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Almost every family we speak with regarding an intervention wants to know our success rates. The question inevitably follows with what percentage of alcoholics or addicts recover. There’s absolutely no way to answer this question accurately.
Our first advice for anyone researching this topic isn’t to believe any of the numbers you read.
The alcoholic finds recovery, or they continue using alcohol or drugs. What can you do to help the alcoholic or addict while living your own life, regardless of whether or not the substance user gets sober? As you search the internet for the answer to what percentage of alcoholics recover, you’ll find countless treatment centers trying to sell you their success rates.
You’ll also find reputable government agencies that receive their recovery rate data from different types of treatment agencies. Some of these are harm reduction, while others are abstinence-based. These numbers may not tell the whole story because there’s no way to accurately determine the percentage, and too many variables are factored into the recovery success rates.
Treatment centers and agencies that treat substance use and mental disorders have their determination of a successful outcome. An Intensive Outpatient (IOP) agency may consider an alcoholic only drinking on the weekends rather than daily as a reduction in use. An Intensive Outpatient (IOP) agency may consider an alcoholic only drinking on the weekends rather than daily as a reduction in use.
As a result, the agency acknowledges a successful outcome. A treatment center that believes in complete abstinence-based recovery would consider any alcohol or drug use an unsuccessful outcome. A different treatment center may think that a successful outcome occurred because while the person is still using substances, they’re not using their drug or alcohol of choice.
For abstinence-based treatment centers, their alum departments call past clients and then determine their success rates based on the answer the past client gave over the phone. Almost any alcoholic or addict you call will tell you they’re doing well even when they’re not. Anyone who goes to Alcoholics or Narcotics Anonymous and is now sober will tell you that they lied when they received the call from their treatment center alum department.
In summary, get off the internet and stop researching success rates because none of them are accurate.
Bragging or boasting about success rates is merely a sales tactic for the agency or treatment center. Success rates on reputable sites such as the Substance Abuse and Mental Health Services Administration or the National Library of Medicine are only as accurate as those reporting the information and samples from small populations.
The substance user is going to stay sober or continue to self-destruct. Regardless of the success rates, your loved one may not be part of those success rates. The success rates should not be your motivation to do something. Your motivation as a family should come from providing yourself with closure. The more important question is, what percentage of families do something for themselves to help their loved ones?
In other words, what percentage of families do little to nothing, and what percentage of families set firm boundaries, hold their loved one accountable, stop enabling, and stop waiting for their loved one to ask for help or hit rock bottom? For the alcoholic or addict, what percentage followed directions?
Where are those numbers?
According to multiple sources, the success rate of effectively treating pancreatic cancer is approximately 11%. Although there was no data when we researched the answer to how many people still fight to be amongst the 11%, we suspect those numbers are near 100%. The point is the success rates don’t matter. What matters is that your family knows they did everything possible to provide help and resources to their loved ones.
For the alcoholic or addict reading this, your chances of recovery are determined by whether or not you surrender and follow directions. Where most substance users fail is when they treat the symptoms and not the cause. Relapse often occurs after attempting to correct the problems directly rather than addressing the behaviors that lead to the addiction that leads to the issues.
In this blog, we’ll look at the following questions:
- What constitutes recovery from alcohol addiction?
- What percentage of alcoholics recover?
- What helps people recover from alcoholism?
- What puts people at risk of relapse from alcohol?
- How do you help a recovering alcoholic?
What Constitutes Recovery from Alcohol Addiction?
It’s an excellent question; depending on the agency or the clinician, you’ll get a different answer. Many assessment instruments primarily focus on the problems that result from alcohol or drug use and not the cause of the alcohol or drug use.
As treatment methods and strategies have evolved, they appear to have gone in the opposite direction. What was once a hard-lined approach to accountability is now a softer touch of rolling with the resistance and meeting the substance user where they are.
Many clinicians believe that the alcoholic or addict is the most qualified person to determine what they need to recover. Moving the power from the clinician to the substance user has primarily been responsible for a sharp decline in abstinence-based recovery rates. While assessment instruments mainly focus on the losses and the problems, some effective treatment centers focus on the causes of the addiction after the assessment and intake into the center or agency.
