There are certainly many paths to recovery, but only one for you. What is the best choice for you? We do not know; and you can never really know. You only get to live life once, and however you live it you will not know how it might have gone had you lived it differently. Time runs in one direction. Scientific studies often tell us what happened on average to the people who received this or that treatment, and we will cite some of those treatments in this blog, but at the end of the day you won’t have something happen to you on “average.” Something remarkably interesting will happen to you as you embark on the journey of recovery and you begin to measure your path to recovery in relation to how it works in your own life.
What Lies Ahead
The substance of our program is grounded in experiential and eclectic models of psychotherapy. We are interested in helping you develop a new relationship with your thoughts, emotions, and physical self. We want you to feel comfortable in your body and your environment. We start with following Maslow’s Hierarchy of Needs by addressing your physiological and safety needs; ensuring you are hydrated, nourished, rested, possibly receiving psychotropic medications to assist with mood stabilization and sleep, and removing environmental triggers to reduce stress and increase the physical recovery. We then move into addressing your psychological needs through social prescribing, team-building exercises, psychoeducation, and mindfulness to help change the neuroplasticity of the brain that support a lifestyle that has kept you stuck. Finally, through our case management, written work, and individual therapies, our aim is to help you continue moving in the direction of self-fulfillment. We will help you develop your “recipe” for recovery.
To Abstain or Not to Abstain
Some people claim that there is a single inevitable course for untreated substance dependence: an inevitable downward spiral or “hitting bottom.” Research studies do not support these claims. Some people drink or use heavily and then stop and do not use at all, or maybe return to nonharmful patterns of use. Some drink and use heavily and then go through patterns of nonharmful use followed by periods of harmful drug and alcohol use. We will not mince words; we are an abstinent-based program as we want to give the brain every opportunity to grow and make decisions without the effects of mind-altering substances. However, our goal is not to convince you or shame you to quit. Our program here offers help and support for the decisions you have made and intend to make regarding your own recovery.
Reasons to Abstain
The decision about whether to abstain or control your use of alcohol or drugs, while ultimately personal, is not one to be taken lightly. If you have not given significant time to the question should I abstain, we recommend you do so now. As you think it over, consider all the alternatives. The outcome you want from treatment is centrally important to the treatment itself. Without a doubt, some people succeed at moderating their drinking after treatment. But there are undeniable risks that come with an attempt at moderation. If you are considering moderation as an approach to dealing with your substance abuse problem, we would ask you to consider what would have to happen for you to pronounce your efforts a success or a failure. And by consider we mean seriously think it through. We will help you to process the different things to weigh in making your choices for moderation or abstinence. Below are a few things to think about that weigh on the side of abstinence.
You will not die from quitting. One consideration is that no one ever died from letting go of addictive substances. Some things with which people have problems, like compulsive eating, are hard because you have got to eat. But other things are not necessary for survival. It is simply not a biological imperative that you drink or use drugs. You need not ride a motorcycle at excessive speeds without a helmet, gamble beyond your means, or engage in daily anonymous sexual encounters, and all these behaviors carry significant personal risks. If you feel compelled to engage in these activities when doing so at the expense of other areas of your life that matter to you, we would argue that the prospect of not engaging in these activities deserves very long and careful consideration. We are absolutely not going to tell you to quit. The choice to engage in all activities – including drinking or using drugs – in your life is absolutely yours and yours alone. And, yes, we realize that absolute freedom is scary and can, itself, be a source of considerable anxiety for you. We will have more about that later. What we want you to be aware of is that to give you the best chance to make this decision for yourself, we will require complete abstinence of all drugs and alcohol during your time in our program.
Habitual behavior is hard to control, especially when you are on autopilot. A lot of our behaviors are sort of automatic. Perhaps you have noticed this in your own life in areas outside addiction. Here is an example of a client who was always taught to clean his plate at dinnertime, grew up working class, and was taught that wasting food was a no-no. It is a huge effort for this client, as an adult, to decide when to quit eating based on how his stomach feels rather than by whether his plate is empty or not. He is gradually learning that he does not have to fill his plate; and, even if he does fill it, he does not have to empty it. He may make a conscious choice to not go to buffets. Why? Although he no longer piles his plate high, he also seldom eats a minimal portion when he goes to a buffet. Some circumstances make behaviors more likely (and, often, make them happen automatically). If you are having problems with addiction, you do not want to be spending time on autopilot, especially when addictive substances are involved. We will teach you how to be mindful and present, rather than on autopilot in your daily living.
Some substances make it easier to use other substances or more of the same substance. Some substances – and alcohol is a great example – lower your inhibitions when you use them. You know when you want to do something and that little voice in the back of your head tells you not to for some reason? Some substances incline you to pay less attention to that little voice. So, for example, if you are at the bar and the band starts playing, you might be a little reluctant to step out on the dance floor. You want to, but you feel a little inhibited. If you have a couple of drinks, the inhibition melts away. This is not in and of itself a bad thing; particularly if what you feel inhibited about is asking someone to dance. Now consider this – what if the thing you feel like doing but feel inhibited about is having another drink or using some cocaine? Alcohol has the same effect on those inhibitions. In Alcoholics Anonymous (AA), they sometimes say, “One drink is too many and 1000 never enough.” This is not strictly true; however, there is some basis for concern. Being able to accurately estimate one’s blood alcohol does not make a person immune from decreased inhibition or lapses in judgement. There are good reasons that there are laws against driving while intoxicated or under the influence of even a small amount of alcohol. A lack of inhibition and poor judgement when you are piloting a ton of steel at high speed toward trees and cliff edges and other people can have disastrous consequences.
