It’s well-known that addiction hijacks the brain. Even though addicts are aware of the negative consequences of continuing to use, they still do it. As the disease progresses, they will start to lie, steal, cheat, and worse… anything to get their drug of choice. Eventually, they find themselves alone, with all their relationships in smoldering ruins and nowhere to turn for help. But is there hope when it comes to overcoming addiction? Can you ever get over it? If so, how?
With comprehensive treatment that lasts long enough, it is possible.
About 60% of those with lifetime substance use disorder do achieve a period of sustained abstinence eventually, according to several studies.1
RELATED: How do drugs affect the brain?
The Three-Year Advantage to Overcoming Addiction
Your chances of staying clean and sober increase as time passes. An interesting study published in the December 2007 edition of Evaluation Review followed over a thousand people for eight years after their recovery.2
It demonstrated that the longer you are abstinent, the lower your chance of relapse. Here’s how it breaks down:
- Approximately 36% of people in their first year of recovery will stay clean and sober
- From one to three years, two out of three (66%) will sustain it
- At three years, 86% will remain clean and sober
- At five years, 86% will remain clean and sober
As you can see, the likelihood of staying clean and sober increases significantly over the first three years of sobriety and then stabilizes, according to the study.
This timing dovetails with the stages of recovery.
It’s at about the three-year mark that those in recovery make the switch from repairing the damage caused by addiction (relationships, career, self-esteem and finances) to the growth stage, which is lifelong:
“The growth stage is about developing skills that individuals may have never learned and that predisposed them to addiction. [While] the repair stage was about catching up…the growth stage is about moving forward.”3
There is also a financial benefit to recovering from addiction, which also appears to reach a significant milestone at three years of sobriety.
The eight-year study on addicts in recovery found that at one year, there was a significant increase in number of days worked and a decrease in days they experienced financial problems. After three years of abstinence, there were significant reductions in the percentage of families who were living below the poverty line, which the study’s authors concluded showed gains in financial status.4
Why does this happen? Two reasons: the illegal activity associated with drug use stops and legitimate income earning begins. Over time, these gains add up to a much-improved financial position. It doesn’t happen overnight, but it does happen.
All of this also illustrates why, when it comes to gauging addiction treatment success, we should take a longer view.
Rather than looking at sobriety at 90 or 120 days, is the person still clean and sober at one, two and three years out?
Most importantly, how do we get people to the three-year mark, where they will achieve maximum chance of maintaining their newfound sobriety?
What is the Most Effective Treatment for Overcoming Addiction?
The most effective treatment for addiction is, in a few words, long-term5 and comprehensive.6
Addiction treatment must address every aspect of a recovering addict’s life, including navigating a successful re-entry into the real world. Ongoing support is also needed for those critical first three years, and beyond.
Long-Term Treatment for Overcoming Addiction
Most people outside the field of addiction recovery tend to think of the detox process when they think about treating an addiction. In reality, this is only the beginning.
Detoxification is the physical withdrawal from your drug of choice. There is an acute phase, with the most serious physical symptoms. Then comes the post-acute phase, where you are out of the danger zone physically, yet still don’t feel great and are perhaps experiencing some mental anguish as well.
Both these stages can sometimes hamper recovery, as addicts run from the pain and uneasiness back into the quick escape of drugs or alcohol.
As uncomfortable as withdrawal is, though, it’s still the (relatively) easy part. It’s the underlying issues that drove you to start using, as well as changes to the brain, that are longer-lasting and more difficult to recover from. For example, changes to the brain brought on by addiction can persist for months (perhaps even years) after drug or alcohol use is completely stopped.
This does not mean long-term addiction treatment has to be of the same intensity over the course of the disease, however. You can gradually step down through less intensive levels of care as you gain momentum in your recovery. The final stage of outpatient treatment, for example, involves one to three hours of treatment per week, working the timing around the rest of your life.
Comprehensive Treatment for Overcoming Addiction
Establishing a firm foundation in everyday life is so critical for recovering addicts. Why? Because failure to do so can lead to relapse.
Consider this letter from a mother of a crack addict, written to authors of the Evaluation Review study:
“My daughter has been an addict for 12 years. She is the mother of four children, all of which she has lost parental rights to. She has been in prison most of the 12 years, and had many programs, doing well in what was offered during incarceration.