Harm reduction models determine successful outcomes such as reducing use and others on abstaining only from your drug or alcohol of choice. In contrast, a successful outcome for abstinence-based programs is defined as complete abstinence from all drugs and alcohol. Harm reduction models focus on a reduction of alcohol or drug use and a decrease in problems that occur as a result of drug and alcohol use.
A methadone clinic may consider someone with a positive outcome in their recovery because they show up every day and have stopped stealing to obtain money for illegal opioids on the street. While this is undoubtedly a victory, if this same person is still occasionally testing positive for other substances while enrolled and still living with their parents, is this a successful recovery?
The answer depends on who you are asking and what the goals are. We see much more room for improvement in the above scenario; some are okay with the improvement. Either way, an abstinence-based center would say this is ridiculous, while a harm reduction model would say this is excellent progress.
“Neither the harm reduction nor the abstinence model focuses on determining recovery rates based on a behavior change; they both focus on reducing or eliminating use as a guide for success. Coincidentally, if either model focused on changing behavior that led to substance use, a reduction or elimination of use would follow. Focusing on behaviors first would accomplish more goals and get to the root of the problem”.
The two most common models focus on the reduction of harm and use and the other on the ability to abstain from all drugs or alcohol. And while both of these goals are positive, it does not solve the inner problem of the substance user.
Drugs and alcohol solve the problem for the addict or alcoholic. Reducing or taking away drugs and alcohol only exposes more of the problem. Unless these behaviors, perceptions, beliefs, viewpoints, opinions, traumas, experiences, etc., are addressed, it’s almost impossible not to revert to the old solution of drugs and alcohol.
What Percentage of Alcoholics Recover?
The word recover is determined by what model you choose.
Is a person in prison for 20 years away from drugs or alcohol now recovered even though they haven’t addressed one single behavior that led to the substance use that contributed to their prison sentence?
Is someone on buprenorphine recovered because they’re not using heroin or other opiates and are still drinking and engaging in questionable behavior?
Is a miserable dry drunk alcoholic recovered because they stopped on willpower due to a health concern while still being irritable, restless, and discontent while acting out in anger at everyone and everything?
There’s a big difference between sober and dry and between reduction of use and abstinence. There’s absolutely no way to answer what percentage of alcoholics or addicts recover because too many people have a different theory or viewpoint on what recovery is. From our experience, no family calls us about drug or alcohol use; that they realize anyway.
The families that contact us are calling us about the substance user’s behaviors and their sanity. Many families who call us about their loved one using drugs or alcohol have similar scenarios as those who contact us about their loved ones who haven’t used any substances in the last 30 days. Some would say the person who has not used substances in a month has recovered.
Others would say a person is recovering if the person is using less alcohol or drugs. Some believe a person recovered because they’re not using their alcohol or drug of choice and are now using something else. Very few people see the difference and almost always focus on alcohol or drugs. It’s uncommon for people to see the behaviors as the driving force of the addiction and the problems families and substance users experience.
The book Alcoholics Anonymous uses the word recovered quite often in its text. Many members of Alcoholics Anonymous believe they’ve recovered from a hopeless state of mind and body while conceding they will always be an alcoholic.
In other words, they’ve changed their behaviors and perceptions and addressed their traumatic experiences, spiritual malady, character defects, and shortcomings that led to alcohol and drug use. They didn’t stop drinking or using drugs by exercising willpower, and they changed everything about themselves. Gauging recovery by behavior would be your most significant barometer. This approach does not always tell you when they’re consuming alcohol and drugs; it will always tell you when they’re not.
Success rates for alcoholics, as stated in the book of Alcoholics Anonymous, were said to be approximately 50% who fully recovered, with an additional 25% who improved. These numbers are from Alcoholics Anonymous before Dr. Jellinek invented the disease model concept in 1960.
