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The problem with the above is not with the answer, it is with the question. The way the question is worded assumes that all people who use substances comprise a population composed of similar individuals, while in reality we find people experiencing a range of substance use patterns and problems. Some definitions are in order.
Harm reduction is the process of reducing harm to the individual or society without necessarily reducing or eliminating the substance use. Examples of such strategy are drinking low risk amounts, changing the drinking pattern such as not drinking and driving or taking prescribed psychoactive medications only as prescribed.
In contrast, the disease model describes a disease, disorder or illness which is progressive, fatal and incurable. It is also described as a chronic, relapsing brain disease, for which there is currently ample evidence, and for which the only reasonable intervention is total abstinence. These two positions initially appear to be totally incompatible until one looks at the different patterns of use and the best way to do so is to divide the population of users by degree of risk.
There are individuals who make low risk choices characterized by drinking low risk amounts, not drinking in high risk situations (e.g., driving or operating machinery), using prescribed psychoactive medications only as prescribed and no use of illicit drugs. We will refer to this as “Risk Phase 1. Their use results in no problems and there is no significant increase in tolerance. The harm reduction strategy for this population is to continue to make low risk choices, or said another way, no change from the current pattern.
In this next phase of risk, Phase 2, individuals are beginning to use substances in a high risk manner such as drinking high risk amounts and making high risk choices (drinking enough to be impaired when driving) or misusing prescribed medication. In this phase, individuals may develop social dependence and we see the onset of state dependent learning. The individual may begin to have problems such as a single DUI or missing work but as yet without consequences but does not meet diagnostic criteria for substance abuse or dependence. A harm reduction strategy for these individuals is to return to Phase 1, return to making low risk choices. .
People in phase #3 present a more complex picture. In this phase we find the development of psychological dependence, the substance use is more integrated into the person’s life, there is state dependent learning, high risk choices become more important than relationships and we find the individual defending his or her use choices. This phase tends to correspond to substance abuse or substance dependence without physiological dependence.
Individuals in this phase manifest substance-related health or impairment problems, blackouts and drinking to cure hangovers. While return to low-risk drinking choices may still be possible, only about 50% may be able to do so and the individual may require outside help to change choices. The critical issue here is that continued use likely to lead to Phase 4 (see next) and the safest choice at this point is total abstinence.
Phase 4 represents the most severe pattern of use and corresponds to the diagnosis of substance dependence with physiological dependence. In this phase we see physical addiction, withdrawal, compulsion, loss of control and increasing tolerance. The substance use now results in more negative, more severe outcomes than in Phase 3 up to possible institutionalization or death. Since return to low-risk choices no longer possible, the only rational response requires total abstinence, which usually requires outside help to achieve and maintain.
For many clinicians who hold to the disease model of addiction, the idea of harm reduction is repellent because they think of it as applied to those people that find their way into treatment. However, on average, these patients in treatment are in treatment because they have the most severe substance use disorders and its resulting problems (e.g., legal, employment, medical, family). They are generally in Phase 3 or 4.
For those in Phase 3 harm reduction (trying to return to a lower risk pattern of use) may be hazardous and for those individuals in Phase 4, harm reduction is inappropriate and contraindicated. However, for those in Phase 4 who are in the Precontemplation Stage of Change, a non-abstinence approach such as reducing amount or frequency of use, is sometimes employed as an intermediate goal.
Returning to the original question of whether harm reduction and the disease model of addiction can coexist, the answer is a definite “yes” and is clearly related to the degree of risk or problem severity of the substance user. While the only totally safe alternative for every drinker/user is abstinence, people in Phases 1 and 2 are unlikely to choose abstinence, and by forcing them into this position we risk the opportunity to apply harm reduction strategies to halt the progress of the problems and thereby reduce the harm to the individual or society.
One of the hardest things to do as a parent is to watch a child self-destruct. We want to help our children succeed and to live lives free from pain and trouble. For a family that is being tested by a substance-abusing teen or young adult, the parents suffer as much as their child.
