Many paths to healing: A reflection on substance use disorder recovery

Change can be hard, but we also know that it is possible, especially if we let people define their own path and support them along the way. Recovery is an individual experience and can change over time depending on what people want, need, or are adequately supported to achieve.

Following International Overdose Awareness Day on Aug. 31, September is National Recovery Month. In addition to honoring and grieving those we’ve lost, let’s take time in September to lean into hope for ourselves, our families, and our communities. With this goal, let’s discuss the meaning of the word recovery and broaden our understanding of the complex and diverse ways of healing.

Some people who use drugs can have a substance use disorder, which is when their drug use causes health problems and disrupts their lives. The concept of “recovery” from this disorder has been narrowly defined. Historically, it meant complete abstinence, often quitting substance use all at once. Many programs, support services, and housing opportunities were based on one’s ability to reach and maintain this difficult, singular goal. This meant that anyone struggling to make a change, anyone using substances to manage trauma, pain, and a whole other host of difficulties was denied access to crucial support systems and services. Further, they were denied access to the language of healing.

We’ve learned a lot more about substance use, addiction, and recovery in recent years. We’ve learned that even if abstinence is someone’s goal, it often takes several attempts to get there . We’ve learned that if someone is not ready to stop using completely or is using sporadically while trying to stop, medications such as buprenorphine and methadone significantly reduce overdose risk . This is compared to other forms of treatment, such as detox and rehab, where these medications aren’t given, which results in an overdose risk equal to or worse than no treatment at all . We’ve learned more about how various forms of marginalization and oppression — such as racism, classism, homophobia, transphobia, and sexism — intersect with stigma and can compound struggles with substance use, stressing how responsive and individualized services need to be to avoid that outcome.

We’ve learned that, even while continuing to use, people can change patterns of use and stay safer along the way (such as using with someone you know and trust, starting low/going slow, and carrying naloxone ). By doing so, they can improve their quality of life. Such methods can be critical supports for others, often saving loved ones from overdose. If we want people to have time to recover tomorrow, we need to help them stay alive today.

It’s also crucial to support people who use drugs, regardless of where they are on a spectrum of recovery. This can be done by providing person-centered harm reduction education, resources, and services such as medications for opioid use disorder , physical and mental health care, syringe service programs , and naloxone, which is a medication that can reverse an overdose.

To quote social impact leader and co-founder of CHICAGO RECOVERY ALLIANCE , Dan Bigg , let’s celebrate recovery as “any positive change as a person defines it for [themselves].” Only you can know what change you truly need. Let’s celebrate recovery and all the diverse ways people heal.

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