Since introducing the disease model concept, the percentage of alcoholics who recover is hugely lower than that. This drop may be the result of addicts and alcoholics believing they have a disease and that the addiction is no longer their fault; this most likely contributed to suggesting the victim mentality that we face today.
In other words, addiction treatment went from taking accountability and ownership of one’s behaviors, and actions to you’re now a victim, and none of this is your fault. For the record, nowhere in the book of Alcoholics Anonymous does it state that alcoholism is a disease.
The book of Alcoholics Anonymous states that alcoholism causes one to be physically and mentally ill and spiritually sick. Resentments destroy alcoholics more than anything else, resulting in all forms of spiritual disease. Once the spiritual malady is overcome, the alcoholic straightens out mentally and physically.
“The only thing more volatile and unpredictable than an addict or alcoholic who is actively using drugs or alcohol is an addict or alcoholic who isn’t using drugs or alcohol and is still spiritually ill and acting out the behaviors that led to the substance use.”
It’s inevitable that within days of an intervention, a family forgets about the behaviors that caused all the problems. The loved one is in treatment, and they can’t understand how they’re somehow worse than before in the first 30 days. They almost always assume because the drugs and alcohol are gone, so should the problems be.
Even more complicated, the substance user is telling the same lies in treatment as they did when using substances. The difference now is that the family is more likely to believe their loved one because they’re not using drugs or alcohol. This thinking causes many families to give in, side with the substance user, and allow their loved ones’ treatment to be cut short. Within days of the person returning home, they’re back to using drugs or alcohol, and the family calls us and blames the treatment center. The familiar pattern is a vicious cycle between the substance user and their family.
One last thing to note in the above example is when the opposite happens. The substance user is off to treatment and instantly becomes a model client. They’re saying and doing all the right things, and the family lets their guard down. Beware, this is almost always a manipulation on the substance users’ part.
Sometimes the substance user isn’t even aware they’re playing this game. They genuinely feel better mentally and physically and convince the treatment center, their family, and themselves that they’re good to take it from here; this is the scarier side of things we must explain to families. It’s not easy to explain that although their loved one appears to be doing well, they have a long way to go.
What Helps People Recover from Alcoholism?
To start the recovery process for alcoholism and drug addiction, the substance user must move through the stages of change. The turning point in these stages is the contemplation stage of change. In this stage, the substance user either sees and feels the need to do something different or they don’t. Once they see the benefit of getting help, they move through the remaining stages of change.
What helps them see this need for change is a change in their environment. As long as they feel comfortable in their routine, they cannot and will not see the need to do anything different. Families are a huge part of this environment that often prevents the substance user from seeing or feeling the need to do something different.
Holding the substance user accountable and setting boundaries is essential to moving someone out of the contemplation stage. Waiting for the substance user to ask for help or hit bottom while doing little to nothing to change the environment often results in the situation staying the same. For the substance user to recover from alcoholism or drug addiction, they first need to see and feel they have a problem with alcohol or drugs.
How will they know the need to address a problem when they don’t think or see they have a problem? Too many people focus on allowing the substance user to lead the way as they await the magical day they will ask for help. Families can expedite this by addressing the environmental concerns holding the substance user back from seeing and feeling the need to seek help.
Once the substance user has been able to move out of the contemplation stage, evidenced-based treatment options can help them on a path to being recovered from a hopeless state of mind.
The final stage of change is called the maintenance phase. It should be called the growth stage; clinically speaking, it’s the maintenance phase. The substance user continues their recovery and relapse prevention journey in this phase with various treatment methods.
Two of the most prominent evidence-based strategies recommended while in treatment and after treatment are 12-step facilitation and Cognitive Behavioral therapy. CBT and 12-step facilitation seek to change negative behaviors and thoughts which drive addiction.
Anytime the addict or alcoholic can change their perspective from negative influence to positive, they’re at an advantage in their recovery. In our experience, one of the number one things a substance user can do is take accountability for their actions.
Switching roles from victim to the cause of the problem is said to be when the lightbulb goes off. Substance users spend the majority of their time blaming everyone else and everything else for their problems, leaving little time to focus on what they may have done to put themselves in a compromising position.