“Recovery Benefits Everyone” is the theme for this year’s Recovery Month. This holds especially true for parents whose child is in need of recovery. Too many parents have had to stand by and watch their child become lost to substance abuse. Too many parents feel helpless to do anything for their child because they feel like they’ve done everything they can to help, and failed. There are things parents can do to prevent their child from abusing substances, and to help them if they are addicted.
Parents need to remember while their children are still young that they hold much power in the anti-drug/alcohol struggle with their children. Teens and adolescents do hear what their parents are saying and are much less likely to get caught up with substance abuse if their parent had regular talks with them about it. Talk to your child early and often about the dangers of drugs and that you expect them to avoid using them.
Many parents miss a crucial window of opportunity to get their substance-abusing child help. Parents don’t want to overreact, or they are too busy to notice, or they are too ashamed to admit it is happening to their family. For these reasons, many parents wait and try to handle the situation on their own, rather than get their child help right away. Parents of teens must remain vigilant in talking to their child and watching for signs of drug abuse. Sudden changes in behavior, a change in friends, dropping grades, demanding of privacy, and being more secretive are all things that teens tend to exhibit when they are first starting to get hooked on drugs. It is at this time that a parent should seek help, rather than waiting.
If a parent has tried to get help for their “hopelessly” addicted child and they keep sinking deeper and deeper into their self-destructive behavior, there are still things a parent can do. It may be necessary to show tough love, or to let the child fall to rock bottom before they can recover. Or, maybe the child just needs a supportive parent to stand by them. It is at this time that it would be helpful for the parent to seek professional help for their entire family. A parent can learn from a therapist or support group about what they need to do to help their child. Parents who feel they have no place to turn need to allow a professional to step in and help.
Continuing with numbers 6 through 10, these are the most common myths people have about recovery. Myths 1-5
Myth 6. You can’t force someone into treatment. A person, in the end, has to want to recover for it to be successful, but people do enter into treatment for reasons other than wanting to get better. Family interventions that persuade someone to be carried off to treatment, court orders, and other involuntary means can “force” a person into treatment, and these means are just as effective as a person walking in under their free will.
Myth 7. Treatment is treatment; it’s all the same. One of the main misconceptions about recovery is that rehab is the same everywhere. Many people have failed at their program because they believed this myth. Everyone is different, and there are different types of rehab and different programs that can be tailored to meet someone’s needs. Some people are more likely to succeed if they are in a program with their peers, others thrive in a secluded atmosphere. Still others will require a program that treats their specific addiction or has the medical capacity for them to safely detox. Treatment should be personalized for each patient.
Myth 8. Relapse sends you back to square one. No one wants to relapse. Everyone going through recovery is afraid of it. It is important for someone in recovery to heed the warnings of doctors and therapists, in an effort to prevent relapse. Developing good stress relieving techniques and avoiding triggers are ways to help. But a person who relapses will still have all the knowledge and experiences they gained from the first time around, making it easier to get and stay sober again.
Myth 9. A person’s recovery is done once they complete treatment. Treatment facilities know that recovery is a lifelong process, which is why many have created after care programs and encourage their patients to join support groups. Staying active with a support group or finding an accountability partner will help someone stay active in recovery. The journey of recovery does not end once treatment is over; a person must work to stay sober for the rest of their life.
Myth 10. Some individuals are a lost cause. Just ask some of the millions of people who have been through recovery and are sober today. A great number of them and their family members would say that they had lost hope along the way. Many of these people know they shouldn’t be alive today, and know almost everyone had given up on them as a lost cause. But because of one spark of hope, they were able to recover. It’s never too late to get help. Treatment can work, recovery is possible. Never give up hope on yourself or someone you care about.
Drug Abuse Recovery – 4 Common Myths Debunked
Three Myths About Drug Addiction and Recovery
September is Recovery Month. Time to get down to business and get help for an addiction you’ve been struggling with. This month is when we educate people on the possibilities of recovery, celebrate with those who have been through it, and encourage those who have yet to make the leap. First, though, let’s get some common myths about recovery out of the way.
