Putting numbers behind addiction recovery

 The news about addiction — rising rates of addiction, record numbers of overdose deaths, and the like — tends to be bleak. As clinicians and researchers, however, we have the good fortune to often see its bright side: recovery.

The narrative has long been that substance use disorder is a hopeless condition that few recover from. Grim statistics often thrown around suggest that only a small percentage of people recover from it. Though there’s some truth to that, the problem is that these statistics are never put into context.

There’s no question that many people relapse after an addiction recovery attempt. But most people make multiple attempts. Just as with changing any heavily ingrained habit, like smoking or unhealthy eating, many people don’t succeed on their first try. But many eventually get there with successive tries.

Around 75% of people seeking recovery from a substance use problem achieve their goal, though it may take them some time to achieve full remission. The average number of attempts before success is five, though the median number is just two, meaning that a small number of outliers — usually individuals with the greatest addiction severity and other concomitant mental health issues — who need five-plus attempts, inflate the numbers, making them look worse than they are.

Along with several colleagues, we recently completed a landmark study which, for the first time, comprehensively surveyed Americans who said they had resolved an alcohol or other drug problem.

Some of what we learned from this survey was indeed disheartening — people who have resolved a substance use problem, for instance, are worse off than the rest of the population in terms of health and employment. But the news wasn’t all bad. In fact, some major positives emerged from this work.

First off, this study found that 22.3 million Americans have overcome an alcohol or other drug problem — that’s 9% of U.S. adults at the time we did the survey! That nearly 1 in 10 U.S. adults have overcome a substance use problem is testament to the fact that not only is addiction recovery possible, it’s common. To further contextualize this finding, in the year these data were collected (2015), there were more people who endorsed having resolved an alcohol or other drug problem in the U.S. than had an active alcohol or other drug use disorder (22.3 million vs. 20.8 million).

We also saw significant improvements in quality of life and a decrease in psychological distress over time in recovery, showing that people and their lives get better after resolving a substance use problem. Just about anyone in addiction recovery will tell you as much, but these findings are important because they provide hard evidence that counter the false narrative about substance use disorder being a hopeless condition.

And it’s not just that well-being improves. We also found that 80% of people who had overcome an alcohol or other drug problem accomplished at least one major achievement associated with self-improvement and family engagement since overcoming a substance use problem — things like getting a new job, completing a university degree, or volunteering. And as you might expect, accruing such achievements was associated with improvements in quality of life and well-being over time.

These results challenge commonly held beliefs about the nature of substance use disorder as a constantly recurring condition with little room for improvement. The reality is that this disorder has a good prognosis and is typified by significant improvement over time in recovery.

Along these lines, we found that more years in recovery were associated with an increasing number of achievements. This likely represents a reciprocal process, with more years in recovery leading to more achievements and better outcomes which, in turn, support continuous recovery. With time, people continue improving their quality of life and achieve things they weren’t able to before.

Starting early appears to be one key to better recovery outcomes. Though addiction recovery is associated with numerous positives regardless of one’s age, data suggest that getting into addiction recovery young, regardless of the severity of an individual’s addiction, is associated with better subsequent global functioning and quality of life.

Taken together, this research stands in stark contrast to the heavy stigma and pessimism surrounding substance use disorder, which dramatically compound the burden of addiction. For many people, they represent a major barrier to seeking help and achieving recovery.

Individuals with addiction are often viewed as unstable and dangerous, and are much less likely to be wanted by others as friends or part of their families compared to people with other mental health conditions. Numerous social and legal barriers also impede individuals’ efforts to rebuild their lives after resolving an alcohol or other drug problem, such as laws preventing people with histories of drug arrest from getting federal loans to go to school, and widespread corporate policies forbidding hiring of people with criminal records, even for nonviolent charges related to drug possession.

At the end of the day, addiction is a highly treatable disorder from which the majority of people eventually recover. And our recent study shows that in spite of numerous legal and social barriers, most individuals in addiction recovery go on to rejoin society and contribute to it in numerous meaningful ways.

It’s time we provided individuals with the resources they need to rebuild their lives in addiction recovery, rather than erecting or maintaining barriers to their success. Doing so benefits not just those seeking addiction recovery, but society as a whole.

David Eddie is a research scientist at the Recovery Research Institute and Center for Addiction Medicine at Massachusetts General Hospital, a clinical psychologist in the Department of Psychiatry at Massachusetts General Hospital, and an assistant professor of psychology at Harvard Medical School. John Kelly is the director of Recovery Research Institute, associate director of the Center for Addiction Medicine, and professor of psychiatry at Harvard Medical School.

https://www.statnews.com/2021/05/03/people-recover-from-addiction-they-also-go-on-to-do-good-things/