The 12-step theory does an outstanding job of helping the substance user look at what they did wrong rather than focusing on what the other person did to them. If you dig deep enough, you’ll always find something you did that put you in the position you were in to be hurt.
For those who did absolutely nothing, such as a harmful act to you as a child, there’s still something you can do differently. You either go through life as a victim, resentful at the person, place, or thing that wronged you or address the trauma and the experience to heal. If you choose the first option, you go through life angry and hateful while finding a justification to hurt yourself and others.
In summary, there’s never a time when you can say, “I did nothing wrong.” Even when you didn’t do anything wrong, how you address the problem sets the stage for your mental health and future growth and success.
“Alcoholics Anonymous states that Resentments are the number one offender of the alcoholic. Even when it’s not your fault, if you don’t address the trauma or the experience, you go through life as a victim justifying your bad behaviors and substance use. The victim mentality often results in the substance user trying to make everyone who will allow it feel their pain by trying to inflict pain on others.”
These concepts and theories are why interventions done by a family without a professional often fail. When the family attempts to talk their loved one into treatment, they either forget or are unaware of the victim mentality of the substance user that drives addiction.
When the perceived problem, the family, addresses the substance user without a professional, confrontation is bound to occur. Please keep in mind that we stated “the perceived problem.” We aren’t saying the family is the cause of the problem; we’re only stating that the substance user often feels they are.
What Puts People at Risk of Relapse from Alcohol?
Many treatment centers and agencies focus on relapse prevention plans. Like most assessments and treatment center curriculums, much focus is on the external and light exploration of the internal cause of addiction.
Several relapse prevention strategies and initial prevention strategies for high-risk populations focus more on natural causes than behavioral ones. Relapse prevention strategies often focus on triggers such as people, places, and things. Few look at relapse’s internal why, when, and how that stems from behavior, perception, and past experiences.
A relapse prevention plan that teaches people to avoid compromising situations is essential, especially in the early stages of recovery. Focusing on triggers alone to stay sober is like concentrating on willpower alone. When someone is engaged in recovery efforts and has recovered from the behaviors, past experiences, and perceptions that caused the addiction, they will be less likely to be triggered by tangible reasons. When people relapse, they don’t slip on a banana peel and fall onto a drug or a glass of alcohol.
“Relapse starts long before the person consumes alcohol or drugs, providing they were sober first. There’s a difference between relapsing and resuming alcohol or drug use. Relapse occurs when someone has sobriety first; resuming is someone who was abstinent and never changed anything.”
Families of substance users often say they relapsed right after treatment or after a short period of abstinence; this isn’t a relapse but picking up where you left off. Relapse consists of improving first and then going backward. Only quitting or maintaining abstinence while maintaining restless, irritable, and discontent behavior is resuming.
The Merriam-Webster dictionary defines relapse as “to slip or fall back into a former worse state.”
For those who feel the problem is and only is alcohol or drugs, then we can see how one would call a return to alcohol or drug use a relapse. For those who understand addiction is behavioral, we define relapse as reverting back to old behaviors and habits that caused substance use. Very few manage to fight urges to revert to substance use without changing behaviors.
Anyone reading this knows who those people are because they often refer to them as dry drunks. The only thing worse than an active alcoholic or drug addict is a dry one. A dry substance user exhibits behaviors similar to an active substance user. These are the same reasons families call us in the first place. Not because of the alcohol or drug use but because of the substance user’s lifestyle, behavior, and choices.
