Abstinence has long been recommended as the ultimate treatment for addiction. But what if the research supports a different approach to recovery?
In the classical protocols for addiction, abstinence is king. Twelve-step programs and other strategies help people quit a certain substance or behavior and stay off it forever. While this strategy absolutely works for some people, it doesn’t work for everyone. According to the American Addiction Centers, only about five to 12 percent of people who go through a 12-step program actually succeed in recovering from their addiction. So what if there’s another way to work with addiction? What if abstinence isn’t the only option?
The Link Between Addiction and Trauma
As addiction and trauma research has increased and improved in recent decades, it’s become clear that addiction and trauma are almost always linked. Addiction isn’t the problem, essentially; it’s a coping mechanism. Regardless of one’s behavior or the substance they are using, the addiction is a misplaced way for the person to calm themselves, quiet extreme emotions, and, in many cases, function despite deep emotional pain. For some people, their addiction is truly standing between them and death.
In many traditional forms of therapy, a therapist will not see a client if they are actively using. To paraphrase Adi Jaffe, who wrote the book The Abstinence Myth, that’s a bit like telling someone with a broken leg they can get help down the hall, but they have to walk all the way there without their crutches. Obviously, some substances will interfere with cognition, making it harder for someone to benefit from therapy. But therapy doesn’t necessarily always have to be about cognition—it can also be about connection, care, listening, and a safe place to start working out what’s going on with the pain that sits beneath the addiction.
Concerns with Non-Substance Addictions
There are also a few logical quandaries that arise when practicing the belief that abstinence is the only option for addiction recovery. If one is addicted to food, sex, or work, quitting those things completely isn’t really an option. Recovery is going to have to include working on the relationship with those things in order to heal. It’s also easy enough for people experiencing addiction to switch from one addiction to another; to give up a certain substance but then find another way to dull their emotional pain.
There are also many addictions that are seen as socially acceptable. Caffeine is an addictive substance, and addiction to work can lead to the breakdown of one’s health and relationships. In a society that is hyperfocused on productivity, there is very little stigma surrounding addictions to things that make us more productive, even when those things greatly impact our well-being.
Is It an Addiction?
Further complicating the issue, in recent years, plant medicines like cannabis and psilocybin have been increasingly studied and legalized. If someone is regularly using a substance that was formerly illegal but is now legal for medicinal use, does that qualify as an addiction?
One simple way to know whether you are addicted to something or not is this: Pleasure (or the experience of taking good medicine) brings us more deeply into our bodies and into our feelings, helping us feel more like our authentic selves. It can increase our empathy as well as our ability to communicate, express feelings, and care for ourselves. Addiction is simply the relief of no longer having to feel your feelings.
From this perspective, it’s really not about the substance but rather about an addictive energy. Drinking wine for the sensual experience, to enhance the taste of food, or as an act to share with another person is an expression of pleasure and connection to your body. Drinking wine to disconnect and dull your feelings, especially to the point of consistently harming your body with hangovers and impairment, is more like an addiction.
Addiction Versus Connection
One of the strongest elements of 12-step programs is the group aspect. People are encouraged to come together to talk about their feelings, problems, and relationships with the substance or addiction they are struggling with. As many recovery programs and specialists remind us, the opposite of addiction is connection, not abstinence.
We know that addictions tend to seem hereditary. But if we think of addiction from a wider perspective, we can also see that what might be passed down are survival and coping mechanisms, not necessarily an addiction itself. In his book In the Realm of Hungry Ghosts: Close Encounters with Addiction, Gabor Maté, M.D., explains what he learned from his decades as a doctor in the Downtown Eastside of Vancouver, known for its disproportionately high rates of drug use. Maté could see addictive behaviors being passed down through families, especially where there was no infrastructure to support people through safe housing, healthy food, and recovery programs.
A New Way to Heal Addiction
So what if addiction could be healed by healing the trauma that sits behind it? What if addictive energy is a powerful survival mechanism, not something to be fought but to be understood and supported so that it can rest?
There are many strategies to help people with trauma and addiction. Medication and even some plant medicines (utilized legally with a skilled and qualified practitioner) could help someone heal their addictive energy. Private therapy, especially when it addresses trauma and the body, can be transformative. Groups, whether in a 12-step program or elsewhere, can help establish connection, which supports the fight against addiction. Specific therapeutic techniques like EMDR and neurofeedback can also help some people.
Of course, many of these resources require money. Specialized therapies that might be helpful in particular cases might not be available in someone’s area. Even when free and accessible mental health programs are available in places like hospitals, they may be more re-traumatizing than helpful due to a lack of resources for both patients and the potentially underpaid and overworked staff.
But perhaps the approach to understanding ourselves and our addictions better is simple. Connecting with friends and speaking the truth can be powerful. Twelve-step programs have a lot of benefits and are free and found in all major cities. Mindfulness meditation can help teach us to get curious about our addiction and how it works and what it might be protecting us from.
However we choose to approach addiction, maybe we don’t have to think of abstinence as the only choice and the only way. Maybe this could be the start of a kinder, gentler recovery process. This strategy could certainly lead to abstinence, and that may indeed be the best thing for you. But if we didn’t have to start there, maybe it wouldn’t be so hard to get there.