One of the most favorable circumstances for using substances is using substances. This probably sounds like a play on words, but it is not. When you go to the supermarket, they may have people at the ends of the isles to give you little bites of food. If you eat a little, it sometimes cues eating a lot. Free samples are not really free. Like an old potato chip commercial used to say, “Bet you can’t eat just one.” This is not necessarily anything specific to addictive substances; it is also true of a lot of other things in our lives. The difference is that those other things have likely not caused you the same level of problems as drugs and alcohol. You have probably never lost a job from eating too many potato chips or crashed your car after too much chocolate or had a spouse file for divorce after buying a gallon of ice cream. Keep in mind, we are not suggesting that one chip inevitably leads to another. It simply increases the chances that you will keep indulging until the bag is empty. Likewise, taking one drink increases the odds for taking another, and this will ever be the case. Given this truism, it is well worth your time to consider very, very carefully if you want to put yourself in that position. You must ask yourself, Is the increase in likelihood worth it to me at this point in my life? If you are reading this, your answer is probably no. We are here to help you with tools to be able to make healthier, conscious decisions in your life.
Moderate drinkers often do not stay moderate for long. While we do not know of any strong evidence that suggests drinking always leads to more drinking, there is considerable evidence that drinking predicts drinking and that more drinking predicts more drinking. Although the use of a little bit of substance may or may not send you into a spiral of intoxication, it certainly increases the risk of more use. For example, in a very large clinical trial for alcoholism treatment called Project Match, patients were divided into three groups based on their drinking patterns during the year following treatment: one group abstained, a second drank moderately, and a third group drank heavily. If we look at the number of people in the abstaining, moderate, and heavy drinking groups, we find that at year three, most of the abstainers (71 percent) were still abstainers. Most of the heavy drinkers (78 percent) were still heavy drinkers. Most of the moderate drinkers; however, were no longer classifiable as moderate drinkers; 27 percent had become abstainers and 50 percent relapsed to heavy drinking.
These data suggest a few things: 1) they suggest that some individuals, though diagnosed with alcohol dependence, do moderate their drinking, and continue to stay moderate over time. However, many do not. And 2) the data suggests that a substantial number of individuals may ultimately find their way to abstinence, for whatever reason, even though they do not start out planning to abstain. In essence, while we will support decisions you make for yourself after treatment, we will promote a lifestyle that includes abstinence and offer tools to help you in that regard.
Reasons to Keep Drinking and Using
Different drugs, and alcohol especially, are a big part of our culture. Depending on your social network, many events in your life may have drinking or drug use as a social component. If you make the decision to abstain, it is likely, especially in the initial stages of recovery, that you will feel awkward in these settings. Many people will have opinions on whether you should drink or use. Some will actively offer you something to drink, a toke, or a line. A few will actively attempt to undermine your resolve. Social discomfort is not insignificant, but we will offer you help to develop your own resolve, whatever that may be.
Alcohol, and indeed, even drugs have played an enduring role in the unfolding drama of history. Champagne launched ships, cold beer has been a signal that the workday is done; and drinking wine, smoking marijuana, and eating hallucinogenic cactus have all been part of religious sacraments. None of these are, in themselves, “bad.” The “alcoholic’s” problem is not that he drinks. It is that he must drink. Neither alcohol nor drugs need to be deplored or demonized before you can choose to let them go. The decision to do so may be for you, as Shakespeare put it, sweet sorrow. Or you may make the choice simply because you feel it is time to leave the party. You do not have to make an enemy of drugs and alcohol to decide that it is time for you to stop using them for good – and we have already discussed some, we think, fairly compelling reasons you might want to do just that. Again, the choice rests with you. We will help you to choose the right path for you.
Choosing Your Path
There are many paths to recovery from substance dependence. Some may tell you that there is only one way out of the trap of addiction – You must be saved in the such-and-such church! You must go to AA! You must Suck-it-up! You must go to treatment! And so on and so on. We at Came to Pass are taking pains to redefine the universe of treatment; one with many alternatives.
There are many paths into and out of substance dependence. It is simply the case that many people have recovered without doing any of these things. And still many more people have failed to recover even while doing all of them. History is unquestionably filled with people who recovered with just a bit of friendly advice and no treatment at all. There are certainly people who just got up one morning and decided to let it go. However, if you were one of them then chances are pretty low that you would have found your way to this website.
And while there are as many paths to recovery as there are people struggling with addiction who seek some other way of living, observation over time has suggested that some paths probably work better than others. We do know some things that predict whether people will have long-term problems with substances. People with stable jobs and families and good, strong social support have an easier time recovering, on average, than those who do not. People who start drinking or using later in life are more likely to recover, on average, than people who start earlier. People with fewer other psychological problems are more likely to recover and avoid relapse, on average, than people with more severe mental health issues. But even here, we need to point out that these things are true about groups of people on average. Some people keep drinking or using even though the cards are stacked in their favor, and some people recover with all the cards stacked against them.
And what about you? Which are you? Do you fit neatly into any of these categories? Or are you the exception to the averages? We do not know. At the risk of sounding like a broken record, we are not here to tell you whether you should abstain from drugs and alcohol. We have our opinions of what works because that is what worked for us. We are open-minded enough to say this is a matter for you – and only you – to decide. If, however, you have decided for yourself that it is time to let go of drugs and alcohol, if you find that drugs and alcohol use is getting between you and a life that you could love, then we offer our services as a support in the task.