An exploration of desired abstinent and non-abstinent recovery outcomes among people who use methamphetamine Full Text

This cutoff has numerous limitations when applied to examining recovery from AUD (see Pearson et al., 2016 for a review). First, alcohol consumption levels are not used as a criterion in accepted diagnostic schemes for AUD (APA, 2013), and it is therefore unclear why a drinking practices dimension would be included in sober house definitions of recovery from AUD. Diagnostic schemes instead emphasize drinking in harmful ways and under conditions that increase risk for adverse consequences in alcohol-related functioning and development of tolerance and physical dependence. The 4+/5+ consumption cutpoints were originally developed to screen for AUD risk in general and medical populations, and incorporating them into definitions of recovery, particularly as superordinate evidence of recovery, is a newer development of unproven scientific and clinical utility. Collectively, these studies support adoption of a more flexible definition of recovery (or other inclusive term) that focuses on improvements in areas of functioning adversely affected by drinking and enhanced access to non-drinking rewards.

Contextual Factors and Broadening Definitions of Recovery to Include Functioning

In some cases, people who abuse alcohol without a dependency may be encouraged to try moderation rather than abstinence; however, if this proves ineffective, they too are encouraged to completely abstain from alcohol use. Alcoholic detox is the procedure by which alcohol is removed from the body through a forced period of withdrawal. A licensed medical practitioner may administer other drugs designed to help limit the effects of alcohol withdrawal syndrome during the detoxification process, and the sufferer may also begin the rehabilitation program at this time. There are many different paths to substance use recovery, and 12-step programs are just one resource that people may find helpful.

How is recovery defined?

It seems logical that PWUM, many of whom have a MUD, are primarily concerned with cessation of methamphetamine. However, these gradients suggest exceptionalism surrounding certain substances and may further suggest that participants’ acceptance of various substances is ultimately dependent on their ability to function in a way that supports their goals and quality of life. Which substance PWUM https://northiowatoday.com/2025/01/27/sober-house-rules-what-you-should-know-before-moving-in/ find acceptable to use in recovery may also be related to the legality of substance (i.e. legalization of recreational cannabis) and subsequently the perception of how “hard” a drug may be. An individual may be abstaining from alcohol and not meet DSM-5 criteria for AUD, but be a miserable “dry drunk” (Pattison, 1968) with little or no improvement in functioning or well-being.

12-Step Programs – Alcoholics Anonymous (AA) and similar 12-step programs offer a structured framework for individuals to connect with others with firsthand experience managing alcohol addiction. It can be beneficial to hear the experiences of others who have been there and to have a community for support and accountability. Inpatient Rehab – Also known as residential treatment, inpatient rehab provides a structured and immersive program where individuals reside at a facility for a designated period. This intensive level of care provides a supportive environment, 24/7 medical supervision, and a range of therapies, including individual, group, and family, as well as holistic, adjunctive approaches, such as yoga and meditation. Inpatient rehab is particularly beneficial for individuals with severe Alcohol Use Disorder and co-occurring psychological concerns.

Component 1: Definition of Remission From DSM-5 AUD

The program emphasizes healthy lifestyle choices, stress management techniques, and the development of a balanced approach to competition and personal well-being. Recovery can feel isolating, but rehab can foster a sense of community by connecting individuals with others who share similar struggles and aspirations. Being surrounded by peers who understand the challenges of addiction provides encouragement, motivation, and accountability. Group therapy and support meetings allow individuals to share their experiences, learn from others, and develop meaningful relationships that continue beyond treatment. This peer support network can become an essential part of long-term recovery. Finally, in terms of financial, social, and relationship outcomes, participants identified not getting in trouble with the law as their primary concern.

Abstinence Not Required: Expanding the Definition of Recovery from Alcohol Use Disorder

This is because the alcoholic has a mental obsession that he or she can drink like a normal person. This obsession of the mind encourages the alcoholic to drink again despite the consequence that piled up. Once this physical phenomenon has taken place, the alcoholic will not be able to stop drinking. Recovery from alcohol addiction generally follows the stages of abstinence, withdrawal, repair, and growth. There is an important distinction between being “sober” and being in “recovery”.

What Does Alcohol Use Disorder Look Like in Day-to-day Life?

While the recovery period may be challenging, it’s also filled with milestones that can transform your life into one that’s better than you could have previously imagined. Combining therapy with support groups can greatly improve your odds of success. Therapy combined with an AUD program tends to lead to a high recovery success rate. Clinical evidence suggests that the most common causes of relapse during this stage are neglecting self-care or not attending self-help groups.

Lastly, participants reported that reducing cravings (91%) and identifying as a person in recovery (81%) were also important substance use-related recovery outcomes. Our findings indicate the importance of non-abstinent recovery outcomes among PWUM, suggesting high acceptability of non-abstinent recovery targets by people with lived experience. Further, the essential importance of non-abstinent outcomes, especially in the financial/social/relationship and mental health domains, were highlighted, providing novel targets for delivering SUD treatment/recovery. M. Jellinek led several initiatives aimed at increasing the study and dissemination of science related to “alcoholism,” including early work studying members of AA and patients in treatment. There has also been a growing acceptance of non-problematic substance use as a marker of recovery among people with lived experience 17.

