Recovery Management

The process of recovery management is complex at times and simple at times. Addiction recovery first depends on not taking the first drink of alcohol or the first draw of pot or the first snort of cocaine or the first shot of heroin. If it were as easy as telling someone to just say no, there would be no need for treatment, and the problem would surely be solved quickly. The average addict has probably received such advice myriad times – however, the idea of the first drink or the first use is a profound and difficult realization for the addict, even if it’s obvious to everyone else in the addict’s life.

In the mind of an addict, the drug (and alcohol is included as a drug) is vital to holding things together. The concept of not using any mood altering is unfathomable. So, when an alcoholic takes the first step in AA, which is — “We admitted that we were powerless over alcohol — that our lives have become unmanageable” – this is a tough realization for the alcoholic. The same acceptance is required of the cocaine addict and the opiate addict. There can be no real recovery unless first a person admits they have a problem and that change is required. Often, this is not fully understood when dealing with a person who’s trying to do something about their addiction. The addict might speak the words that they know they have a problem, but true acceptance and realization is something deeper than simple admission that could be just to get people off their back. In order for a person in recovery to commit to recovery management, it’ll take more than superficial acknowledgement.

It’s possible to put someone in an inpatient facility with locked doors and keep them from using drugs. This will start the recovery of the body and brain in a physical way, but it doesn’t touch the psychological obsession or the emotional damage caused by years of addiction – it also doesn’t address in any meaningful way any underlying co-occuring disorders like depression or anxiety or PTSD.

Also, when discussing abstinence, this too is more complex than just not using a mood altering drug. In cases of co-existing psychological or emotional conditions, or in cases where addiction has caused depression or anxiety that doesn’t dissipate simply because the person is abstinent, an anti-depressant or anti-anxiety medication might be necessary. Recovery management entails medical management. This is where medical understanding of addiction is critical. The doctor who medically understands addiction will make a decision to prescribe medication with utmost care and supervision.

So, after the person has accepted abstinence, even if it’s temporarily, and other co-occuring issues have been identified, recovery is dependent on a combination of education, therapy and action. Knowledge is power, and the addict must first know everything possible about the disease of addiction. Knowledge alone will not create long term recovery, but knowledge is necessary for sustainable recovery. The job of the addiction therapist/counselor/doctor is to educate the addict about drugs and addiction, emotional intelligence, coping skills, relapse prevention — recovery management.

Some deep issues are dealt with right away if they’re blocking acceptance and recovery, but most often in addiction treatment that lasts for 4 to 8 weeks, the deeper issues are dealt with over the long term as a part of recovery management. It takes quite a bit of counseling and education just to get an addict prepared to deal with deep issues. The discharge plan should include referral to a therapist that deals with the particular issue(s) that the recovering person is facing post-addiction treatment.

It’s also recommended that the person follow up with their doctor and let the doctor know they’ve been through treatment and that the doctor can consult with the treatment facility’s medical director regarding ongoing recovery management as it pertains to medical needs.

I’ve already mentions AA — there are various forms of recovery support available. The recovering person must decide which support system they’ll use – addiction recovery is a long term endeavor, and, thus, the emphasis on recovery management. After the holidays, I’ll write a series of posts that address the details of treatment and long term recovery, and what constitutes the healthy counselor/client relationship. Happy Holidays!