Different Approaches to Recovery

I'm about to sound old, but "back in my day," the approach to recovery was limited. We either went to rehab, AA, jail or died. Or we could do what I did and quit cold turkey, but as I've said a million times before, I don't recommend that approach.

Thankfully, the days of old are long gone. We've learned so much about our amazingly ever-adapting, malleable brains. Yay, science! Now, there are so many approaches to recovery to choose from. It's up to you to figure out which one is right for you. My only recommendation is that you don't do it alone.

I tried to recover and heal alone, and that was a terrible mistake. Whichever path you choose, please find a Sobriety Circle to surround yourself with.

Before we take a look at your options, there are a few things to be aware of when you make the courageous decision to quit using:

• If you're experiencing overwhelming feelings of hopelessness, have thoughts of suicide, or other thoughts of self-harm, seek professional help immediately. It's an act of bravery to reach out. The Suicide & Crisis Lifeline is 988. You can also text "HOME" to 741741.

• If you're experiencing withdrawal, seek medical guidance. Withdrawal from some substances, including alcohol and benzodiazepines, can be dangerous and may require medical supervision. You can contact the SAMHSA National Helpline at 1-800-662-4357. It's confidential and free.

• Acute withdrawal from one drug can be very different from acute withdrawal from another. Be informed and be prepared. Seek medical assistance when needed.

• Be aware of PAWS (Post-Acute Withdrawal Syndrome). Some people experience ongoing psychological, emotional, or physical symptoms after acute withdrawal. Symptoms and how long they last can vary, so seek medical or professional support if you need it.

Approaches to Recovery (in no particular order)

Harm Reduction

Harm reduction is an approach that recognizes that people who struggle with substance use need compassion and empathy first and foremost. They need life-saving tools and information, not shame.

It focuses on reducing the negative consequences associated with substance use and recognizes that not everyone is ready or able to stop using right away. Harm reduction strategies can include:

• Medication for substance use disorders.

• Naloxone and other overdose-reversal medications.

• Syringe service programs.

• Strategies to reduce the risks associated with substance use.

• Connections to treatment, healthcare, and other support.

With this approach, positive changes that reduce harm can be considered progress.

California Sober

This is a recovery lifestyle approach in which someone chooses to abstain from certain substances while continuing to use others, either recreationally or therapeutically.

There is some debate in the recovery community about this approach, and there isn't one universally accepted definition of "California sober." I believe in people finding a recovery approach that works for them because only they know themselves, their goals, and what supports their recovery.

It's one I use myself.

Medication Assisted Treatment (MAT)

Medication can be an important part of treatment for some substance use disorders. You may also hear the term medications for opioid use disorder (MOUD) or medications for alcohol use disorder (MAUD).

For opioid use disorder, FDA-approved medications include:

• Methadone

• Buprenorphine

• Naltrexone

For alcohol use disorder, medications include:

• Disulfiram

• Naltrexone

• Acamprosate

Medication may be used alongside counseling, behavioral therapies, peer support, and other recovery services depending on the person's needs.

Residential/Inpatient Treatment

Residential or inpatient treatment provides a structured environment away from many of the stressors and triggers of everyday life. Programs vary in length, services, and level of care.

Some programs provide medically supervised withdrawal management, while others may require detoxification or withdrawal management elsewhere before admission.

During treatment, people may participate in individual and group therapy, learn about their triggers, develop coping skills, and receive support from professionals and peers.

For some people, this higher level of structure and support may be an important part of beginning or strengthening their recovery.

Outpatient/Intensive Outpatient Programs (IOP)

Outpatient treatment can provide more flexibility than residential treatment because you can continue living at home while attending scheduled therapy, groups, and other services.

An Intensive Outpatient Program, or IOP, generally provides more treatment and structure than traditional outpatient care while still allowing someone to continue with many of their responsibilities at home, work, or school.

The appropriate level of care depends on the individual, their needs, their circumstances, and a professional assessment. It can also change throughout recovery.

Cognitive-behavioral therapy (CBT)

For many people struggling with addiction, thoughts, emotions, and behaviors can become connected in patterns that aren't helping them move in the direction they want to go.

CBT can help you identify those patterns, question whether your thoughts are accurate or helpful, recognize triggers, develop healthier coping skills, and discover different ways of responding to challenging situations.

While I'm not biased on any approach someone takes, this is one that helped me achieve emotional sobriety and heal from betrayal trauma.

Trauma-Informed Care

This approach recognizes that some of us (me included) may have experienced trauma. Trauma-informed care prioritizes emotional and physical safety, trust, collaboration, choice, and empowerment during recovery.

Finding the right professional is important if you've experienced trauma. A trauma-informed provider understands how trauma can affect us and works to avoid retraumatization while giving us a safe, non-judgmental space to recover and heal.

Depending on your individual needs, treatment may also include specific therapeutic approaches such as EMDR, CBT, DBT, somatic therapies, or others.

12-Step Programs (Like Alcoholics Anonymous and Narcotics Anonymous)

I'm sure most of you reading this have heard of 12-step meetings. They were helpful to me on my own journey.

They are peer-based groups where members share their experiences, strengths, and hopes with each other. The 12 steps include acknowledging powerlessness over addiction, developing a relationship with a higher power as each person understands it, taking a personal inventory, making amends when appropriate, and continuing to practice the principles of the program.

Many people choose to work through the steps with the help of a sponsor. Meetings can also provide something incredibly important in recovery: community.

I heard about emotional sobriety in AA.

Secular Recovery Programs (like SMART Recovery)

These offer a secular alternative to 12-step programs and take an evidence-based approach. SMART Recovery, for example, is grounded in cognitive behavioral science and focuses on self-empowerment and developing skills that support change.

It's also peer-based and provides a sense of community. Its four main areas focus on building and maintaining motivation, coping with urges, managing thoughts, feelings, and behaviors, and living a balanced life.

This can be a good approach for people who prefer a science-based, self-directed recovery program without a spiritual component.

Faith-Based Recovery

Like the name suggests, this approach incorporates religious or spiritual beliefs into the recovery process. You may find things like prayer and spiritual counseling, support from trusted faith communities, and faith-based treatment programs.

This may be a good fit for someone whose faith or spirituality is an important part of their life and recovery.

The cool thing about all these recovery approaches is that no one size fits all.

For me, after white-knuckling it, I went from 12 steps to trauma-informed care, and from there, I moved on to a secular recovery program. Now, I'm California sober.

My recovery has changed as I've changed. What worked for me at one point in my life wasn't necessarily what I needed later, and that's okay.

There are many paths to recovery. The important thing is finding the path, or combination of paths, that works for you.

Let’s Stay Connected

If this resonates with you, I’d really love to know. You can comment below or email me. You’re also invited to join other Bookenders on Reddit.

And if you’re looking for deeper exercises, I wrote Bookends of Recovery & Healing Workbook to help you heal from betrayal trauma and addiction by using creative exercises, action tools, and guided reflection.

Warmly,
Laura 🌻