Here are some warning signs for relapse in a sober person who’s slipping back:
- Dishonesty & Omission
- Diversions and Script Flipping
- Distorted Perception
- Inflated Ego and Pride
- Spiritual emptiness
- Criminal behavior
- Little to no compassion for others
- Lack of ownership and responsibility
- Lack of respect toward others
- Problems with authority
- Selfishness (irresponsible behavior)
- Know it mentality (has to be correct, and everyone else is wrong)
- Victim mentality
- Finger-pointing and casting blame
- Everyone else’s fault, and no accountability for their actions
- Stop, never start going to meetings
- Stop, never start working with others such as a sponsor or mentor
- Finding issues with treatment centers and 12-step groups, or other groups such as Smart Recovery
- Not Medication Compliant
- Lack of motivation, not looking for a job, working the system
- Not making amends and correcting past mistakes with those people, places, and institutions that the substance user harmed
- Justifying substances such as alcohol, marijuana, and legally prescribed narcotics
- They only go to treatment or quit to get back the stuff or things they lost in their addiction.
These same warning signs occur in someone who’s actively using substances or abstinent and has not yet addressed the causes of the substance use. Many of these behaviors and symptoms are present in those who have impulse control disorders.
Aside from the behaviors listed, one of the biggest reasons for relapse right after treatment is the last bullet point above. Although every behavior or scenario is a huge red flag, the intent of why someone went to rehab or stopped is a massive predictor of relapse. Most substance users and their families feel the problems that occur while using drugs or alcohol must be addressed first. It’s prevalent for substance users to work the solution to the addiction problem backward.
Behaviors, perceptions, and past experiences cause the obsession and the compulsion that leads to substance use that leads to the issues. Most substance users skip the first two and focus on repairing the external damages first.
Once the substance user gets their living situation back on track, gets their car back, finds a job, meets someone, etc., they feel well and are cured. The problem is they often quickly lose these things again when they skip addressing the behaviors, perceptions, and past experiences that caused the obsession and the compulsion to use alcohol and drugs.
Families believe stopping alcohol and drug use is the only thing that needs to happen. As a result, families often let their guard down too soon. Thinking this way causes many families to resume or never stop enabling their loved one and believes, just like their loved one, that the substance user is a victim.
How to Help a Recovering Alcoholic
In our experience, detachment from the person’s behavior and addiction is one of the most helpful things a family can do for themselves and their loved ones. Detachment isn’t tough love; it’s loving the person and saying no to the behaviors and the addiction with boundaries.
One of the family’s biggest fears is thinking the substance user will feel pushed away and unloved as the result of an intervention or setting boundaries. At some point, a family has to communicate that they accept the person’s decision to use drugs or alcohol and ask the substance user to accept their decision to detach from it.
In our experience, families who engage in their family therapy contribute to the overall success of their loved one’s recovery. The entire family changed; therefore, it’s necessary for all affected to address their concerns. There are many evidence-based treatments for the substance user and the family. Therapists and social workers have many different evidenced-based intervention strategies depending on the substance user and their family in the recovery journey.
The family should focus on their recovery and allow the substance user to focus on theirs. Where many veers off track are putting little effort into themselves and putting all their effort into trying to control the substance user’s recovery. A family working on themselves has a much easier time accepting the substance user regardless of their path. There are many resources available for families and substance users.
“There’s not a lack of resources to help families and substance users; there’s only a lack of effort in accepting the resources available and following through with the suggestions of those resources.”
Families and substance users don’t see professional suggestions as an alternative solution during the intervention or recovery process. They hear someone trying to take away the family’s solution of codependency and enabling and the substance users’ solution of drugs and alcohol.
How you help an addict or an alcoholic is by not allowing them to stay comfortable with enabling and comfort. When substance users see a need to do something different, they almost always will. When someone or something stands in the way, it removes the addict or alcoholic’s ability to see the need for change.
Family First Intervention Focuses on the Family First
Our intervention program can help families change what they have been doing that may not be as effective as they would like. The greater the effort families and substance users put into recovery, the greater the opportunities for change and happiness. Helping an addict or alcoholic recover starts with helping the family first.
An intervention is not about how to control the substance user; it is about how to let go of believing you can.
“The most formidable challenge we professionals face is families not accepting our suggested solutions. Rather, they only hear us challenging theirs. Interventions are as much about families letting go of old ideas as they are about being open to new ones. Before a family can do something about the problem, they must stop allowing the problem to persist. These same thoughts and principles apply to your loved one in need of help.”Mike Loverde, MHS, CIP