When she is released from prison, she is always hopeful for success… [however] she is immediately faced with four major challenges: getting a place to live, finding a job, transportation, and obtaining continuing recovery treatment….
Now she just got [out] of jail three weeks ago, went through what I just described above, and went back onto the streets. She was broke and shoplifting, and now will go back to jail, do the program for probably the tenth time, and be released again the same way. There are many like my daughter, so addicted they will end up dead.”7
You can’t be in a hurry when it comes to addiction recovery. And you can’t approach it with half of a solution.
Holistic recovery programs are all-encompassing, aiming to rebuild every area of an addict’s life.
From growing stronger physically and establishing healthy coping strategies to forging a spiritual foundation, new social system and way of life, recovery must be an “all-in” proposition.
As previously mentioned, after detox, recovering addicts move through progressively less-intensive levels of care. Each level is designed to address underlying issues and conditions and equip them with the knowledge and practical means by which to maintain their recovery.
As their level of care decreases, their involvement with the outside world increases. This allows for a gradual reintegration into the real world.
The best addiction treatment centers facilitate this re-entry in multiple ways. They offer continuing outpatient treatment, with flexible time frames, as well as referrals to sober living facilities for extended stays, assistance with finding employment, and alumni groups that provide active support.
What Helps You Stay Clean and Sober?
The tools you develop in treatment, as well as everything you do in life, plays a big role in whether – and how long – you will stay clean and sober. The following factors have been shown to assist in the maintenance of sobriety:
- A reduced-risk environment
- Increased self-confidence, or self-efficacy (the belief that you are able to successfully deal with life’s situations and challenges)
- Spiritual support
- Social support
- Increasing your number of clean and sober friends
- Ongoing mental health treatment
- Involvement in a 12-step program
- Helping others
These factors are addressed in the through the levels of care as well as with after-care support.
Reducing Environmental Risk
Our environment has a great influence on us.
Neighborhoods with higher levels of crime and drug use, for example, serve as a breeding ground for even more drug use and crime, as a result of the perception that residents are indifferent to it.8
Beginning treatment requires total removal from your current environment. You will stay removed from this environment for the course of your treatment.
However, if, after treatment, you go back into the same environment from which you came, it can trigger relapse.
Here’s where a sober living home can fill the void. Living surrounded by others who are sober and clean can help you stay sober and clean as well.9
Overcoming Addiction Through Increasing Self-Efficacy
Self-efficacy is really self-confidence, or a belief in your ability to successfully handle life’s challenges.
When it comes to drug and alcohol use, those who are highly confident that they can stay sober and clean are more likely to successfully complete treatment and maintain their sobriety.10
How do you develop more self-efficacy?
Building strong coping skills through cognitive behavioral therapy (CBT) and then successfully bringing those to bear in everyday life is the best way to shore up belief in yourself.
In fact, a 2005 study identified coping skills as “central” to relapse prevention.”11
Coping skills involve building communication, social and problem-solving skills. Each time you use these newfound skills in life instead of turning to drugs and alcohol, you have a “mastery experience.” In turn, each mastery experience builds your belief in yourself as someone who can successfully cope without illicit substances.
Spiritual Support in Overcoming Addiction
There is scientifically supported evidence that faith and spirituality are protective factors against relapse.
In a 2008 study, individuals who maintained their recovery had significantly greater levels of faith and spirituality as compared to those who relapsed.12
Another study published in 2015 showed that those who reported that they felt God’s presence on a daily basis and believed in a higher power as a universal spirit also had better outcomes than those who did not.13
Several studies have shown a relationship between having faith or spirituality and sobriety length. Addicts also said that faith was “an important component of their recovery efforts and… helpful in maintaining changes made during treatment.”14
On a general level, “higher levels of religiosity and spirituality have been associated with greater physical and mental health,” as shown in many studies.15
Although you may find yourself stranded during active addiction, you are not an island.
We were built to be in relationship with others.
You need support from other people in order to maintain your sobriety. This includes good relationships with family, friends, co-workers, employer and/or employees… the entire constellation of people whom your life touches.
