I wrote an article last month for Medium called “What is Recovery? Abstinence, Sobriety, or Something Else?”
In that piece, I reviewed the latest definitions of recovery published by national and international authorities like the Betty Ford Foundation, the Substance Abuse and Health Services Administration (SAMHSA), and the American Society of Addiction Medicine (ASAM). Then I discussed a more recent definition that resonates with me:
“Recovery is an individualized, intentional, dynamic, and relational process involving sustained efforts to improve wellness.”
I’m partial to this definition because it foregrounds the idea that recovery is active, personal, and defies absolute codification. That’s why I concluded the article with my personal definition:
Recovery appears to be a verb.
Working with the idea that that definition of recovery is valid and useful, I’ll address a related topic in this article:
Why recover?
Or, in other words:
What are the benefits of recovery?
Just to be clear, I’m talking specifically about recovery from alcohol and substance use disorders — since that’s my field — and therefore, the benefits I discuss will be related to the changes that occur in people’s lives when they move from active addiction to recovery.
Here’s what I mean by those two terms:
Active addiction is exactly what it sounds like: the period of time when an individual is using alcohol and drugs regularly and their use interferes with their physical and emotional health, and disrupts their family, work, social, and civic lives.
Recovery, on the other hand, is the period of time that begins after an individual with an alcohol or substance use disorder takes proactive steps to restore and repair the harm caused by their time in active addiction. They may enter treatment for alcohol abuse, opioid addiction, or a problem with other illicit drugs. They may go to community support groups or begin recovery on their own: whatever the case, when they take that step, that’s when recovery begins.
That’s when things begin to change.
And as you’ll see, that’s when most things begin to change for the better.
Recovery: The Initial Benefits
Let’s get some of the basics out of the way first. Meaning the most obvious, immediate, and direct effects of entering recovery:
· No more hangovers.
· No more withdrawal rollercoaster.
· No more anxiety about where to find the next drink or dose.
· No more hiding alcohol or drug use.
· No more lying to friends, family, and co-workers about alcohol or drug use — if that was happening.
· A beginning to the end of the shame, guilt, and self-loathing that often accompanies addiction.
Let’s stop right there for a moment, with the phrase a beginning to the end. When an individual enters recovery, no one guarantees success. What addiction professionals — and people who’ve been in recovery — can guarantee, however, is that anyone entering recovery has a chance at success. They can start the work of unravelling — and hopefully healing — the painful, difficult, and often debilitating emotions and patterns of behavior they experienced during active addiction.
When an individual enters recovery, they’re at a new beginning. And by my definition of recovery, they’re in action: they’re making life better, on the verge of accruing all the benefits I just listed. All those things are a big deal to the individual in recovery. They all make a difference — but they’re only part of the story.
Gathering Data on Recovery
In fact, they’re a small part of the story.
I’ll explain.
Yes, the emotional healing is huge. Living without hangovers is an improvement. Stepping back from the daily dance with withdrawal symptoms is an enormous relief. Those are all good things. But at the end of the day, these positive aspects of recovery are subjective. And since my work is based on objective evidence, which means data, which means numbers, I’m going to focus this discussion on three important surveys conducted on recovery over the past decade — surveys that give me numbers I can use to demonstrate to you the positive benefits of recovery:
1. “Life in Recovery: Faces and Voices of Recovery” (2012, U.S.A.)
2. “The Australian Life in Recovery Survey” (2015, Australia)
3. “The UK Life in Recovery Survey” (2015, United Kingdom)
These surveys are important for anyone interested in learning more about recovery because collectively, they represent the first organized effort by addiction professionals to quantify the effects of recovery on people in recovery. If you’re interested in recovery, I suggest you click all three links. You may not want to read every chart and table, but here’s a tip: the executive summaries and conclusions include most of what you want to know.
Here’s an excerpt from the introduction to the “Faces and Voices of Recovery” survey, which does a good job explaining the rationale behind — and need for — all three surveys:
“It was not until the past decade that federal agencies, policy makers, service providers, and clinicians [began] considering recovery as a desirable outcome that [supplants] reductions in drug and alcohol use as the goal of addiction treatment services. This shift in emphasis was spearheaded by a growing grassroots movement of persons in recovery, a community recently estimated at over 23.5 million adults in the United States. Little is known about the recovery experience as research on this population, often hidden in plain sight, remains in its infancy.”
It’s hard to argue with the necessity of such research: 23.5 million adults accounts for roughly one tenth of the U.S. population. The prevalence rates are similar for both Australia and the U.K., and all three reports tell a strikingly similar story: the recovery community is large, operates in relative anonymity, but when people enter recovery and join the community of people in recovery, life improves on almost all levels.
Life in Recovery: The Survey Results
In order to learn more about the recovery experience from those in recovery, researchers designed the surveys to measure specific areas of life — which they call domains — in which recovery leads to significant changes.
Those domains are:
1. Family
2. Social and civic functioning
3. Physical and mental health
4. Legal status and involvement
5. Employment and school
I’ll offer data from the U.S. survey, in part because I live and work here in the U.S., and in part because, with few exceptions, the numbers from the three surveys are almost interchangeable. They’re close enough that citing the numbers from one country gives a good idea — although not perfectly accurate — of what’s happening in the other two.
First, though, a little information on the survey respondents.
Recovery Status
· 75% said they were in recovery
· 14% said they were recovered
· 8% said they used to have a problem with substances and no longer do
· 3% said they were in medication-assisted recovery
Time in Recovery
· 9% said they’d been in recovery less than 1 year
· 13% said 1–3 years
· 10% said 3–5 years
· 16% said 5–10 years
· 19% said 10–20 years
· 32% said they’d been in recovery over 20 years
Now, for the information you’ve been waiting for: the survey results. According to people in recovery, what changed when they entered recovery?