Myth 1. You don’t know anyone that has been in recovery. Many people would be surprised to find out that a friend or acquaintance has been through recovery for a drug or alcohol problem. Most people choose to not have their addiction and treatment become public knowledge, but the fact is that 4.3 million people aged 12 or older received treatment for substance use disorders in 2009. (1) Half of all American adults know someone who has been in rehab, and many more know someone in need of it.
Myth 2. Drug addicts and alcoholics don’t try hard enough to get sober. While a person does choose to abuse substances in the first place, people don’t choose to continue in a life of addiction. An addiction causes someone to lose control, and they become powerless to their substance, no matter how badly they want to be free from it. Sometimes, the only way for someone to overcome the triggers, cravings, and relapses is with professional recovery through detox and behavioral therapy.
Myth 3. Someone who is a “functioning addict” can get sober on their own. There are people who can live an almost normal life while addicted to drugs or alcohol. While the problem might not seem very serious to those on the outside because the person is able to carry out their responsibilities at work or at home, they may need professional help. The cravings and dependence that a businessman has can be just as strong as those of an addict out on the street.
Myth 4. Treatment is a lonely and isolated journey. Some people wish to have complete privacy during their recovery, and that may work for them. Studies have found, however, that people are usually more successful when they have family and friends around that support them. Sometimes hiding an addiction is detrimental, but opening up and relying on family, friends, and those who have been through recovery can have more successful results.
Myth 5. It is necessary to hit rock bottom for a successful recovery. While many people attribute the change in their life to the fact that they hit rock bottom and had nowhere else to go, not everyone needs to get to that point. In fact, treatment is much more successful if it happens earlier in a person’s addiction, because the harder-core the addict is, the more difficult it is to rehabilitate them.
Drug Abuse Recovery – 4 Common Myths Debunked
Three Myths About Drug Addiction and Recovery
Some people may wonder how a month dedicated to awareness for recovery can really help people in the long run. Many people feel they know enough about drug and alcohol addiction already, but actually, many people are quite uninformed about the issue.
Unless someone has lived through addiction and recovery, or has a loved one who has, they may have a hard time relating to those who have personally been through it. For example, there are still people who stereotype drug addicts and alcoholics. They have a picture in their mind of a man in his early twenties who is always too wasted to talk, or they may picture a homeless person in an inner city neighborhood, living under a bridge. Some people still find it hard to believe that the elderly might be addicts, or that children under the age of 10 are sometimes the addicts, or that high powered businessmen are sometimes the ones struggling with substance abuse. Other people still accuse drug addicts and alcoholics of not trying hard enough to get sober.
Part of the power of Recovery Month is that it creates awareness for the widespread problem of addiction. Even though most Americans know someone affected by addiction, people are so good at keeping these things secret that others are often not aware of the issue. Letting people know that substance abuse can affect anyone is an important message that people of all ages and backgrounds need to hear.
The other important reason for Recovery Month is that it gives people confidence to seek help. Admitting to a problem is not easy, but knowing that others have been through it too and are willing to encourage and support them is very beneficial. Fewer than 10 percent of people who need drug abuse treatment seek it out themselves. “Most who need treatment don’t believe they need it or they’re not ready for it or they can’t afford it or they don’t know where to find it,” said the director of Utah’s substance abuse division, Richard Nance. (1)
Support from family, friends, others in recovery, and the community in general can make all the difference in the world for those in treatment. “I don’t think people realize how hard it is to come into a place after years of using alcohol or drugs, to come into a place, stop using, and try to find a new way to live,” treatment professional Amy Mitchell said. “And for our community to say, ‘Hey, we appreciate you, and we notice it,’ that says a lot.” (2)
The theme for this Recovery Month is “Join the Voices for Recovery: Recovery Benefits Everyone”. It will take the effort of many people working together to make a difference; that is what Recovery Month is all about.
Recovery Month activities planned
Recovery Day one of hope, celebration
Sometimes, even in the midst of the drama of our lives, we need to be thankful for what we’ve got. Even someone in this country who is going through recovery from drug or alcohol addiction should take the time to count their blessings.
Addiction treatment in the United States is constantly changing and hopefully always improving. There may be things that we as a country could be doing better to help those in recovery, but we continue to learn and grow through experience.
