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Addiction Recovery – Multiple Pathways?

There is lots of controversy today surrounding drug and alcohol addiction. For example, the opioid epidemic has caused intense media scrutiny on addiction, not all of it positive. Amazingly, many still debate whether addiction is a disease.

Having been in recovery and studying addiction for the past 18 years, I can tell you with absolute certainty what the AMA and Surgeon General say – that drug and alcohol addiction is a brain disease, and it is chronic.

By Nick Cuneo, President & Founder, Clean Recovery Centers
Many different treatment view points
In addition to the disease debate, there are numerous questions on what treatments work and what don’t. People inside and outside of recovery have many different opinions and views. Some advocate 12 step programs, while others are critical of these programs. Some champion medically assisted treatment while others view it in a dim light. I could go on and on: Addictions Victorious, Alcoholics for Christ, Buddhist Recovery Network, JACDPSO, Celebrate Recovery, Recovery Coaching and more.
My experience
I got sober in 2000 through a treatment center clinical program and a 12 step process. It worked for me, and I still strongly support this approach. Clean utilizes a holistic, very deep clinical program (eastern and western techniques) as well as a 12 step process. The result is a 70% success rate among our graduates.

Last year I attended a Recovery Coaching Training Workshop and found the material fascinating. I discovered that I was in no position, nor is anyone, to claim that only one pathway to recovery will work.

Keep in mind that for thousands of years people suffering from addiction got well, though it was rare. From what we understand, something happened to them, spiritually or otherwise. They learned to live in an entirely different manner and to change their mind set.

R.O.S.C. treatment  
Another major thing I have learned over the years is the importance of shifting the treatment paradigm. Move it away from acute care and more towards ongoing care and support.

For example, Dr. William White advocates for a Recovery Oriented Systems of Care model (R.O.S.C). The treatment centers that implement R.O.S.C. do their best to ensure basic client needs are met for the longer term.

Longer term care and support
Ideally, Behavioral Health Techs and other staff members in R.O.S.C. are trained as Recovery Coaches. These treatment centers and Recovery Coaches become resources for the people recovering. They ensure that clients have access to phone numbers, emails and personal contacts for ongoing medical, legal, educational and housing services. In short, they provide longer term support and motivation for the person in recovery.
Understanding the addict’s mind

Today we have a better scientific understanding of what happens in the mind of an addict when suffering and as they grow towards recovery. Thoughts are simply millions of neurons firing off in a series of sequences. When a person thinks in a healthy manner, numerous areas of the brain are accessed and reasonably sound decisions take place. Healthy neuropathways become carved into the brain.

However, when a person is in the depths of their addiction, the brain becomes literally scrambled and high-jacked by the disease. The homeostatic environment in the brain becomes completely disrupted – serotonin and dopamine production is negatively impacted. These chemicals called neurotransmitters are necessary for the brain to function normally and for a person to feel well.

Nothing matters to the addict but “using”
However, when a person in addiction attempts to think, the areas of the brain required for sound thinking are not accessed. Judgment goes by the way side and extremely unhealthy neuropathways become carved into the brain. The ensuing behavior is that of someone temporarily insane. At this point, the suffering addict is “living to use and using to live.” Nothing else matters!

That’s hitting the bottom, but when a person is truly willing to get well, their thinking slowly begins to change. They go through detox and the brain begins to heal slowly.

Begin therapy when the mind is ready
Effective therapy should begin as soon as the mind is clear enough to receive it. This therapy should be aimed at helping the recovering addict develop a new manner of thinking and living. Repetition helps carve new, healthy neuropathways into the brain. The process of the 12 steps is a very healthy way to accomplish this.
A higher power . . .
The recovering addict accepts that they have a problem and attempts to find a power greater than themselves to help (often, at first, this power is simply a group of people in recovery).

The recovering addict then makes a decision to follow the advice and suggestions of the power that they deem greater than themselves.

Old thinking disappears . . .
These actions help relieve individuals of pent up resentments and misdeeds while in addiction. As a result, they make a decision to practice this manner of thinking daily.
New thinking surfaces . . .
Now the recovering addict begins to help others suffering from addiction to get well. Often prescription medication is required, particularly in early recovery.
30 to 40 days typically not long enough for recovery
Long term recovery is enhanced greatly when the recovering person has access to an R.O.S.C model. It is apparent that we need to move away from such an intense focus on the acute care setting. Many addicts can stay clean for 30 to 40 days in a residential facility that keeps substances they are addicted to out of reach.

It is different when the person returns home or even goes to a sober living facility. Many have been suffering from addiction for years, and their life skills are minimal. They can become easily overwhelmed.

R.O.S.C. model a big help
Having access to an R.O.S.C. model can alleviate the feeling of being overwhelmed and enhance the feeling of being safe and supported. As a result, the chances of the recovering person staying clean and sober is enhanced greatly.

There are often many similarities within the different pathways to recovery. Most of these aim to halt the destructive thinking and manner of living practiced by the suffering addict and to replace it with healthy thinking and living skills.

What worked for AIDS can work for addiction
Unfortunately, many people choose to look at the differences. We are now in a National State of Emergency. The time has come to look at the similarities and try to respect each other’s opinions. Thousands of people are dying. This is no time to debate whether one pathway to recovery is better than another be it AA, NA, CA, Celebrate Recovery, SMART therapy, through the church or medically assisted therapy.

The AIDS epidemic was largely resolved by people coming together and removing unhealthy stigma. It is my hope and prayer that very soon the same thing can happen with addiction.

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