What They Say About People Who Abuse Substances
“They have to want it.”
“It will only work if they are ready.”
“You have to let them hit rock bottom.”
These are common sayings in 12-Step meetings, in recovery communities, by family members and friends. It’s even sometimes (unfortunately) said in professional treatment. To be fair, it’s said out of love and kindness towards the stressed family member or friend. It’s said to persons who are and have been agonizing over trying to help their loved one get needed help. The problem is that it is not true.
For long term, contented sobriety, yes, the person in recovery needs to develop a life they enjoy clean and sober. But to initiate treatment? No, they don’t need to have “hit bottom” or “want it.” There is NO research that supports outcomes are better if a person “wants it” vs. entering a treatment program via a “nudge from the judge”, or parents, friends, employers, or romantic partner.
Unfortunately, substance abuse disorder (SUD) is an illness that has a high recurrence** rate, but that rate is not tied (so far, in terms of research) to reasons the individual sufferer entered treatment. Once in treatment, a person has access to life-changing (or, more scientifically accurate, brain changing) information, skills, and habits that can work regardless of the motive that got the individual to the treatment setting.
What CAN We Do To Help People Get Into Recovery?
As a professional who treats professionals and their families, I don’t want friends and family to lose themselves as they try to help the person with a substance use disorder. When I work with family members of the person who has a substance use disorder, often a significant amount of that work is teaching and guiding friends and family in creating their own life worth living regardless of what the person with the SUD does/doesn’t do. This sometimes means accepting that it IS the person with the SUD who has to engage with the components of healing associated with recovery from substance use. It does NOT mean that the person with the SUD needs to be “ready” and to step back and wait for that readiness.
Encourage the friends and family members to get their own support and information but know that treatment CAN (and sometimes does) work regardless of what initiated it. The “rock bottom” and “they need to want it” sayings are around not by evidence but tenacity and perceived authority.
They are lay-person and recovery colloquialisms but not clinical “truth” and not effective. If you have a way to get a sufferer into treatment, do it. Let the process and information of treatment offer the person who needs help treating the illness be exposed to evidenced based options for healing their brain and body.
Make sure, though, that the treatment is well selected, specialized, and informed. I provide outpatient care to high functioning persons with a substance use disorder or their family members.
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