Key Terms

According to the Fan et al. (2019) definition of recovery, an abstinent individual who is struggling with abstinence, experiencing considerable distress, and who disengages with their social environment would be considered “recovered,” solely because he or she is abstaining and does not meet criteria for AUD. Third, consumption-based thresholds have not been well-validated in clinical or general population samples. Research has found that consumption cutoffs lack sensitivity and specificity for predicting problems related to alcohol use and they do not differentiate individuals based on other measures of health or functioning (Pearson et al., 2016; Wilson et al., 2016). Cutpoints also ignore the influence of weight, sex, and health status in determining the effects of different levels of alcohol consumption (e.g., blood alcohol level) (Pearson et al., 2016) and are based on single-episode drinking, whereas recovery is better conceptualized as a process of change (SAMSHA, 2011). Alcoholism is considered incurable, but that does not mean that people who have it cannot quit drinking. Following the initial treatment phase, alcoholics are encouraged to continue their participation in therapy and support groups.

• Antabuse, for example, makes people ill when they consume even the tiniest amount of alcohol.
• Many rehab centers also offer outpatient treatment and connection to sober living arrangements for after a person has completed inpatient treatment.
• M. Jellinek led several initiatives aimed at increasing the study and dissemination of science related to “alcoholism,” including early work studying members of AA and patients in treatment.
• Further, people who use methamphetamine (PWUM) engage in treatment at particularly low rates 5.
• Participants were then asked to describe in an open-ended question which substance-related outcomes are most important.

Overwhelmingly, participants endorsed recovery as not using any methamphetamine (98%) and 88% of the sample reported methamphetamine use reduction as a “very important” or “essential part of recovery”. Similarly, 90% reported that not using substances is “very important” or “essential to recovery”. However, participants were more likely to endorse non-abstinent recovery when asked about the use of specific substances, especially legal substances. For instance, 80% of participants reported not using alcohol is “very important” or “essential”, 65% reported not using cannabis is “very important” or “essential”, and 18% reported not using tobacco is “very important” or “essential”.

In a rehab facility, individuals receive care from trained professionals, who can guide patients through evidence-based therapies, such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and trauma-informed care. In terms of cognitive functioning, there was little variability in terms of responses as participants endorsed all four domains as “important” or “very important” to recovery. Even though the open-ended questions asked about non-drug-related recovery outcomes, it is worth noting that participants clarified that their concern was ultimately drug-related. This was especially true for cognitive functioning domains, which were tied directly to drug use.

For many, alcohol temporarily helps manage the persistent desire to avoid feeling bad—it temporarily relieves symptoms of depression and anxiety, providing a way to self-medicate in a socially acceptable manner. However, this self-medication can quickly spiral into a destructive long term cycle, as alcohol is a depressant that can exacerbate symptoms and worsen conditions. This leads to heightened symptoms, greater distress, and an increased desire to experience symptom alleviation. Although recovery is an integral part of the substance abuse treatment process, the concept itself isn’t tied to a single event or specific point along the journey from abstinence to lasting sobriety. This can occur in a rehab facility on an inpatient basis, or it can be the first goal in an outpatient rehab plan.

So far, there’s no consensus on the medical definition of recovery in alcohol treatment literature. In 2021, researchers estimated nearly 30 million people ages 12 years and older in the United States had alcohol use disorder (AUD). These individuals may be staying away from alcohol, but they are not treating the underlying issues that had either led to their drinking in the first place or developed as their alcoholism progressed. Making significant life changes, such as cutting down on or stopping drinking, takes time and courage.

In severe cases, substance-induced psychosis can develop, causing an individual to experience hallucinations and delusions, which are physically dangerous. Rather than emphasizing powerlessness and embracing a higher power, the SMART Recovery approach emphasizes viewing substance use as a habit that people can learn to control. It draws on aspects of cognitive-behavioral therapy (CBT) and helps members to build motivation, cope with cravings, change addictive thoughts, and adopt healthy habits.

Establishing non-abstinent outcomes for opioid use disorder (OUD) has been critical to garnering greater acceptance of medications for OUD and shifting the recovery paradigm from abstinence to remission 34. Establishing desired non-abstinent recovery outcomes for PWUM may similarly be critical to the development and acceptance of interventions and other harm reduction strategies for MUD. While non-abstinence outcomes have been more broadly accepted for AUD 15, non-abstinence outcomes have been debated for OUD. Effective medications like buprenorphine or methadone are underused in part because 12-step programs often view these medications as replacing one drug for another 41; thus, perpetuating the view that medications are not a valid pathway to recovery. Moreover, PWUM and people with other stimulant use disorders are overlooked by most treatment providers due to a lack of pharmacotherapies or widely implemented behavioral interventions.