There is also the challenge before us to educate and create awareness for the hope and purpose of recovery, but we have certainly come a long way. We now have a wide variety of treatment programs, tailored to meet the needs of different patients. We have groups that are helping preserve someone’s job while they get treatment. We have generated a greater tolerance and understanding toward those with an addiction. We can be thankful that our treatment is nothing like that in some other areas of the world.
A recent article in the New York Times describes in detail what treatment is like in Russia. More like jails than treatment facilities, patients are kept chained or in cages surrounding their beds while they complete their withdrawal. There are no medications to ease the pain, or rehabilitation, or therapy; patients are simply forced to quit their substance cold turkey, and stay until they are deemed ready to go home, which can take up to a year in some cases. Patients are fed bread and water, and after the worst of their detox is over, they can perform designated jobs while remaining isolated from the rest of the world. Those who have witnessed the system of recovery call it primitive, brutal, and ineffective.
“What they present as drug treatment has absolutely no basis in evidence,” said Diederik Lohman, a senior researcher at the monitoring group Human Rights Watch. “What [they do] has little in common with international best practice standards based on research and is unlikely to have any beneficial effect on patients.”
Sergei Polyatykin, head of the medical department at an advocacy group called the Say No to Alcohol and Drugs, said of this approach: “It’s not treatment, it’s jail. Imprisonment and torture can’t help drug addicts to kick the habit. Only a small percentage stay off drugs.” (1)
Russian officials feel they have little choice. Russia is suffering with a heroin epidemic that they cannot contain. But it is also clear that this treatment does not work. No one is teaching these patients how to live back in society without their drugs. There is no rehabilitation, and 90% of addicts in the country relapse.
Bringing the focus back to our country, we can be happy at the treatment options we have. We can be proud that so many people have recovered from their addiction, and can be hopeful that we can keep finding ways to help more people. As we remember the struggles that many have gone through during their recovery in this country, let’s also be thankful that their recovery was made possible by caring staff, loving family, and hard work and commitment.
(1) In Russia, Harsh Remedy for Addiction Gains Favor
Recovering from a drug or alcohol addiction is a unique experience for each person. Some people find that it is exactly as it should be and they make it through rehab with few problems. Others have to fight and claw their way through it at every step, battling relapse the whole way.
Whatever the process is like, taking someone from a life of addiction to a life free and sober is an amazing thing. Many people consider it a miracle when someone who was an addict can be a functioning, contributing member of society. There are countless stories of the miracles people have experienced that have lead them to seek the road of recovery.
Of course, along the way there are also often miracles that happen. What actually got someone into treatment in the first place might be something amazing, but what caused a turning point to occur in treatment might also be miraculous. Sometimes the person experiences the miracles at the end or after recovery, as they find ways to help touch other people’s lives. Someone staying sober for years after recovery is a miracle to some people as well, and these individuals often continue to appreciate the gift of recovery they have been given throughout their life.
When we experience something wonderful or miraculous, we want to share it with others. Some things are just too good to keep to ourselves. That’s why this month is such a big deal. People who have gone through recovery, or have known someone close to them who has, know it is not an easy process. To finally be well enough to be back in society again is a huge feat, and we all want to take the time to recognize and celebrate that.
Recovery is a miracle, and we want to hear about real experiences people have had. Treatment Solutions Network’s second annual essay contest is devoted to this topic. We are asking high school students in Miami Dade, Broward, and Palm Beach school districts to take part in this year’s essay contest. This year’s winner will receive a VIP experience with the Miami Heat.
The question we are asking is this: Recovery and miracles go hand-in-hand; share with us how you, personally, have seen recovery work a miracle in your life. Whether it was you, or a friend or a relative, how has someone you know overcome addiction and become a recovery miracle by not only surviving, but thriving in the community?
We want to hear about the experiences of our young people. This essay contest, like so many other events going on this month, will help us all create awareness for recovery. Through this, we hope others who really need treatment will find the help they need.
