Common and Mistaken Beliefs about Treatment and Recovery

It’s not unusual for family members to have questions or misconceptions about addiction and recovery.  Maybe more than any other medical condition, the field of substance use disorders and addiction have been plagued with misinformation, stereotypes, and mistaken beliefs.

We’d like to address the most common misconceptions here.

Family Members and Loved Ones Often Believe…

1. Treatment is a cure.

There is no cure for addiction, but there are treatments that can assist those experiencing addiction to find remission, like other diseases. Similar to diabetes and heart disease, a person can live a long and healthy life if they accept and continue to manage symptoms while in recovery.  It’s important to recognize that treatment is only a “launching point” and only one part of a multifaceted road to recovery and long-term health.

2. Treatment will restore the person to who they used to be.  It will also return the family to the way it was before their addiction started.

Recovery requires a profound change in thinking, perceiving, and feeling.  Recovery starts with a “booster” which is often found through treatment.  Recovery is a process, not a cure.  Treatment alone can begin addressing patterns of thinking and healing past hurts, but that’s only the beginning.  

3.  I don’t need to participate in any counseling…my participation isn’t necessary and it won’t matter. I’m not the one with the problem.

Research indicates otherwise. What we know is that family participation does matter and there is a direct correlation of long term recovery to the level of family involvement in treatment and afterward.  Family members must also recognize that if addiction is a family process, so is recovery.  Getting involved, addressing your own needs, and becoming knowledgeable about the disease and recovery process is crucial.  There is a higher risk of relapse if family and other loved ones don’t take time to become educated, establish boundaries, and identify supports for themselves. There’s also a greater risk of leaving treatment prematurely without family education.

4.  Detox alone works and it’s OK for my family member or loved one to leave treatment when they feel ready to, even if it’s ahead of schedule.

The purpose of detox is to physically recover from a state of physical dependence to a particular drug or substance.  The person undergoing detox should “feel better” after undergoing a medically supervised detoxification program.  However, detox alone is unlikely to address the underlying causes and conditions for the addiction.  For example, it can take time to feel mentally “clear” after detox.  The next phase of treatment after detox or residential care addresses how to manage post-acute withdrawal symptoms, cravings, and helps identify triggers, high-risk situations, and mistaken beliefs that can contribute to a relapse.  The person experiencing addiction needs time not only to heal physically and psychologically, but also to learn how to practice the coping and relapse prevention skills that will contribute to sustainable recovery.  It is completely possible that denial will return, and the person in treatment will try and convince you that they are ready and prepared to leave.  It is suggested to ask for a therapeutic recommendation before you say “yes.”  

Other Early Recovery Thinking Traps:

• “Pink Cloud” otherwise known as the “antibiotic effect”:  What happens often when you are given antibiotics for an infection?  It’s a 10-day supply of rather large pills you have to take 2-3 times per day.  If you stop taking them on the 5th day because you feel better, you risk a repeat infection. The same is true for treatment and early recovery. The “Pink Cloud” is a period of wellness and feeling good in which the person in treatment feels they’ve “beat addiction” or “have the problem under control.”  While this period of time is exciting and beneficial, it can sometimes bring with it a stream of minimizing thoughts and denial about the possibility of relapse, causing them to want to leave treatment early.
• “I’ll just go to meetings when I get home. I need to get back to work.” These are often excuses for ending treatment early and they are based on the common delusion that they can handle the disease on their own.  What they don’t anticipate are the stressors they will expose themselves to, often before they are prepared or ready.
• “I’m feeling better, so I probably don’t need more treatment.”  We’ve addressed this one in the paragraph above.

5. “If they loved me, they would just stop using drugs or alcohol!”

