The phrase, “treatment works,” is often used to counter the pessimism about recovering from addiction. The version heard at 12-Step meetings is, “it works if you work it.” Seeing the remarkable recoveries that people with substance use and gambling disorders achieve has made my professional life gratifying.
A subset of people who successfully travel the road to recovery have a bumpy ride. For me, one of the most powerful experiences has been listening to, at Alcoholics Anonymous meetings, the stories of people whose early years of recovery were marked by painful relapses, but who went on to decades of abstinence from addictive substances.
At Kolmac, our practice has been to admit almost all comers, but when a pattern of relapse becomes apparent, we would refer the patient to residential rehabilitation in a more restrictive setting. Despite that, some people would still not succeed and others would not agree to go at all. I frequently envied community recovery support groups that continued working with their members during their most trying times.
This year, we at Kolmac designed a treatment track to do just that. Now, when a pattern of relapse becomes apparent, and if the patient is not in imminent danger of harm, we have them join a group of Kolmac patients also struggling with relapse. They focus on ways to understand and prevent relapse. The group is separated from the rest of our patients because their relapses detract from the treatment experience of patients whose recovery is smoother.
The Kolmac staff and I are finding our work with this group of strugglers very challenging. Most of these patients have already progressed to the point of accepting they have a problem with substances. But they have been using substances to hold at arm’s length the pain of personal issues that, because they are unresolved, reappear with a vengeance. This appears to be a driver behind their repeated relapses.
Despite this complication, most of these people show persistence and determination – the grit – to address these issues and pursue recovery despite the pain. I believe that together we are breaking new ground in using intensive outpatient treatment to extend addiction treatment, and I will update my readers on our progress as we learn more.