When it comes to Treatment & Recovery of Addiction, One Size Doesn’t Fit All

– Brian Coon, MA, LCAS, CCS, MAC, Director of Clinical Programs

While it is true that styles and pathways of recovery differ with each individual in recovery, it is also true for the care plans of formal addiction treatment services using best practices. This is known as the individualization of care.

While we acknowledge individual differences, is there anything that is the same within what we know about addiction? Addiction disease has a widely accepted set of diagnostic criteria (the American Psychiatric Association), a descriptive definition covering physical, emotional, behavioral, spiritual and relational aspects of the illness (the American Society of Addiction Medicine) and a large body of research clarifying these aspects of the illness. This body of research grows each year.

As the available research evaluating addiction illness grows, our understanding of addiction disease grows. This has led to a clearer picture of the commonality of addictive illness, regardless of the substance (e.g. alcohol, cocaine or prescription opiates) used or the behavior one is engaged in (gambling, etc.). The disease of addiction has never been better understood or better defined for all. Although the disease is well defined and our understanding of it is uniform, best care is individualized.

Why is that?
Not all people enter the disease with the same life or lifestyle. Not all people manifest all possible aspects of the illness. Not all people are equal in their length, complexity and severity of addiction illness. The common definition of addiction that describes and defines the problem is not a replacement for understanding the person as an individual.

What does the person using formal treatment to enter recovery specifically need?
A formal intervention is needed for some and not others. Medically managed withdrawal is needed for some and not others. For many a residential start to formal treatment is needed. Some will do best in a longer term of residential care that includes stepping down through extended care and/or a sober residence. Some will benefit from medications aimed at withdrawal, post-­‐acute withdrawal, or psychiatric conditions. Some people will benefit in early recovery through medication support aimed at reduction of cravings.

Everyone comes to treatment with their own key relationships and family connections. Thus, every plan for care varies in terms of education, referral and vital support necessary for the relationships in each individual’s life.

The goal is always promoting change and recovery at the level of key relationships and the family system, but again specific plans will vary. Are some of the family members or key relations in recovery? Do they themselves need or want education regarding their own health and healing within the context of the personal recovery of the one in treatment? Will they do best with a counselor of their own?
All of these questions illustrate that a one-­‐size-­‐fits-­‐all approach will not work best with key relationships and the family system in view.

Many are familiar with substance use problems through personal experience of one kind or another. Many are also familiar with the requirements of early recovery and of sustaining recovery. Due to our experience or familiarity with addiction or recovery, it can become easy to overlook the variables found within each person or to broad-­‐brush the idea of a recovery plan.

In short, we need look no farther than the Big Book of Alcoholics Anonymous to see clearly the centrality of the disease and of recovery, as well as the ways within which each person’s individual challenges and journey into and through recovery differ. Quality care and vibrant recovery appreciate and draw from both.