There are many different definitions for the term “recovery” as it relates to substance use disorder, addiction, and alcoholism. Different organizations and fellowships describe recovery differently, just as some individuals personally define recovery differently from others. For years, “recovery” was defined by abstinence or by sobriety- the idea that recovery was achieved when an individual was sober for an extended period of time. However, we know that, unfortunately all too often, sobriety does not equate to recovery, and that just because someone puts down alcohol or drugs does not necessarily mean that their life improves or that they have found recovery. For many people, those described in the 12-Step recovery communities like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) as the “hopeless variety”, it is pretty well agreed upon that an individual’s life will no doubt get worse, not better, when they stop using drug and alcohol if they are also not implementing a “program of recovery.” While on the outside their life may begin to look better, as they may be able to show up for work, pay their bills on time, or perform other responsibilities, internally their emotional state will suffer and ultimately lead them back to misusing substances.
So, we know that sobriety recovery does not equal recovery. Therefore, what does the term “recovery” really mean and how can we truly define recovery? Here are some examples of how several organizations define recovery from addiction:
The working definition of “recovery” by the Substance Abuse and Mental Health Services Administration (SAMHSA) is “A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.”
The National Institute on Drug Abuse (NIDA), uses SAMHSA’s working definition, saying that “recovery is a process of change which people improve their health and wellness, live self-directed lives, and strive to reach their full potential. Even people with severe chronic substance use disorders can, with help, overcome their illness and regain health and social function. This is called remission. Being in recovery is when those positive changes and values become part of a voluntarily adopted lifestyle. While many people in recovery believe that abstinence from all substance use is a cardinal feature of a recovery lifestyle, others report that handling negative feelings without using substances and living a contributive life are more important parts of their recovery.”
Additional definitions have been applied through the years from different organizations. The American Society of Addiction Medicine (ASAM) since 1982 has defined recovery as “reaching a state of physical and psychological health such that abstinence from dependency-producing drugs is complete and comfortable.” In 2013, ASAM updated its definition of recovery to include “a process of sustained action that addresses the biological, psychological, social and spiritual disturbances inherent in addiction.” In 2007, the Center for Substance Abuse Treatment used the definition of recovery as “a process of change through which an individual achieves abstinence and improved health, wellness and quality of life.” William White, author of “Slaying the Dragon- The History of Addiction Treatment and Recovery in America” and of the ongoing William L. White papers, defined recovery in 2007 as “the experience (a process and a sustained status) through which individuals, families, and communities impacted by severe alcohol and other drug (AOD) problems utilize internal and external resources to voluntarily resolve these problems, heal the wounds inflicted by AOD-related problems, actively manage their continued vulnerability to such problems, and develop a healthy, productive, and meaningful life.”
As demonstrated by the numerous definitions above, there is unfortunately no standard definition of “recovery” within society, much less within professional circles. While an individual in Alcoholics Anonymous or another 12 Step group may define their recovery by abstinence through spiritual awakening that comes through taking the 12 Steps that eventually leads to “emotional sobriety” (or more specifically, recovery), a different individual may define recovery through a reduction in use of substances while overcoming clinical issues and life challenges through therapy. Some individuals may consider recovery through harm reduction efforts or moderation of substances. Others may define recovery through a form of enlightenment that drives direction and purpose. There are numerous ways to look at recovery based on the individual situation of the individual with a substance use disorder.
However, while it is nice to say that an individual’s recovery occurs when they define it for themselves, there is one overriding point regarding what recovery means when reading through the many different definitions stated above: Quality of Life.
Each of the definitions stated above use a fairly vague but extremely important point that recovery equates more to quality-of-life measures than to abstinence, although for those suffering from addiction and substance use disorder, abstinence is often part of the quality-of-life equation. The difficulty is defining quality of life, standardizing quality of life, and understanding what quality of life means on a case-by-case basis for the many individuals and families impacted by addiction.
So how can we define high quality of life as it relates to addiction recovery?
We know that, according to many of the definitions described above, quality of life needs to include health and wellness practices, as well as connection, meaning and direction. These are all vital pieces of a purpose-driven life, that is abundantly full. Following these goals also often leads to a life of happiness and contentment. However, these are also fairly vague concepts and often difficult to quantify. It is very difficult to help someone suffering from addiction to find recovery through a roadmap of lofty ideals based around an internal or spiritual compass of purpose and direction. So how might we figure out how someone suffering from addiction can find and sustain recovery more practically, achieving a high quality of life but using these principles as a guiding force? Here are some ways:
Creating, meeting, and often exceeding educational and academic goals is key for creating a high quality of life. Addiction often interferes in the educational trajectory of an individual. They may have left high school before graduation, wanted to but never attempted higher education, left college before completing a degree, or never moved forward in graduate school. They may be in need of a GED, diploma, or degree. They may have a dream to find a trade through a vocational school and never taken action due to their addiction. Whatever the circumstances or situation, academic and educational goals are important to set and meet when in recovery seeking to maintain a high quality of life.
