Suboxone, and just drug craving suppression, then the medication is just doing what it is supposed to do. Most people have this experience with this medication, which is why it is so effective at helping those individuals achieve prolonged abstinence from opioid-based drugs. The overall experience is characterized as a stabilizing, contributing to and facilitating normal behavior rather than fostering erratic addictive behavior. The neuro-adaptive changes that are typically induced by the active addictive process do not happen when a person is taking Suboxone properly. In a manner comparable to how addiction creates negative neuro-adaptive changes in the brain, recovery stimulates positive changes. The effects of these beneficial changes include less depression, less anxiety, and less addictive cravings. This allows for sustainable happiness that is stable and consistent over time. This is the true “bottom line” that really indicates success. When a person is chemically abstinent, but otherwise not living a globally healthy lifestyle, these positive changes develop less. This is typically seen in the “dry drunk”, who is abstinent but otherwise unhappy, unpleasant, and emotionally stunted. Everyone is capable of a successful recovery but a global approach is necessary. Abstinence is enough to start the recovery process, but more is needed. A person needs to grow emotionally, psychologically and spiritually by making positive changes in the many facets of life. Sustainable happiness is the ultimate goal of successful recovery, not just “clean time”. Raul J Rodriguez M.D. is the founder and Medical Director of the Delray Center For Healing, an outpatient treatment center with a clinical focus in the treatment of trauma, anxiety disorders, eating disorders, depression, bipolar disorder, and addiction.

Delray Center For Healing 403 SE 1st Street, Delray Beach, FL 33483 www.delraycenter.com • 888-699-5679