I attended a training recently by Mark Sanders, LCSW, CADC, on best practices in mental health and substance abuse treatment. He raised some interesting points about dependence and recovery.
What makes for a better outcome for those people who have developed substance dependence? I learned that people who have greater resources before the problematic substance use will have greater resources for recovery. People with success before addiction – education, employability skills, healthy family support, and positive group affiliation – will have an easier time of recovery.
Which people will have more difficulty with recovering from addiction? People who slip through the cracks of the helping profession. Some people go back and forth between chemical dependence, mental health, criminal justice, and child welfare systems without recovering. This can also include multiple medical hospitalizations and periods of homelessness. Gabor Mate, M.D. says that drugs don’t cause addiction any more than a deck of cards cause compulsive gambling. There needs to be a pre-existing vulnerability. For some people, the seed of addiction is planted years before they use.
Some people fall through the cracks due to unresolved trauma. Complex trauma includes multiple layers and years of traumatic experiences. These experiences could include neglect, abandonment, unresolved grief, multiple placements, parental substance abuse, adult emotional unavailability, multiple losses, exposure to domestic violence, or other types of abuse.
Illicit drug use is an effective coping tool, until those substances create negative outcomes.
• They numb emotional pain
• They medicate psychiatric symptoms
• They provide constant companionship
• They are predictable
• They provide relief from trauma and abandonment
What can we do to help people along the path to recovery? The first thing we can do is give them hope. We can assist them in finding stable housing, employment, a stable therapeutic relationship, meaningful daily activity, and significant interpersonal relationships, including peer-based support. If we can give them hope and practical assistance, they can more easily recover.