Being able to pay bills and have steady income is vital to a high quality of life. This could be a “recovery job” where an individual is learning the basic tasks necessary to be successful in early recovery, such as gaining confidence while acquiring a job, getting a paycheck, and paying bills. Or this could be a long-term career that offers advancement and financial success. Employment is an important marker in recovery and high quality of life whether it is someone new in recovery who has never held a steady job, or an individual who faced addiction during their career, and is now learning to reenter that career while navigating a new life in recovery from addiction. Either way, the ability to seek, find, and engage in the workforce, where an individual will receive a paycheck and be able to be financially self-supporting is paramount to sustaining a high quality of life in recovery.
While all too often those in early recovery believe that finding a sexual or romantic relationship will make them happy and a help find them a high quality of life, that is often not the case, and often can interfere in their journey of recovery. However, there is truth that a high quality of life measure is determined by an individual’s satisfaction of their relationships. Not early recovery romantic relationships, but the value and satisfaction that an individual has with the important relationships with their family members, their significant others, and their friends. In turn, the importance of relationships in maintaining a high quality of life extends to relationships with employers, employees, and co-workers, as well as other social relationships. Humans are social creatures and crave connection. Recovery too depends on social bounds and connection. Therefore, the deepness and meaning that an individual has with the people they are in relationships with in different areas of their life, and their personal satisfaction with those relationships, will inherently lead to a higher quality of life.
Stable Housing/Healthy Living Environment
Having stable housing and a healthy living environment is paramount to finding a high quality of life in recovery from addiction. For many individuals in active addiction, there was little stability in their living situation or little health in their environment. Many individuals were homeless, or incapable of paying for stable housing. Additionally, if they were able to afford their living environment, either by paying to rent or own a home, the living environment was often chaotic. Stable housing and a healthy living environment play a vital role in people’s recovery from substance use disorder and addiction. The stress that occurs from being unable to pay rent or afford housing and therefore living under the threat of losing a place to live or being homeless can lead an individual down the path of relapse. Therefore, any quality-of-life measurement of a person in recovery must include stable housing and a healthy living environment.
Selfless Thoughts and Acts/Charity/Helping Others
In the 12 Step rooms, within the process of 12 Step recovery, a well-known saying is that “selfishness” and “self-centeredness” are the root of the problem of addiction and alcoholism. For anyone in recovery from addiction, regardless of the avenue they choose to find and sustain recovery, selfishness plays a role in their addiction. Being unable to think of others, how actions impact others, or putting other’s needs above their own, is typical of any individual dealing with a substance use disorder. Therefore, to find and maintain recovery, people are taught to cultivate an attitude and daily action of selflessness. This can come in many forms and through different actions, but the ultimate goal is to go from a mindset of selfishness and self-centeredness to a mindset of unselfishness and helping others. Giving back, volunteering, taking part in charitable giving, and other types of similar outlets are important to maintain recovery. These types of actions also are often associated, outside of recovery, with happiness, contentment, and a high quality of life. Ralph Waldo Emerson said, “The purpose of life is not to be happy. It is to be useful, to be honorable, to be compassionate, to have it make some difference that you have lived and lived well.” Jim Rohn was quoted as saying, “He who serves the most, reaps the most.” And Pablo Picasso said “The meaning of life is to find your gift. The purpose of life is to give it away.” Regardless how you classify it or present it, the need to live selflessly, to think about the well-being of others, to seek to give back, and to have a mindset of helpfulness and charity are important pieces of a high quality of life and having a life worth living.
Basic Life Skills for a High Quality of Life
Daily functioning and the ability to cultivate and use basic and important life skills is a hallmark of finding a high quality of life. These can be simple skills, such as keeping a clean-living environment, having a daily hygiene routine, budgeting, keeping a calendar, and making sure basic needs are met for an individual and their family. This can also include many actions and activities that often go unattended or are avoided during active addiction, such as dealing with creditors and handling credit issues, taking care of issues that are often passed on to parents or loved ones to handle, and overall just being a productive member of society. The ability to do basic life chores and meet daily life responsibilities is important in maintaining a higher quality of life than they were living while in active addiction.
