Recovery is the term used to describe the process of bringing the addiction into remission. Remember that there is no cure for this problem. Once the brain has become addicted, it stays that way. However, even though the disease of addiction remains, it can be successfully managed. It is possible to stop using the addictive substance and to be happy that you did.

Recovery proceeds in stages. The first involves coming to the point where the choice is made to stop using and to change. People usually have a lot of mixed feelings at this stage: fear of coping without the drugs or alcohol, worry that staying abstinent is not possible, a longing for the initial benefits of the substance, shame or guilt about negative consequences, anger at loved ones who coerced treatment.

Some physical consequences of the addiction are likely, depending on what drug was used, and there might be symptoms of withdrawal to contend with. Professional help is very important at this point. You need a physical check-up, and you may need detoxification. Counseling helps you deal with fears and with mixed emotions. Many alcohol and drug counselors are also recovering from addiction and can relate very personally to what you are going through.

A decision has to be made as to whether you need residential treatment - for example, in a hospital setting - or outpatient treatment. In years past, twenty-one- or twenty-eight-day inpatient programs were standard. In recent years, there has been a push towards developing outpatient options, much of it coming from insurance companies that limit reimbursement for inpatient programs.

Limited social support, physical problems, complicated addictions, and the presence of other psychiatric disorders like depression or anxiety are indicators of the need for inpatient treatment. A person’s failure to remain abstinent in an outpatient program also suggests the need for residential treatment.

The bottom line is that making progress in recovery is time-consuming. If it takes a month in a hospital setting, or three months, that’s what it takes. Some people are able to successfully utilize outpatient programs, but many are not. It’s important to remember that this is a serious and long-term kind of problem, no matter what the constraints may be on insurance coverage. Public sector programs, such as those run by mental health centers or state hospitals, sometimes provide for a longer stay at a reduced cost, since they are subsidized by government funds.

Elizabeth Connell Henderson, M.D.

Glossary

Appendix A: Regulation of Addictive Substances

Appendix B: Sources of Additional Information