That’s like saying “if he/she loved me, they would stop having diabetes (or heart disease).”  The disease of addiction isn’t about will power, or love.  It is a disease that has no cure.  It is considered a disease of physical, mental, emotional and spiritual nature. Unlike other diseases, our culture has been made to believe that people choose to become addicted to drugs and alcohol, and therefore can choose not to use drugs and alcohol.  It is much, much, more complicated than we’d like to believe. It’s a disease that changes brain function, structure, and related circuitry required to form memories and experience pleasure.  

6.  Abstinence alone is enough.

Abstinence is one of the many prerequisites of recovery, but in itself does not constitute recovery.  In 2007, a working group of researchers, treatment providers, recovery advocates, and policymakers was formed to operationalize a standard definition for “recovery” to provide improved recovery-oriented interventions. The working definition of “recovery” became: “Recovery is a voluntarily maintained lifestyle characterized by sobriety, personal health, and citizenship” (Betty Ford Institute, 2007).  It is necessary that people in recovery change their behavior and ways of thinking in addition to abstinence.  For example, someone abstinent from alcohol that frequents bars or socializes with drinking peers is taking an unnecessary risk, especially early in recovery.  Additionally, it’s important to avoid stopping medications (antidepressants, etc) without medical advice and support as it can cause a relapse, despite abstinence.

7.  It’s ok for the recovering individual to switch to a different drug, legal chemical, or addictive behavior.

Use of another chemical that is addictive, or a behavior supported by compulsive activity (gambling, eating, exercise) impairs insight and judgement and often leads to a recurrence of use of the original substance.  

8. I’ll be competing with 12-step (AA/NA) and/or the sponsor for attention from my loved one.

It’s normal for family or loved ones to feel resentful, jealous, or left out because of the recovering person’s participation in their recovery program.  It’s also normal to wonder why they can disclose personal things to people they hardly know.  The reality is that love, home, and family are not enough to support abstinence, alone.  The best way for family to resolve these feelings is to identify and focus on the benefits, and create their own recovery program with Al-anon or Nar-anon and focus on you.  Remember how badly you wanted them to get better and become a part of the family again?  It is also reasonable to attend an open meeting with your loved one, occasionally.  Family members and loved ones should also be open to meeting some of the new friends of your loved one, and not be afraid to attend recovery events or celebrations. After all, if they’re working hard on their recovery, you can too.

9. Psychiatric medications such as antidepressants are drugs too and should be avoided.  It’s just a scheme from the pharmaceutical companies anyway.

The Journal of the American Medical Association (JAMA) reports that roughly 50% of the people with severe mental disorders are affected by addiction.  Antidepressants and other medications can help prevent relapse and are crucial to healthy functioning and recovery from addiction.  When psychiatric medications are prescribed and taken according to medical advice, they are not necessarily addictive.  People in addiction recovery also living with a diagnosed mental health disorder must adhere to a scheduled medication regimen, and avoid “playing doctor” and taking themselves off medication without medical supervision.  Often, withdrawal symptoms or adverse reactions can occur when removing a medication without medical supervision, placing their recovery in jeopardy as the brain adjusts to the change in medications.  Family members must understand the importance of their loved one remaining on medications and following up with medical appointments.  It is also crucial to identify medical professionals that understand and have advanced training in addiction medicine, if possible.

10.  They have to come to the family holiday or family reunion, even if there’s alcohol or other drugs. They can handle it.

Family members and friends must recognize the risks posed to their recovering loved one when in the presence of actively using friends or family.  Remember, recovery is a long process and your loved one may be exceptionally fragile to triggers and high risk emotional states once treatment is completed and for a good time after.  Active users of drugs and alcohol often feel uncomfortable around a recovering person and could unwittingly contribute to a relapse in spite of good intentions.  Others may encourage the newly recovering person to use, insisting the recovering individual is not really addicted.  Misery sometimes loves company.  Do not shame them for choosing not to participate in a risky event. Separation may only be temporary to allow for further change to take place that will allow them to “handle it” down the road.  It is also entirely normal for them to feel resentful or jealous of family and friends that are actively using.  It is not always a sign that relapse is imminent.

