When you think of addiction recovery these days, the likelihood is that you don’t think of the path to improved mental health and wellbeing. The West’s most visible portraits of recovery from addiction are of spoiled, out-of-control celebrities entering rehab to get a career boost or atone for bad behaviour, and then we all wait with baited breath for said celebrity to crash and burn again. In fact, a 2004 poll conducted by the recovery advocacy group Faces and Voices of Recovery found that most people think of recovery as the attempt — and typically, failure — to get well.
September was Recovery Month in the US, with different wellness experts and researchers weighing in on the true nature of recovery. Over the past two decades, there’s has been a great deal of research which sheds light on our misconceptions about the recovery process, and is causing the addiction-treatment establishment to reconsider its fundamental nature. Let’s take a look at the opinions of one such wellness expert: William White, a senior research consultant at Chestnut Health Systems, who is himself in long-term recovery from methamphetamine addiction. White is also the one of the most comprehensive and compelling histories of American addiction treatment, Slaying the Dragon.
In 2007, White served on a consensus panel convened by the Betty Ford Institute to create a new definition of recovery. The panel sought to address such definitions of recovery, such as labelling an alcoholic who drinks moderately as “recovered” because they’ve demonstrated positive change. White comments, ‘If you don’t have any boundaries about what recovery is, then the term ceases to have any meaning. If we proposed to define recovery from cancer by any sign of progress, people would think we were out of our minds. We tried to [convey some of that idea, however]. I’m proposing that we use the terms “partial recovery,” “full recovery” and “amplified recovery,” because some people get far better than well.’
While White’s own definition of recovery isn’t exactly the same consensus definition that the Betty Ford Institute came up with, it’s still pretty similar. ‘The only nuance I have [that is different] from the Betty Ford Institute consensus is that [I use the word] remission [instead of sobriety], and that includes deceleration of use, particularly for those with lower problem severity,’ White explains. ‘The research shows that people whose problems with alcohol or other drugs that were not that severe are more likely to be able to successfully [moderate, rather than quit entirely].’
He adds, ‘We’re still trying to figure out a whole philosophy of choice. People need to have choices relevant to their pathways to recovery. But how do you talk about a philosophy of choice, when traditionally, people in AA said [sarcastically], “Your best thinking got you here.” This is part of the frontier we’re working on right now. It’s quite exciting. Where does a philosophy of choice fit in terms of your stage of recovery? If addiction means being robbed of choice, at what point do I regain the power to make choices, at what point do I become a free agent where I really can [make good decisions for myself]?’
So is there hope for patients who have to be coerced into recovery? White concludes, ‘Of course, to say that recovery is voluntary doesn’t discount that there may be some therapeutic effect for some people in coerced treatment. We don’t find a lot of differences in outcome between coerced and voluntary clients. You can initiate abstinence or my definition of recovery under external pressure, but long-term recovery can only be sustained by voluntary choice.’