Recovery real-talk, M.A.T. part three, conclusion

Regardless of the person’s current substance use, recovery means:

1. Honest self-reflection

2. Self-care and dignity

3. Enriching activity

4. Good friends and authentic intimacy

5. Reasoned priorities

6. Diminished obsession with the drug of choice.

There may be other categories of wellbeing to consider but I stand behind these six.

Honest self-reflection. Old wisdom, Socrates would say that the easiest person to lie to is oneself. No doubt informed readers will mentally reference Step One of the 12-Step tradition. “We admitted to ourselves that we were…” Yes indeed. The most important part of Step One are the initial two words, then the next two. Any mathematics teacher will know the axiom; before we can solve the problem, we must identify the problem. A person who is not having an honest internal dialogue will not find their recovery. External motivators may inspire initial changes, but without the powerfully rewarding benefits of self-determination, abstinence is hollow.

Self-care and dignity. In non-recovery/active addiction its easy for a person to give very few, if any, cares about themselves or how they present to others. This is common for a few major reasons. First is shame. If I hate myself, then the mild social punishments that occur from my disheveled slovenly presentation are inconsequential to me. Second, if I’m a thug, criminal, gangsta, I’m proud to say that “I don’t give a f*ck what people think of me.” Third, in active addiction there are more urgent concerns than washing my clothes and “If I smell a little, so what, as long as it’s not too bad, no one cares.” Well, it matters that you smell like dirty laundry.

In recovery, a person recoups some self-worth and they begin to act as if they matter. They begin to care about the impression they make on strangers. They have the spare time to manage personal hygiene in a more typical way. They take care of their person better.

Enriching activities. Jobs, Money, Usefulness to others, Skill-based recreation. In my time working with adolescents, who frequently diminish and discount their futures (which makes motivational interviewing tricky) the key measures of treatment effectiveness are time and achievements in enriching activities. Improvement in a chosen skill-based hobby naturally evokes self-esteem. Along with public affirmation, it’s a sweet dopamine recipe. It might even feel better than weed. For adults, its more of a choice of direction. In a mutually exclusive sense, a person cannot move toward their important life goals, and toward addiction, simultaneously. The person in recovery knows this while a person Not in Recovery may not. If I am to understand my particular client has a history of substance use disorder, the second or third question to them will be “Tell me about your recent successes”.

Good Friends and Authentic Intimacy. In the realm of shame, self-worth and self-care, one can also find loneliness, isolation and social fear. If I don’t like myself at all, it’s quite reasonable to assume that others will feel the same way about me. Another cause for isolation: in many cases, active addiction teaches a person to be distrustful of others. And they are rightfully adaptive to a community that will betray trust. A third cause for isolation: too busy… “I can’t chill with my friends when it takes all my time to find, use, and recuperate from my beloved drug/alcohol use.” Another pitfall for those in active addiction is inauthenticity. If a person must display a false mask; if they are a fake person, then the relationship is consequently a fake relationship.

In recovery, some people will change their crew. Without zero doubt, if a person is gonna stand a chance at sustained recovery they must diminish the time they spend with problematic friends. And, if a person is still primarily surrounded by people who are using and not in recovery, well that’s a red flag for their recovery status. In other words,

Johnny: “Just because I’m hanging out with Joe and John, and they use fentanyl, doesn’t mean that I am going to start up again. That’s just an oversimplification. I don’t plan to use any of their supply at all. What they do is their business and I do what I do.”

Me: (internally) It seems significantly implausible that he will avoid resuming fentanyl (internally even deeper) that’s something a person says when their addiction is running the show. (Audibly) “I think two months from now I’d love to find out that you’re right. But after my experience doing this… and please don’t judge me harshly… but here’s the thing. If you can’t play on the team anymore, sooner or later you’re gonna stop socializing in the dugout. Take a minute and think about that. If you keep hanging out with Joe and John, it’s gonna be pretty obvious that you aren’t taking your recovery very seriously, because chillin’ with them tells everyone that you wish you were still playing ball.”

But after that initial social change, some people in recovery learn that the typical human specimen has good intentions toward others. They begin to see that teaming up for common [healthy] goals is worth the risk. They learn to understand how to determine ‘security clearance’ for the people in their life. The share meaningful experiences with others that bind them. They reciprocate risks and rewards with others and it pays off. A person in recovery is gaining self-respect and typically, sooner or later, self-confidence. They are more likely to put themselves in the public eye. When they meet people, they are less likely to display a drug persona, or front. They are more likely to be themselves, which makes them more attractive to others.

To summarize the underrated social aspect of recovery, I’ll quote attachment and trauma recovery guru Brene Brown: “Fitting in: become who you need to be accepted. Belonging: be who we are.”

