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There is a lot of controversy surrounding drug and alcohol addiction today. The Opioid Epidemic has caused intense media scrutiny around the topic of addiction, not all of it positive. Many still debate whether addiction is a disease. Having been in recovery and studying addiction for the past 50 years I can tell you with absolute certainty what the AMA and Surgeon General have said – drug and alcohol addiction is a brain disease, and it is chronic.

By Rick Davila, ACS, PhD., Director of Recovery Support Services, Clean Recovery Centers



In addition to the disease debate, there is debate on what treatment works and what doesn’t. People in recovery and outside of recovery have many different opinions and views. Some advocate 12 step programs while others are very critical of these programs. Some people advocate 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.

I got sober in 1966 through the 12 Steps of Alcoholics Anonymous. It worked for me. I still very strongly support this approach. That said, roughly 12 years ago I attended a CCAR Recovery Coaching Training workshop. I found the material fascinating and discovered that I was in no position, nor is anyone, to claim that only one pathway to recovery will work. 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.

Another major thing that I have learned over the years is the importance of shifting the treatment paradigm away from acute care and more towards ongoing care and support. Dr. William White advocates for a Recovery Oriented Systems of Care model (R.O.S.C). Treatment centers that implement R.O.S.C. do their best to ensure that basic client needs are met for the longer term. Ideally, Behavioral Health Techs and other staff members are trained as Recovery Coaches. The treatment centers and Recovery Coaches become resources for the people recovering. They ensure clients have access to phone numbers, emails and personal contacts for ongoing medical services, legal services, educational services, housing and more. In short, they provide longer term support and motivation for the person in recovery.

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

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 – the production of serotonin, dopamine, etc. is negatively impacted. These chemicals called neurotransmitters are necessary for the brain to function normally and for a person to feel well. When someone suffering from addiction attempts to think, areas of the brain required in sound thinking are not accessed. Judgment goes by the wayside. Extremely unhealthy neuropathways become carved into the brain. The ensuing behavior becomes that of someone temporarily insane. At that point, the suffering addict is living to use and using to live. Nothing else matters.

When a person is truly willing to get well, their thinking begins to change, even if ever so slightly. They go through detox and the brain begins to heal slowly. 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. The recovering addict accepts that they have a problem and attempts to find a power greater than themselves to help them (even if, at first, that power is simply a group of people in recovery). They make a decision to follow the advice and suggestions of that power they deem greater than themselves. They relieve themselves of pent up resentments and misdeeds while in addiction, and they make a decision to practice this manner of thinking daily. They also try to help other people suffering from addiction to get well. Often prescription medication is required, particularly in early 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 the substances they are addicted to out of reach. It is a far different equation when the person returns home or even goes to a sober living facility.

Many of these people have been suffering from addiction for years, and their life skills are minimal. They can become easily overwhelmed and triggered. 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 chance of the recovering person staying clean and sober is enhanced greatly.

There are often many similarities among the different pathways to recovery. In short, most of these pathways aim to halt the destructive thinking and manner of living of the suffering addict and replace it with healthy thinking and living skills. 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 our utmost 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, medically assisted therapy or more. 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.