Meeting Life Responsibilities
Meeting life responsibilities goes hand-in-hand with basic life skills mentioned above. This can include daily life routines and chores, but also include things like paying bills on time, showing up for family and work responsibilities, and taking the daily action needed to maintain recovery. It is important for people in recovery to do what they say they are going to do, that their actions align with their words, and that they show up when they say they are going to do so. Too much of life in active addiction is spent avoiding responsibilities, so showing up and meeting responsibilities is key to maintaining both recovery and a high quality of life.
Health and Wellness
Individuals in active addiction or with substance use disorders often report a poorer health-related quality of life than others. While using drugs and alcohol, many people neglect their normal health needs (basic hygiene) or dismiss ongoing health and medical issues (don’t regularly see a primary care physician or don’t go get health-related matters checked out.) Therefore, most people in active addiction begin engaging in recovery in less-than-ideal health. Entering recovery, learning to live in recovery, and maintaining a high quality of life means that individuals need to begin to focus on their health and wellness needs. This means beginning to take preventative health seriously and making regular appointments and check-ups, making sure they are managing any underlying or related health or medical conditions, and beginning to engage in a healthy lifestyle, supported by diet and exercise. The better someone feels physically, the better they will feel mentally and emotionally, and the better their quality of life will become.
Recovery-Oriented Community and Support
Obviously for anyone that finds recovery through a recovery community such as Alcoholics Anonymous, Narcotics Anonymous, or any other 12 Step group, or other recovery groups like SMART Recovery, Celebrate Recovery, or Refuge Recovery, will look to find recovery support and connections in those groups, but anyone that seeks recovery will need to find a supportive community that they can turn to during both good days and bad days. Connection is key in recovery, none possibly more so than the connection and support and individual will receive from their community within their chosen avenue of recovery. However, regardless of how someone seeks and finds recovery, they will need a healthy, supportive community to help them stay connected to their healthier way of life.
Spiritual, Religious, and/or Holistic Practices
Additional support and connection to achieve a high quality of life will come from seeking something greater than themselves. Often in 12 Step fellowships, seeking God or a Power greater than themselves is part of the recovery program for any individual. However, in other forms of recovery, the value and importance of any spiritual practice is key. Whether it is spirituality, religion, or just a spiritually minded healthy holistic practice, seeking to get both outside one’s self, further inward to one’s thoughts and emotions, connecting to a powerful and like-minded spiritual practice and the community within that practice is important to stay on the path of recovery and maintain a high quality of life.
Finding Direction, Purpose, and Meaning and achieving a High Quality of Life
All of the above quality of life measures supports the necessity of a person in sustained recovery finding direction, purpose, and meaning in their lives. This can be on a macro level, a micro level, or both. It can be on a daily basis, or through lofty goal setting. However, above all else, on a regular basis a person living in recovery from addiction hopefully is waking up each morning with excitement for the life they have and the life that they have built and are building. They want to cultivate an attitude of gratitude and feel empowered to live life on a daily basis. They should be finding things that excite them, that interest them, that stimulate them, that makes them part of life rather than feeling apart from life, as many people do during active addiction. Meaning, direction, and purpose is key to achieving a fulfilling life, a full life, and a high quality of life.
It is important to remember that recovery doesn’t always mean sobriety, and that sobriety does not necessarily equate to recovery, but most often, recovery from addiction is the end result of sobriety combined with a high quality of life. Unfortunately, we do not yet have standardized quality of life measurements to dictate that someone is thriving in recovery. Many people, once finding recovery and incorporating important values and principles into their lives, naturally begin to cultivate the aspects described above and, in turn, learn to live a high quality of life. Or, while seeking recovery, find that they have achieve a high quality of life as a byproduct of seeking and maintaining recovery. However, the important takeaway is 1) That for many people sobriety is vital, 2) For anyone suffering from addiction, recovery is necessary, and 3) For anyone that wants to thrive in recovery and in life, incorporating the quality-of-life principles described above will go along way to helping them achieve a self-directed, desirable, enjoyable life that they can be proud of.
If you or someone you know needs help for addiction or co-occurring disorder issues, please give us a call. Maryland Addiction Recovery Center offers the most comprehensive dual diagnosis addiction treatment in the Mid-Atlantic area. If we aren’t the best fit for you or your loved one, we will take the necessary time to work with you to find a treatment center or provider that better fits your needs. Please give us a call at (410) 773-0500 or email our team at [email protected]. For more information on all of our drug addiction, alcohol addiction and co-occurring disorder services and recovery resources, please visit our web site at www.marylandaddictionrecovery.com.