Reasoned Priorities. There are well founded neurobiological reasons that a person who has suffered in severe addiction will have uncalibrated priorities. Consider ‘urgency’ versus ‘importance’. An important thing might be non-urgent. And all those things will get prioritized after drug use. A person in severe active addiction cannot find the time to manage the non-urgent items of their life. Here’s a common example: a person gets pulled over for having an expired license plate. They are given a fix-it ticket which might result in zero penalties if they prove within a month that it’s been renewed. That can happen to most anyone right? But a person who is dominated by their addiction might not rate it as a problem at all. Consider a person in active addiction will feel physically and emotionally ill if they fail to procure and consume their drug. That is a direct and immediate concern! In comparison, a problem with my driver’s license some weeks from now is vague and theoretical; it’s a hitch in the human-constructed modern world that may or may not impact my lifestyle at all. Come to think of it, anything in the ‘future’ can get taken care of by ‘tomorrow me’, today me has more pressing concerns. Come to think of it. My ‘someday goals’, I’m sure that those will happen ‘someday’… not worried.

Unfortunately, a person suffering with severe substance use disorder’s desire to use their drug of choice is reinforced by an evolutionary neurological imperative. To the person, subjectively speaking, their ‘desire’ to use is indistinguishable from a ‘need’. Sadly, this puts their substance use desire above the deepest, most important things in their life, such as being a good parent – at least while the addiction is unsatiated.

A person in recovery from substance use disorder is going to find use for their time. A person in recovery will notice their past failure to empathize with their future-self. In fact, they may resent their past-self for wasting so much time and effort. They will likely conduct themselves as a responsible person, parent, partner, employee, citizen, etc. They might find themselves exceptionally goal-oriented and ‘on-fire’.

Diminished obsession. The person in early recovery from severe substance use disorder might think of their drug all, the, time. The person may pray to their higher power asking for the Wanting to cool off, if only a little bit. They will be surprised when “I almost didn’t even think about drugs at all this morning”. As a newer alcohol and drug counselor, I found myself stumped when my client said: “I just want to not want a pill.” He was talking about opiate use disorder. I didn’t have the answer that suited us. For abstinence-based recovery I still don’t. In abstinence-based recovery, the answer for obsession is mindfulness, prompt awareness and acceptance, redirecting the desire to something healthy and attainable …and faith, possibly prayer …and community – no strategy spared.  Any recovery hero who learns to observe and interrupt their drug captivations and cravings, who can spot their absent-minded reveries and redirect their attention away from their red-hot drug of choice desires, they have found a peace and deeper understanding of discipline than most everyday people can imagine.

Being in recovery means the person has found a strategy to gradually, over time, decrease the frequency, intensity and duration of their craving bouts. Prescription opioid replacement medications like buprenorphine and methadone satiate the opioid desire and make it literally unnecessary. Wouldn’t it be something if that was the easy answer… stabilize the chemical dependency and the obsession goes away? Not quite... The habitual human mind gives every person in recovery some of the same obstacles to surmount. First, a person can passionately want something they know will not satisfy them; or desire something that they hate having, or wish for and even strive for something that cannot even exist for them. Second, a person can feel that a precious future goal is sacrificial in the face of an immediately achievable desire. Third, a person can become overly driven with relapse prevention strategies and tactics ensuring they ‘do not do it’. Which is essentially saying “What I want is to have the nothing which is a challenge.” Try explaining that to a logistician or computer programmer. It doesn’t work in math or in life, the will-power trap: Just don’t do it. Just don’t do it. Obsessing on the opposite. Unfortunately, whether it’s the Pro or Con side of the debate, the topic on the floor is ‘getting high’. And that’s why folks don’t stick with their diet. Because will-power wears out. It’s been called Ego Fatigue. Its not enough to resist and deny a passionate want. That powerful cannon of human desire must be re-aimed and fired at something that it can usefully hit.   

To summarize, real world, for helping a person assess recovery: We know that consumption of mind-altering substances is an area for query. How much or little are you consuming, what changes, what pro-recovery moves do you have planned? But please do not stop there. Do not let someone say ‘not abstinent, not in recovery’ without checking what they mean by recovery. Here are some additional real-talk questions to determine recovery status regardless of substance use levels.

“Tell me about your employment or enriching activities?”

“Tell me about your three closest friends and their substance use or lack of.”

“Tell me about your substance-related mental captivation, obsession or lack of.”

“Tell me about your internal experience when you decided to change your substance use.”

“Tell me how the substance-use changes have impacted your self-esteem?

“Tell me about your recent achievements?”

A person who is clean and sober may not have developed a strong recovery, yet a person who remains chemically dependent can display all the indications of a sustained and profound recovery. A person who has been on ‘subs’ for five years more likely deserves a handshake than a judgment on their recovery. While it may not be obvious based on substance use, a strong recovery might be on display if your looking for right evidence.