When I was in active addiction, I was vaguely aware of what “addiction” was. My job exposed me to the mental health world as I worked within a healthcare system. I was not a clinician, so my knowledge remained on a superficial level. However, I was aware that the Diagnostic and Statistical Manual (DSM) was “The Book” used to diagnose both mental health and substance use disorders.
I had access to these manuals via my “psychiatrist co-workers” in the health system.
On many occasions, I found myself looking over the criteria for substance abuse and dependency, as it was called at that time (1998).
I would read the criteria over and over again, dissecting the words and to see if it applied to me. I was not living under a bridge or eating out of a dumpster. I had not been to jail. I was losing my family…but I had not lost my family.
Consequences of Addiction
Most of my consequences were internal:
- I was never able to sleep.
- I was “dope sick”/experiencing withdrawal on most days but didn’t really know what was happening to me.
- I was using opioid-based pain pills that were prescribed to me from several doctors.
- I never bought it off the street. This allowed me to buy into the concept that “it was from a doctor and couldn’t be that bad.”
- I was always running out of pills early.
- I was always terrified of running out early.
- I had suicidal thoughts.
But no one really knew what was going on with me. Not even my family. I was in an internal hell. But it wasn’t dramatic, and I wasn’t a “scumbag, liar, cheater, and thief.”
I was a pretty high-functioning person who was quietly, yet desperately, dependent on substances to get through the day. Oh…on a side note: alcohol was ever-present, and I was probably more dependent on alcohol than any other substance. It was just socially acceptable, and therefore I didn’t identify it as the main problem.
Denying the Criteria of Addiction
Man… I would look at that Diagnostic Manual. I would play with the criteria in my mind.
The Book l said inability to control use was a symptom.
I would tell myself that really didn’t apply to me because it wasn’t lack of control. I actually wanted to drink 24 beers and eat 10 Percocet… so I was in control…it was my choice.
The Book said inability to cut down was a symptom.
I would tell myself that I really could cut down if I wanted, but “I just haven’t decided to yet”…
The Book said interpersonal problems due to using was a symptom.
I told myself that it was my wife that had an attitude problem, and it really wasn’t on me.
And I looked at The Book over and over…and as time went by, I had more and more trouble explaining away the symptoms. But I was always able to do so because I was never talking to anyone about it.
My mom and my wife told me to see counselors or to go to AA, and I flat-out refused. I was clueless as to what was happening to me…
I turned The Book upside down to see if it made more sense from a different angle. I couldn’t figure it out.
Once I went to an Employee Assistance Program (EAP) counselor, and I was just waiting for her to ask me about my use and give me some answers. But all we talked about was “stress” and “career planning.” You see…she wasn’t a drug and alcohol specialist, so we didn’t go there.
I just simply never discussed my substance use with anyone despite the fact that it was destroying my life. And it got worse. I did temporarily lose my mind and my family and my sense of purpose and my future….
- Why did it have to roll on so long?
- Did I have to “hit bottom”?
- Did I have to “become ready”?
Or would I have benefited from a conversation?
As you can probably assume…I eventually found recovery and went back to school. I got a graduate degree in Sociology with concentration in Addiction Studies, became a therapist, went back and got an MBA with a concentration in healthcare management.
I jumped through a bunch of hoops and got licenses and certifications. Started working in the field in 2001—basically as soon as I entered recovery. And I’ve learned a lot. Both personally and professionally.
What Everyone Should Know About Addiction and Recovery
Based on all this…Here’s what I believe people need to know and how this played out in my life:
1) Substance use disorder (SUD). It is a real problem. It’s a brain issue. It’s not bad behavior or just a bad habit. It will get worse, and it will not just go away on its own. My recovery journey started with education and awareness. Unfortunately, I got into recovery during a time when the “hit bottom” and “come and get it when you want it” model was the only available treatment. I never discussed SUD with another human being because they were all waiting for me to “accept” the problem. I understand the philosophy and justification for such a model. However, I reject it wholeheartedly and have come to believe that people can begin recovery even if they are unsure about addiction status. You do not need to “admit” anything in order to initiate the process.
2) Recovery takes on many different variations. Just like other diseases, there are different stages or different “species” of addiction. There is no such thing as a garden-variety drug addict—as you so often hear people say. The word “addict” is demeaning, and people say addicts are scumbags and liars and cheaters and thieves. That doesn’t help, and it’s not accurate. It’s an individualized experience. Don’t buy into the hype. I definitely went through a classic progression. From alcohol to weed to “other things” to opioid based pain killers to “whatever I could get my hands on.” Alcohol was ever-present. The other substances came and went over time. Except for opioids, which became my drug of destruction in 1999. I took a pretty traditional route of recovery. Lots of clinical treatment and more 12-step meetings than seem humanly possible. I attended a recovery meeting every day for the first 2 years of my recovery. I don’t necessarily recommend that type of schedule. But we do know that meeting/group involvement is essential to recovery. That was certainly the case for me.
