Does Recovery Mean “Drug Free”?

The short answer is a resounding “NO!”

But it is not that simple. If we are talking about illicit drugs then the answer for the most part is “yes”. However even that is not an absolute. Old school recovery programs are firmly based in abstinence and clearly the literature continues to support the notion that once an addict is an addict then it is not the drug they are using that is so important but rather the disease of addiction that matters. To that end it is very easy for any addict to “switch” his or her addiction from one drug to another. The reality however is that even the process of recovery can be substituted as their new addiction. Care must be taken during the recovery process to not let this happen because extreme behavior of any kind is potentially destructive. There are those like myself who find fault with the “12 step” program because it often creates a process in which the program itself becomes the new addiction. In my opinion “Holistic” programs are more well rounded and are less likely to promote a “new” addiction to the program itself.

I firmly believe that as long as no significant psychiatric disorder exists (eg. bipolar disorder, schizo-affective disorders, personality disorders) it is very possible to recover from your addiction and still go on to experience healthy use of alcohol and nicotine. Addicts often discount nicotine as a drug and feel comfortable about their smoking. Do not be fooled. Nicotine is an abuseable drug. If there is room for the reasonable use of nicotine then there is room for the reasonable use of other substances as well.

In the presence or absence of psychiatric disorders there is always room for Suboxone therapy. In the recent past Detox centers have been very quick to pull the plug on Suboxone therapy in 3-10 days when a client is coming off opiates or heroin. Current literature does not support the quick removal of Suboxone therapy As recently as this week in the Journal of the American Medical Association data was published that supports long term Suboxone therapy over short term use. Adolescents who were maintained on maintained on Suboxone for an extended period of time had significantly higher treatment success than those who were. taken off Suboxone promptly.

Lastly, for those who have a significant Psychiatric diagnosis drug therapy, in my opinion, is not option but is instead mandatory. Recovery simply cannot be achieved without the appropriate and judicious use of prescription medications. Even prescription medicines like clonazepam and xanax have their place is a well designed and supervised treatment program. Given the co-morbidity that exists between substance abuse and psychiatric illnesses if those illnesses are not addressed then we are setting our clients up for failure rather than giving them the tools they need to achieve recovery. The only way to get the psychiatric clients on the same playing field as the non-psychiatric clients is to medicate those patient who require it. It is only then that the recovery process can begin.

So does recovery mean “drug free”? Almost never!

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