Defining Success in Recovery
Substance use disorders resist narrow definition: Individuals in need of treatment present a wide array of symptoms, complicating circumstances and co-occurring mental health concerns. But if the challenges of substance abuse vary on an individual basis, definitions of success in recovery can differ just as much.
Whereas many understand recovery as lifelong abstinence from mind-altering substances, recent shifts in the world of addiction treatment have called this premise into question. Researchers note that rates of relapse for substance use are equivalent to that of other chronic illnesses, such as hypertension or asthma. In light of these findings, some experts have suggested that reducing the frequency and consequences of use would be a more appropriate recovery principle. Others have championed medication-assisted treatment, calling the traditional emphasis on total abstinence unrealistic.
In this project, we sought definitions of success from a different source: about 1,000 individuals who identified as being in recovery. When we asked them to express their own views of relapse and remaining sober, interesting contrasts and conflicts emerged. To find out how people define their recovery success, keep reading.
Keys to Keeping Clean
Before exploring differences in recovery definitions, it’s worth studying which factors and circumstances our respondents found most helpful in their own journeys. Distancing oneself from bad influences emerged as the most constructive choice overall, a finding that seems to confirm the common suggestion to avoid “people, places, and things” associated with past use. Other highly rated factors suggested replacing those old influences with more positive connections: Friends and family and consistent employment were rated “very helpful” factors overall.
Interestingly, measures that entailed outside help, such as participating in treatment or support groups, were rated only moderately helpful overall. But without treatment and ongoing support, many could find self-directed objectives difficult. Indeed, top-rated aspects like making goals or getting more physical activity may be essential to maintaining well-being in ongoing recovery. But given the risks associated with withdrawal, medically supervised detoxification may be necessary before individuals can begin to pursue healthier choices on their own terms. Unfortunately, our respondents found the National Helpline, a federal resource designed to help individuals obtain such treatment, largely unhelpful in their experience.
According to our respondents, the most challenging struggles in sobriety were frequently internal. Mental strain was rated most difficult overall, perhaps because many in recovery experience intense and unpredictable cravings for substances they used previously. Respondents reported emotional challenges were nearly as difficult. Many in recovery struggle with feelings of guilt and shame related to their use, emotions that may eventually precipitate relapse. Others grapple with feelings they once sought to drown with substances: Research suggests anxiety is strongly correlated with problem drinking, for instance.
Our respondents found social problems slightly less difficult. This fact may encourage those contemplating recovery: Although many fear they’ll feel alienated from friends and social events once they stop using substances, these challenges were rated only “moderately difficult” overall. Physical challenges were assessed as the least difficult issue on average, although experiences differ vastly in this regard. Long-term physical effects depend on a variety of elements, including one’s substance of choice and the duration and intensity of one’s use.
Returning to Recovery
As individuals gain more experience in recovery, do they manage to reduce the length and frequency of their relapses? Our findings suggest they do: As time went on, the percentage of individuals reporting they were extremely successful at increasing the length of time between relapses increased. Still, for those who have relapsed on more than one occasion, the median amount of time between relapses was just 20 days. Experts note that while relapse is frequently a part of recovery, it can present distinct dangers: After a period without drugs, users’ tolerance declines, leaving them more vulnerable to overdosing.
Relapse need not entail an extended return to using, however. In fact, the median length of relapses was just three days for those who had relapsed on multiple occasions. Moreover, time in recovery seemed to correlate with self-reported success at reducing the length of each relapse. These findings should indicate an important source of hope: After a slip, people can resume healthy behaviors quickly, rather than abandon recovery entirely.
Our findings suggest that relapse becomes less tempting after a few years in sobriety, but cravings after exposure to one’s substance of choice may never entirely fade. After three years in recovery, the number of people reporting it was extremely difficult to avoid relapse declined slightly, and the number fell further still for those with four or more years under their belts. Experts note environmental cues can often prompt cravings a decade or more after an individual last used drugs, equating these thoughts of using to a conditioned “reflex.”
Time in recovery did seem to erode respondents’ hopes that they could one day use drugs casually, however. More than a third of people in recovery for less than a year harbored this suspicion. After four years, however, this contingent shrunk to just 6.3 percent. Perhaps relapses teach this lesson over a period of several years: Just as our earlier results suggest that experience helps reduce the length and frequency of relapses, so might time in recovery help eliminate the desire to experiment with drugs entirely.
Realizing Recovery: For Today or Forever?
Time also seemed to shift how our respondents assessed success in recovery, although significant differences of opinion existed after any number of years in recovery.
Those with less than a year, for example, were almost equally likely to gauge recovery success in terms of a specific time frame as never using a substance again. With additional experience, however, a great number of respondents gravitated toward the standard of total abstinence.
Conversely, the percentage who assessed recovery using a set time frame dwindled.
The most popular measure of success in recovery emphasized a different kind of milestone entirely: This cohort found triumph in every occasion in which they refused a drink or drug. As experts and individuals in recovery alike debate metrics-driven measures of success over the long term, this standard is one that individuals can meet daily.
Other respondents emphasized emotional benchmarks for success in recovery, either for loved ones or themselves. Some defined success in the language of power and control, resisting their substances that had once dictated their behavior. One respondent, a female with a year of recovery experience, invoked a more modest standard to convey the seriousness of her substance abuse challenges. For her, recovery success could only be assessed “one day at a time.”
Founding a Future – On Your Terms
These results indicate significant differences among persons in recovery regarding the standards of sobriety they establish for themselves. But although our data suggest some areas in which opinions differ greatly, we must strive to respect others’ choices as they pursue well-being for themselves. Indeed, in a recovery community long stigmatized, internal divisions can only prove counterproductive. To truly support those who have struggled with substance abuse, we cannot reject allies whose understandings of recovery differ from our own.
If you or someone you love is in need of help with substance use issues, selecting the appropriate treatment option can seem challenging. Because each individual’s challenges demand personalized care solutions, expert guidance is often necessary to choose the most effective treatment approach. Let our team of specialists help you evaluate your options. With recommendations tailored to your personal, medical, and financial needs, you can begin to define recovery success for yourself.
We collected responses from 988 people who have been in recovery from Amazon’s Mechanical Turk. 58.2% of participants were male, and 41.8% were female. Participants ranged in age from 18 to 78 with a mean of 33.4 and a standard deviation of 9.8. Any respondent who had never been in recovery for a drug or alcohol addiction was disqualified.
Our data was acquired via self reported responses. Issues may arise with self reported data, including: selective memory, telescoping, attribution, and exaggeration.
Fair Use Statement
If you’d like to help spread a message of hope, you’re welcome to share our findings of success and relapse in recovery. Please use our images and information for noncommercial purposes only, and provide a link to this page to attribute our team appropriately.