That’s why it’s a good idea to look for a treatment program that incorporates your family members.
Good relationships with your family help make treatment more effective and protects you again relapse. If you are blessed to have supportive, cohesive relationships with your family members when you enter treatment, for example, you are less likely to experience drug problems (as well as family and mental health problems) three months later, according to research.15
Increasing the Number of Your Sober or Clean Friends
Just like good family relationships bolster your chance of successful addiction treatment, good peer relationships help you recover – and stay sober.
It works the other way as well. If your friends do drugs, you are more likely to do drugs. The more of those negative ties that you maintain, the more you sink your chance for a successful recovery.16
Ongoing Mental Health Treatment
About half of people who experience a mental health condition will develop substance use disorder as well, according to the National Institute on Drug Abuse.17
Mental health conditions will be uncovered and treated as a part of your program at a qualified addiction treatment center.
Of course, these conditions don’t magically disappear once addiction treatment is complete.
In fact, in one study showed that problems with mental health peaked in the one-to-three-year period following the sober/clean date. After that, these problems decreased.18
This further illustrates the need for ongoing mental health issue treatment in overcoming addiction. You’ll feel happier, more well-adjusted, and you will be protecting yourself from relapse.
Involvement in a 12-Step Program
Many studies have shown that participating in Alcoholics Anonymous and Narcotics Anonymous improve the likelihood of staying sober and clean.19
AA and NA also improve participants’ belief in the ability to meet life’s challenges (another protective factor against relapse). Finally, participation improves “social functioning,” which aids in building a social network and increasing your number of friends who are also clean and sober, other protective factors.
In addition, when you combine 12-step involvement with professional treatment, the outcomes are even better.20
The act of helping other people helps you, too.
A host of benefits – from lessened anxiety and depression, improved mood, enhanced life purpose, better physical function and increased self-esteem and longevity – come when you reach out a helping hand to a fellow human.
Those benefits more than double when the you are helping someone who has the same chronic disease that you do, according to a 1999 study.21
When it comes to alcoholism, a 2004 study found that those who were in treatment for the disease and helped others were twice as likely to be sober at one year out versus those that did not.22
Alcoholics with over 20 years sober were found to be significantly more helpful overall than they had been while drinking, according to research. This helpfulness spilled over into every setting – including work, home and 12-step meetings.
However, those recovering alcoholics pointed to helping other alcoholics in a 12-step program as the most significant and highest overall contributor to their contributed sobriety. (They said it contributed “a lot” to helping themselves stay sober… more so than helping in other settings which they rated as contributing very little).23
Interestingly, a 2007 study found alcoholics to be more likely to have Antisocial Personality Disorder (ASPD), yet those who had recovered and sustained long-term sobriety, no longer met the criteria. Moving from being self-focused to focused on helping others (called “response shift”) may be the reason for this stunning transformation.24
Recovery is Possible
Overcoming addiction and getting back into society are processes. Maintaining sobriety is a lifelong endeavor.
The key here is to have patience… and manage expectations. Things don’t immediately fall into place once you put down the bottle, the needle or the pills, but it will happen.
The evidence shows that the longer you are sober, the more likely you are to remain that way. Nearly nine out of ten of those with just three years sober, do just that.
Stress will rear its ugly head again; it does for all of us. But, with the right treatment and armed with the right tools, those in recovery will be able to withstand all of life’s challenges.
1 Dennis, Michael, Foss, Mark, and Scott, Christy. (2007). An Eight-Year Perspective on the Relationship Between the Duration of Abstinence and Other Aspects of Recovery. Evaluation Review, 31. 585-612. DOI: 10.1177/0193841X07307771.
3 Melemis, Steven. (2015). Relapse Prevention and the Five Rules of Recovery. The Yale Journal of Biology and Medicine. 88. 325-332.
4 Dennis, Michael, Foss, Mark, and Scott, Christy. (2007). An Eight-Year Perspective on the Relationship Between the Duration of Abstinence and Other Aspects of Recovery. Evaluation Review, 31. 585-612. DOI: 10.1177/0193841X07307771.