11. I’m responsible for my loved one’s behaviors and recovery, and they reflect on me.

Family members often feel responsible for behaviors of an addicted loved one.  Parents, children, spouses and friends feel they should be able to control or “manage” the behaviors.  It is imperative that family members understand that the person with addiction or in recovery is ultimately responsible for their behavior.  They may not have chosen to have the disease, but they certainly have choices with regards to treating and managing the disease.

If family members believe their responses to their loved one contribute to their behaviors, then the family member can change the way they respond.  Friends and family connected to the individual must recognize the best way to help is to allow the person in recovery to become 100% responsible for their recovery. This helps empower and build self-efficacy.

Family members must accept:

• Addiction is a disease,
• You did not cause it.
• You cannot cure it.
• You cannot control it (or them).

12.  Nagging, lecturing, pleading, and tough love work!

Actually, research indicates otherwise.  No doubt the person in recovery has already told themselves everything you might say.  The person will most likely tune you out, and will not be willing to listen.  This behavior often leads to lying, putting themselves in a position to make promises they can’t keep, and often fuels the opportunity to use.  If you can listen without judgement or reaction, and detach with love, you will save your sanity, and theirs.

13.  I should trust them as soon as they get home from treatment.

Family members and significant others must recognize that trust occurs in time, with consistent, appropriate behavior and communication.  Anxiety will occur. You may be fearful.  Trust is a process.  However, taking their “temperature” every five minutes will most likely result in friction.  You need not walk on eggshells, but it’s important to address issues in a calm and civil manner. If the person in recovery reacts, and you know you have brought up concerns in a calm, civil, and loving way, it’s helpful to remind yourself that you are not responsible for their reactions.

14.  All Al-Anon or Nar-Anon meetings are all alike.  Or, Al-anon and Nar-Anon will help me manage my loved one.

No two programs are the same and these programs are not geared towards helping loved ones.  If you don’t feel like you “fit in” the group, attend a different meeting on a different day.  We recommend attending 6 different meetings before you pick your regular meeting(s).  In early recovery, your loved one is learning about the H.O.W of recovery: honesty, open-mindedness, and willingness. If you find yourself justifying why you don’t belong in a meeting, then you’re missing the open-mindedness portion of this equation.  Additionally, these programs are about managing yourself in relation to your loved one. Remember- you cannot control them.  You can control your reactions and to whom you vent about your concerns- and these programs are tremendously helpful.  Get a sponsor, show up regularly (even if you don’t want to), and you will feel much, much better.  Whatever you do- don’t give up. You wouldn’t want your loved one to give up either. When you attend meetings, your loved one sees you working a program, too. 

15.  Relapse means treatment failed.

Just because someone relapses, does not mean that treatment was ineffective.  That’s like saying treatment for cancer failed after a long period of remission.  Relapse can occur in any disease in spite of treatment success.

These assertions that “treatment failed” are not applied to other specialties in medicine where treatment adherence can be a problem.  It is important to assess if your loved one: 1) completed treatment and followed all treatment recommendations, 2) continued with their intended daily recovery practices, 3) avoided people, places and things that could expose them to high-risk situations for which they weren’t prepared or 4) advocated for their personal mental or physical healthcare needs.  Treatment non-compliance is a problem for each specialty in medicine.  For example, 14% of patients who are provided with prescriptions do not ever fill them.  The WHO also reports that 10% to 25% of hospital and nursing home admissions result from patient noncompliance. Furthermore, about 50% of prescriptions filled for chronic diseases in developed countries are not taken correctly, and as many as 40% of patients do not adhere to their treatment regimens (WHO, 2020). In conclusion, non-adherence is very common and we require your assistance to make sure your loved one recovers.

We understand that getting help for a loved one can be a difficult and confusing process. We are here to help you or your loved one in any way we can. Call us today for more information.