Just about everything.
That means you should get ready, because there’s a lot of information coming your way.
The Benefits of Recovery
Here are the main findings from the U.S. survey. Keep in mind that these findings closely parallel those of the surveys conducted in the U.K. and Australia. Also, keep in mind that the fact we have these statistics is important. It’s easy to say, “Recovery improves life on all levels.” However, it’s difficult to prove an assertion like that without numbers. What you’re about to read are the numbers that support the idea that recovery — in its active verb form — works on multiple levels and leads to benefits that expand outward from the person in recovery, and ultimately improve the lives of everyone around them.
Improvements in Family Life
· Domestic violence:
o 41% of respondents in active addiction reported domestic violence incidents
o 9% of respondents in recovery reported domestic violence incidents
· Custody of children:
o 4% in active addiction reported regaining custody of a child
o 9% in recovery reported regaining custody of a child (these two figures are small, but the change here is, in fact, a doubling)
· Family involvement:
o 68% in active addiction reported participating in family events
o 95% in recovery reported participating in family events
Improvements in Financial Life
· Financial problems:
o 70% of respondents in active addiction reported having issues such as major debt or bankruptcy
o 38% in recovery reported having issues such as major debt or bankruptcy
· Paying bills:
o 41% in active addiction reported paying bills on time
o 91% in recovery reported paying bills on time
· Paying debts:
o 40% in active addiction reported paying bills on time
o 82% in recovery reported paying bills on time
· Paying Taxes:
o 55% in active addiction reported paying taxes on time
o 83% in recovery reported paying taxes on time
· Credit:
o 41% in active addiction reported having bad credit
o 76% in recovery reported having good credit
· Planning for the future:
o 28% in active addiction reported saving money for retirement
o 88% in recovery reported saving money for retirement
Improvements in Health
· Emergency Room Visits:
o 22% of respondents in active addiction reported frequent use of emergency services
o 3% in recovery reported frequent use of emergency services
· Infectious disease:
o 17% in active addiction report contracting an infectious disease such as Hepatitis C or HIV/AIDS
o 4% in recovery report contracting an infectious disease such as Hepatitis C or HIV/AIDS
· Mental Health Problems:
o 68% of respondents in active addiction report having untreated emotional/mental health problems
o 15% of respondents in recovery report having untreated emotional/mental health problems
Public Safety and Criminal Activity
· Involvement with legal system:
o 62% of respondents in active addiction reported involvement with the legal system
o 38% in recovery reported no involvement with the legal system.
· Arrests:
o 53% in active addiction reported being arrested
o 5% in recovery reported being arrested
· Incarceration:
o 34% in active addiction reported being incarcerated
o 5% in recovery reported being incarcerated.
Employment and Education
· Steady work:
o 51% of respondents in active addiction reported having steady work
o 83% in recovery reported having steady work
· Poor performance reviews or getting fired:
o 51% in active addiction reported having work problems of getting fired
o 10% in recovery reported having work problems or getting fired
· Good performance reviews:
o 49% in active addiction reported receiving good work reviews
o 89% in recovery reported receiving good work reviews
· Furthered their education:
o 37% in active addiction reported pursuing education or job training
o 78% in recovery reported having steady work
· Dropped out of school:
o 33% in active addiction reported dropping out of school
o 4% in recovery reported dropping out of school
There you have it: dramatic improvement in every relevant life domain the survey(s) covered. I gave you all that data to make one point crystal clear: when an individual enters recovery — when they take action, embrace the verb, and do the work — they quite literally have the chance to change almost everything about their lives.
The Recovery Movement
Recovery is much more than an end to hangovers. Recovery is more than an end to the dangerous and destructive cycles of addiction: recovery enables an individual to rejoin a world they may have thought was no longer available to them. A person who enters recovery increases their chances of recreating stable family relationships, finding gainful employment, improving their financial situation, improving their overall health and wellness, and decreasing the likelihood they’ll contract an infectious disease, get arrested, or become otherwise involved with the legal or criminal justice system.
These studies show the immense power of living a life in recovery as compared to living a life in active addiction. The data they contain lend further weight to the movement in healthcare that transforms the goal of any kind of treatment away from a discrete, fixed-point goal — the reduction of symptoms and/or the absence of disease — to a goal that’s not a fixed point, but rather a dynamic, evolving, healing process that gives individuals the agency and ability to live a meaningful life based on criteria they themselves define.
When individuals are empowered by the treatment process, they can thrive. When they thrive, that change in them resonates in the people around them. That brings us to the second answer to the first question I posed in this article:
Why recover?
The first answer, of course, is that when you enter recovery, you can improve your own life. The second answer is that when you do the work of recovery, you can become a positive force for good in the world. That’s my aspirational interpretation of the survey data, for what it’s worth. But in the name of scientific circumspection, I’ll end this article on a slightly more grounded note, with the words of Dr. Alexander Laudet, author of the “Faces and Voices of Recovery” report:
“These findings underline the fact that recovery is good not only for the individual, but also for families, communities, and the nation’s health and economy.”
Christopher Johnston, MD, ABAM, is the Chief Medical Officer for Pinnacle Treatment Centers, a leading drug and alcohol addiction treatment provider. Dr. Johnston has practiced addiction medicine for the past 15 years, initially in a family practice setting primarily for opioid dependent patients and for the past eight years at Pinnacle working with individuals in residential and outpatient programs with all types of substance use disorders. He is double boarded in both Addiction Medicine and Family Medicine. Dr. Johnston attended UMDNJ — New Jersey Medical School in Newark and completed his residency at Virtua Health in Camden County, NJ, where he was in private practice for 25 years.