2nd Annual South Florida Student Essay Contest on Addiction Recovery
Rocklin resident recounts life of drug addiction
New Book Transforms Abuse and Trauma into Healing
Many people want to find ways to help others. There are so many ways we can be a benefit to others, by helping them physically, spiritually, or emotionally, and when we help others, we almost always experience a benefit ourselves. This September, as we observe National Recovery Month, there will be many ways to help others through our actions.
Recovery Month is a huge, nationwide, month-long chance to create awareness for substance abuse and mental health recovery. It is during this month that we celebrate those who have recovered from an addiction, as well as show our appreciation to those professionals who have helped people recover. It is also a time to help others get into the treatment they need, so that they can also experience true recovery. To accomplish these goals, organizations hold parades, picnics, contests, walks, and other events that help get the word out.
People who feel a strong desire to help the recovery community grow in strength and numbers see this month as a time to really get to work helping others. This month would not be what it is without the many volunteers and supporters who really make it happen.
Many of these people put the time and energy into making a Recovery Month event successful because they care and want to help out. Some of the organizers have also been through their own recovery, or that of a close friend or relative. They have seen firsthand the ways recovery can change a life and they want to spread that success to others.
One of the best ways we can help others this month is to get involved with a Recovery Month event. If you are in a position to research and plan an activity or event, go for it! There will be people to help you. The National Recovery Month website is a great place to start to get ideas and helpful hints on how to successfully run an event. Other people might find it easier to help with a local event that has already been scheduled. Or maybe your financial or other support is what is really needed at this time.
There is much to be thankful for during this Recovery Month. Many people would not be where they are today, or even here at all, if they wouldn’t have gotten into the right treatment facility. However, there are still many people in need of the right program. Many people settle for less than ideal programs, or are too afraid to check themselves into treatment at all. This month, by creating awareness for recovery, we can help others get the treatment they really need.
2nd Annual Recovery Month Essay Contest
Minnesota Recovery Connection Celebrates National Recovery Month
As we near the beginning of Recovery Month, it might be helpful if we take a look at the numbers of people who are in need of treatment and the outcomes of that treatment. Many people have made it through their drug or alcohol recovery, and we celebrate them this month, but there are many more people in need of treatment.
Drug and alcohol abuse affects millions of Americans every year. Alcohol, designer drugs, and prescription drugs are the unseen dangers of today, with many children and adults falling prey to this kind of substance abuse with little warning. According to the World Health Organization, worldwide, approximately 2.5 million people die each year due to alcohol use and 15.3 million people have a drug dependence. Prevention should start at a young age, but only a third of parents discuss the risks of abusing prescription medicines with their kids. (1)
Treatment is available, but many people don’t get the help they need. In 2009, nearly 20.9 million people aged 12 or older (8.3 percent of the population) needed but did not receive treatment for substance use disorders in the United States. 31.9 percent of the 6.1 million adults aged 18 or older who reported an unmet need for mental health care didn’t receive mental health services because they believed that their problem could be handled without care. In addition, 18.5 percent of these 6.1 million adults didn’t know where to go for mental health care. (1)
Recovery Month is all about those who have journeyed through treatment, as well as those who have helped them along the way. In 2009, 4.3 million people aged 12 or older received treatment (at any location) for substance use disorders. Treatment does work. Between 70 and 90 percent of individuals with a mental health problem have significant reduction of symptoms and improved quality of life with a combination of medication, therapy, and other support. (1)
Part of what makes Recovery Month so significant is that it shows other people how important treatment is. More people need to have a better understanding of substance abuse and mental health disorders and the way these things can be effectively treated, in order for the stigma to be reversed. Recovery Month helps with that. Approximately 75 percent of the population now believes that recovery is possible from addiction to highly abused substances, such as alcohol, prescription drugs, and marijuana. Half of all adults over age 18 know someone in recovery from an addiction to alcohol, illicit drugs, or prescription drugs. Fewer than 20 percent of Americans say they would think less of a friend or relative if they discovered that person is in recovery from addiction to alcohol and/or drugs. Two-thirds of Americans believe that treatment and support can help people with mental illnesses lead normal lives. Let’s not stop here, though. We need to keep working to create even more awareness for recovery.
SAMHSA’s Latest National Survey on Drug Use & Health
2009 National Survey on Drug Use and Health
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