3) Following logically behind premise number 2: There are multiple ways to get better. There is no one prescribed way to recover. It is an individualized experience. I certainly experienced this reality in my recovery. I went to many different types of meetings. I have done nearly every type of therapy currently available. The key takeaway is: Don’t quit. Keep adjusting your program and keep trying different things.
4) I wish someone would have engaged my family in the process. Families are profoundly impacted and deserve information. Families should be included – not removed – from the process unless their involvement is dangerous for the person who needs recovery or for the family members. My family got the basic information regarding substance use disorder from Al-Anon. That was incredibly helpful and was instrumental in them confronting my addiction and setting boundaries. Today, the options for families are more diverse. However, the family is still treated as an “adjunct” to the recovery process. We believe the family is central and primary to the recovery process.
5) You are allowed to talk to someone without making a commitment to quit everything altogether and “never take another drink.” This would have been the most beneficial piece of information for me when I was out there. I stayed away from addiction counselors for years because I wasn’t going to quit everything. This was very problematic for me. I would not meet with a counselor or a recovery coach because I knew “they would tell me to quit drinking all together.” The concept of total abstinence drove me away. Motivational interviewing and moderation management are essential techniques. People can start recovery without a full commitment to abstinence. It’s a process.
6) You don’t automatically need to go to rehab. There is a clinical assessment process that indicates level of care. You would never know that based on the media and based on the behavior of some rehab marketers. But rehab is not always necessary. Interestingly, according to the Recovery Research Institute, only about 13% of people who identify in long-term recovery report they did it via “rehab.” Many times, people get better in the community via outpatient or various other services. Ultimately, it was community-based services that helped me. Self-help groups (AA, NA, SMART recovery, All-Recovery) were essential to my recovery. Individual therapy is also a key aspect of my recovery. I have found myself on a continuous journey. That requires constant adjustment and tweaking.
7) There are many people in recovery who did not go to jail and/or eat out of a dumpster. We have allowed ourselves to become caricatures and we promote stereotypes of the scumbag drug addict. I’m sure this chases many people away from recovery. Don’t buy into that… it’s a very diverse crowd. My “bottom” was certainly not a “low bottom.” Strangely, there was a period in early recovery where I was self-conscious about my story. I literally felt that my bottom was NOT bad enough. But as time went by, it became clear that there were more people who fell into my “high bottom” category than the “low bottom” made for TV movie stories. Those situations do exist. People do find themselves homeless and in jail. Bad things happen on a regular basis. But many people with SUD are high functioning. We walk among you! Recovery is for everyone.
8) There is medicine available that can support recovery. Staying alive is first on the agenda. Don’t let uneducated and uniformed people tell you otherwise. It’s not the only option. But it is an option. This was not available when I was entering into recovery. Medicine Assisted Treatment (MAT) did exist, but no one knew anything about it and I was completely unaware of any medicine for Opioid Use Disorder. I would have certainly taken a close look at using medicine. But it was never presented to me as an option.
9) It may be hard to find people who are willing to meet you where you are at in the process of change. Keep looking. Professionals are wrong when they blindly confront you and prescribe one-size-fits-all-solutions. Don’t quit the process based on a bad experience. Find another meeting or another therapist or another program. Be your own advocate. I learned this very quickly in my recovery. I went back to grad school, and it was easy to see that quality varies greatly among professional providers. I have never had a problem firing my therapist or my coach or my sponsor. It’s my life, it’s my recovery, it’s me who will suffer. Therefore, I need to actively manage my recovery team. Become your own advocate.
10) If you are using heroin or pills from the street or meth or cocaine or anything off the street, you are in danger. In today’s world of carfentanil and fentanyl, please understand you are playing Russian roulette every time you use. It is better to seek help – even if you are not sure you are ready for recovery and let a professional help you figure out options – than it is to continue on until you hit bottom. Hitting bottom today means death…too often.
11) YOU CAN GET BETTER. LIFE CAN BE BETTER. I got into recovery because my life was miserable and out of control. And I wanted to get better. I am pleased to announce that LIFE GETS SUBSTANTIALLY BETTER when you change your relationship to substance misuse. You feel better physically, emotionally, spiritually, and psychologically. That’s not to say life is great all the time. Difficulties arise. Life on life’s terms. We are subject to all the stressors of life. However, gratitude runs deep, and the freedom of recovery is profound.
If you are struggling with stress, substance misuse or any other emotional issue give yourself a break. Reach out and have a conversation. Start the process of taking care of yourself. You don’t have to commit to anything. Just reach out!
Rich Jones is Chief Clinical Officer at