What is Recovery in Substance Abuse? Answered by an Alcoholic Nurse

Every September, The Substance Abuse and Mental Health Association sponsors Recovery Month to raise awareness of substance abuse and mental health issues. The concept of recovery is often difficult for the general public to understand. This article will shed light on what it means to be in recovery. Nurses Announcements Archive

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Specializes in Clinical Leadership, Staff Development, Education.

I am an alcoholic and am in recovery. If you are an addict of any type (substance abuse, alcohol, sex, gambling, shopping ect.) and are in recovery, you understand exactly what this phrase means. However, to the general public, including healthcare providers, the concept of recovery is unclear and remains a mystery. To "muddy the waters", there is not one universally accepted definition of recovery. The Substance Abuse and Mental Health Association (SAMHSA) provides this definition- "A process of change through which an individual achieves abstinence, improved health, wellness and quality of life". Recovery definitions agree that recovery is a process with positive physical, mental and social benefits. On any day, it is estimated 700,000 individuals seek treatment for substance abuse. Approximately 40-60% of addicts relapse and relapse is often part of the recovery process. It is difficult to determine how many people actually "recover" since substance abusers typically report they are better than they actually are.

SAMHSA expands the definition of recovery and describes "Guiding Principles of Recovery". Let's take a closer look:

Recovery is self-directed and empowering

There are many paths to recovery. The progress towards recovery depends on the individual and how they "work it". As an individual works towards recovery, there is typically an associated feeling of empowerment. This is important because there is a loss of "self" during active addiction.

Recovery involves a personal recognition of the need for change and transformation

Part of recovery is simply acknowledging a problem exists and there is a need for change. I was like many others and recognized a need for change only after I had negative consequences associated with my drinking. Consequences of substance abuse are different for each person, but often includes health issues, loss of job, loss of family, arrest and others.

Recovery is holistic and has cultural dimensions

Recovery extends far beyond abstinence and considers the whole person. When I was in rehab, we were required to check-in every day by using reflecting on how we are physically, mentally, spiritually and emotionally. Culture plays a central role in determining a person's path to recovery.

Recovery exists on a continuum of improved health and wellness

As nurses, we often care for patients who are in active addiction. They may be admitted for seizures, infections, pancreatitis and many other physical ailments. Substance abuse is all consuming and those afflicted usually put personal health and wellness on a backburner or ignore out of shame. When I left treatment, I made appointments for my annual physical and desired to make my health and wellness a priority.

Recovery is supported by peers and allies

My father is an alcoholic and has been in recovery for 25 years. Over the years, I often heard him say "there are those who know and those who don't know". It is important to build a support network with others in recovery- those who know. In my active disease, I felt alone and did not think anyone could possibly understand what I was going through. It was such a relief to talk and interact with people who were also in recovery.

Recovery emerges from hope and gratitude

Hope and gratitude are an attitude and how you perceive the world. The world is viewed positively when you are grateful for what you do have- not just material items.

Recovery involves addressing discrimination and transcending shame and stigma

I lived with shame and guilt for so long, I felt as if everywhere I went people saw only an alcoholic. The patients you care for with substance abuse often don't disclose or downplay the severity of the problem due to common stigmas.

Recovery involves rejoining and rebuilding a life in the community

The addict often isolates themselves from others due to shame and guilt. Part of recovery is to interact with others and become involved with what is going on around them. This could be returning to work, engaging in hobbies, socializing with others and more. Rejoining and rebuilding life in the community will be different for everyone.

SAMSA also identifies four signs that a person is in recovery. These include:

  • Addresses problems as they happen (tendency to avoid in active disease)
  • Have at least 1 person they can be completely honest with (helps to reduce shame and guilt)
  • Sets personal boundaries and know which issues belong to them and which issues belong to others
  • Takes time to restore energy, physically and emotionally, when they are tired (this supports holistic approach to recovery)

As healthcare professionals, we often care for patients in active addiction and also, various levels of recovery. It is important to understand if the patient is in recovery and how the healthcare team can support the patient's progress. Remember, recovery can take many paths and is dependent on the individual. If you are interested in learning more about National Recovery Month, SAMHSA at Home | RecoveryMonth.gov. Does this article improve your understanding of recovery? Each of the above points could be an article independently. What additional information would be helpful?

If you are in recovery and feel comfortable sharing- let us know what recovery means to you.

Resources

SAMSA Home | RecoveryMonth.gov

American Addiction Centers Addiction Recovery - Alcohol and Drug Abuse Treatment Resources

National Institute of Drug Abuse National Institute on Drug Abuse (NIDA) |

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I am a nurse in recovery. I was working as a nurse when it became apparent that I needed to seek help for my addiction. Thank goodness I did, as the last 13 years have been a wonderful journey. I attend 12 step meetings and most of my friends are also in recovery. As you pointed out, the support from others who really understand is invaluable. At times I have disclosed my situation to patients who are trying to find recovery, but it is not anyone else's business as long as I am doing what I am supposed to do to continue to recover. Learning more about myself and striving to become a better person has resulted in my being a better employee as well. I'm extremely grateful to be in recovery. On those days when I care for a patient who is struggling in active addiction, I find my gratitude increases dramatically. Thanks for sharing your post.

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Specializes in Private Duty Pediatrics.

My birth family has many alcoholics, smokers, and drug abusers. As a result, I went the other way; I'm a teetotaler, I've never smoked, I don't do drugs. And I feel like I don't know how to connect well with those who do.

Yes, I'm a nurse; I learned about alcoholism, etc. It's a disease that starts with a choice, and it's a choice that can be easy to make. I understand that an alcoholic needs help to quit drinking, and I know that relapse happens. I tell my friend to "quit, and don't stop quitting."

Do I sound preachy? I don't want to. I want to come alongside, to be there. We're close friends, and share openly. She chose to quit drinking to help a friend. But I don't know what to say when she says, "Kitiger, I don't want to do this. I'm OK: alcohol isn't hurting me."

Yet, she can't quit.

Would you say that alcohol is hurting her because she can't quit?

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Kitiger:

I wouldn't say anything to her about quitting. I think recovery is a personal choice and until the person abusing a substance or activity decides to quit everybody else's opinion is just background noise and can't help but to sound preachy. I'm not saying not to be there for your friend but you should probably consider drawing some boundaries so you don't become a codependent part of some dysfunctional relationship which would only make things worse for her. Is alcohol actually hurting her? If it is let her deal with the consequences of her choice to drink. If its not then her drinking is no big deal. Either way its her choice.

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Specializes in Clinical Leadership, Staff Development, Education.

Congratulations on your recovery! You are so right, I am more patient, understanding now when caring for someone in active addiction.

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Ms. Adderton, this is a wonderful article. I have spent the past 6 years developing an online treatment program for nurses only. I would greatly appreciate the opportunity to visit with you and discover some of your insights as well. Please let me know if you might have a moment to visit. Dr. Fred J. Hansen, Online Recovery (www.onlinerecovery.us) [email protected]. Thank you.

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