Episode 1 - Recovery or Remission? How We Think About Treatment for Addiction
Recovery or Remission?
We’d like to welcome our listeners to our audio journal series. I’m Carolyn Bradfield, CEO of InterAct LifeLine, a technology service focused on helping addictions treatment and collegiate recovery programs keep individuals connected to treatment, to community and to their families to improve recovery and reduce relapse.
September was National Recovery Month, created by the Substance Abuse and Mental Health Services Administration otherwise known as SAMHSA. Held every September the focus is to educate people that substance use treatment and mental health services can enable those with mental and substance use disorders to live healthy and rewarding lives.
I’d like to dig into addiction and the concept of recovery in the way we treat people that are struggling with the disease. The first thing we need to define is the type of disease that addiction represents. When a person develops the disease, the symptoms are often acute, severe and obvious. People experience a loss of control over choices, cravings and compulsive using, and physical withdrawal if they don’t maintain substance use.
There are many other conditions that you would recognize that also have acute symptoms. You pass out from diabetes, can’t breathe during an asthma attack, or experience chest pains during a heart attack. The symptoms appear rapidly but can be treated if caught in time averting a tragic outcome. However, diabetes, asthma and heart disease don’t just go away after a stay in the hospital. They are chronic conditions that stay with you and require on-going treatment and maintenance to keep them in check. In other words, people with those diseases can live healthy and productive lives as long as they take steps to manage their disease, even if the condition is always present.
Addiction must be thought of in the same category, a chronic disease, yet when we treat the symptoms in rehab, reversing those acute symptoms we pronounce the individual “recovered” or in recovery. I often wonder if the better term for what we’ve accomplished is that we put the individual into remission? Let’s explore the difference in the two terms.
Recovery, in the medical sense, means that the person has all signs of the disease gone and there is a complete return to health. You break a bone, set it, and now your arm is as good as new. You experience appendicitis, get your appendix removed, and the symptoms never return.
We tag those with the disease of addiction as “recovered” or “in recovery” if they complete treatment and are no longer using. But perhaps the better way to think about it is that the disease is in remission. A person with the disease has a brain with a predisposition to use again if it is triggered with stress, anxiety, poor health habits and temptations in their environment. They are not really recovered, but rather living healthy lives because they are treating their chronic condition that is now in remission.
Recovery, the term used by SAMHSA and so many others, does not mean that you are disease free. But it does not mean that if you complete rehab, you can go out into the world, return to the habits that brought the onset of the disease and stay healthy.
Recovery should mean that you craft a long-term plan to stay in remission that includes a health and wellness strategy that keeps you asymptomatic. Unfortunately, we continue to treat addiction as an acute disease, manage the symptoms, but fail to have a longer-term plan to stay healthy. That is why relapse rates, according to SAMHSA, are in the 85% range in the first year following acute treatment.
If this were any other disease that could be put into remission, an 85% rate of having the acute symptoms return so quickly after expensive treatment would be totally unacceptable. Imagine going to your dentist having crown, only to tell you to expect that it will fall out in a month or so, you would never accept that.
Here are some thoughts on how to truly put the disease into remission vs. simply “recover” only to need acute treatment again.
#1 Stay connected to treatment longer
Studies show that individuals who maintain a connection with the program that treated them for the acute symptoms, aka rehab, for 6 consecutive months following treatment dramatically reduce the rate of relapse. You don’t have to occupy a bed in a rehab facility to continue treatment. There are on-going after-care options through intensive outpatient programs, addictions therapists and other aftercare solutions that offer structure, accountability, and create new habits to promote health and wellness.
#2 Get connected to a community
There is nothing that compares to having a community of others who are committed to managing their disease in a healthy way. Community allows one to share strategies, get support to overcome struggles, and focus on a lifestyle that is free from substances. Communities can be physical through meetings or virtual through online support groups.
Take collegiate recovery communities as an example. According to the Association for Recovery in Higher Education, individuals who join a collegiate recovery community on campus have a higher GPA, higher graduation rate, and lower relapse rate. Students stay connected to each other, to a shared experience, and to a shared strategy to maintain wellness.
#3 Stay connected or reconnect to family
Most families are undereducated about the disease of addiction. They don’t understand the malfunctioning of the brain and the irresistible urges to misuse substances, chalking up the condition as a moral failure vs. the disease that it really is. Connecting to an educated family ready to support the individual with the disease provides structure, understanding, support and help to craft a strategy to stay in remission.
Let’s celebrate those that are committed to overcoming their disease, recovering from the acute symptoms and maintaining a plan to keep the disease in remission so they can continue to live a healthy and productive life.
InterAct LifeLine is here to make a difference in how people manage the disease of addiction, reducing the rate of relapse and improving the recovery process. We offer treatment and collegiate recovery programs a technology service to keep individuals connected to treatment, to support communities and to families.
This is Carolyn Bradfield and you’ve been listening to our audio journal from InterAct LifeLine.