5 Mohammad, A., Irizarry, K., Shub, R. and Sarkar, A. (2017). Addiction Treatment Aftercare Outcome Study. Open Journal of Psychiatry, 7. 51-60. DOI: 10.4236/ojpsych.2017.71005.
6 Principles Of Effective Treatment National Institute on Drug Abuse – https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment
7 Dennis, Michael, Foss, Mark, and Scott, Christy. (2007). An Eight-Year Perspective on the Relationship Between the Duration of Abstinence and Other Aspects of Recovery. Evaluation Review, 31. 585-612. DOI: 10.1177/0193841X07307771.
8 Kelly, Sharon, O’Grady, Kevin, Schwartz, Robert, Peterson, James, Wilson, Monique, and Brown, Barry. (2010). The Relationship of Social Support to Treatment Entry and Engagement: The Community Assessment Inventory, Substance Abuse, 31:1, 43-52, DOI: 10.1080/08897070903442640.
9 Polcin, Douglas, Korcha, Rachael, Bond, Jason and Galloway, Gantt. (2010). What Did We Learn from Our Study on Sober Living Houses and Where Do We Go from Here?, Journal of Psychoactive Drugs, 42:4, 425-433, DOI: 10.1080/02791072.2010.10400705
10 Kadden, Ronald M, and Litt, Mark D. (2011). The Role of Self-Efficacy in the Treatment of Substance Use Disorders. Addictive Behaviors, 36(12), 1120-1126.
11 Roffman, RA, and Stephens, RS. Relapse prevention for cannabis abuse and dependence. In: Marlatt GA, Donovan DM, Editors. Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors. New York: The Guilford Press; 2005. pp. 179–207.
12 Jarusiewicz, Betty. (2000). Spirituality and Addiction: Relationship to Recovery and Relapse. Alcoholism Treatment Quarterly. 18(4):99–109. DOI: 10.1300/J020v18n04_08.
13 Dermatis, H., and Galanter, M. The Role of Twelve-Step-Related Spirituality in Addiction Recovery. Journal of Religion and Health 55, 510–521 (2016). DOI: 10.1007/s10943-015-0019-4.
14 Heinz, Adrienne, Disney, Elizabeth, Epstein, David, Glezen, Louise, Clark, Pamela, and Preston, Kenzie. (2010). A Focus-Group Study on Spirituality and Substance-User Treatment, Substance Use & Misuse, 45:1-2, 134-153, DOI: 10.3109/10826080903035130.
15 Constantini, MF, Wermuth, L, Sorensen, JL, and Lyons, JS. (1992). Family functioning as a predictor of progress in substance abuse treatment. Journal of Substance Abuse Treatment, 1992 Fall 9(4): 331-5.
16 Kelly, Sharon, O’Grady, Kevin, Schwartz, Robert, Peterson, James, Wilson, Monique, and Brown, Barry. (2010). The Relationship of Social Support to Treatment Entry and Engagement: The Community Assessment Inventory, Substance Abuse, 31:1, 43-52, DOI: 10.1080/08897070903442640.
17 Part 1: The Connection Between Substance Use Disorders and Mental Illness, National Institute on Drug Abuse – https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-1-connection-between-substance-use-disorders-mental-illness.
18 Dennis, Michael, Foss, Mark, and Scott, Christy. (2007). An Eight-Year Perspective on the Relationship Between the Duration of Abstinence and Other Aspects of Recovery. Evaluation Review, 31. 585-612. DOI: 10.1177/0193841X07307771.
19 Donovan, Dennis, Ingalsbe, Michelle, Benbow, James and Daley, Dennis. (2013). 12-Step Interventions and Mutual Support Programs for Substance Use Disorders: An Overview, Social Work in Public Health, 28:3-4. 313-332. DOI: 10.1080/19371918.2013.774663.
21 Schwartz, CE, and Sendor M. (1999). Helping Others Helps Oneself: Response Shift Effects in Peer Support, Social Science Medicine. 48(11). 1563-75.
22 Pagano, Maria, Zelter, Brie, Jaber, Jihad, Post, Stephen G., Zywiak, William, and Stout, Robert, (2009). Helping Others and Long-Term Sobriety: Who Should I Help to Stay Sober? Alcohol Treatment Quarterly. 27(1). 38-50.