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Worth the effort

The most powerful resource promoting recovery from substance use and/or mental illness is not medication but respectful interpersonal relationships, which prove challenging during the pandemic. Yet success is still possible.

Geoff Kane M.D., M.P.H. is chief of addiction services at the Brattleboro Retreat.

Brattleboro

September’s National Recovery Month observance invites reflection on “recovery” and reminds us that recovery from addictive substance use and/or mental illness is worth seeking and protecting.

While people intent on establishing and maintaining recovery can succeed no matter what, the Coronavirus makes that prospect tougher than usual. But recovery is worth the effort, and it is possible to overcome obstacles created by COVID-19.

Individuals with serious substance-use disorders (addictions) and serious mental illnesses have a lot in common. They frequently isolate from others, put themselves in danger, and judge themselves harshly.

People who consume large amounts of alcohol, heroin, and other drugs have the added problem of feeling worse if they stop or cut down because they go into withdrawal.

Further, the values and relationships of individuals in the throes of active addiction or mental illness become distorted — so much so that their behaviors might imply that they care more about their substances or their symptoms than they do their own well-being or the well-being of people close to them.

* * *

Recovery often begins when people face the true depth of their troubled situation and ask for help. Outside help (often from health-care providers) is usually necessary. Clinging solely to the belief in one’s own talent and good intentions rarely if ever works.

Hospitalization or residential treatment helps people with addiction interrupt access to alcohol or other drugs and separate from toxic relationships. Medication for detoxification and/or maintenance paves the way for lasting changes in their lifestyle, along with nonjudgmental support.

Individuals with mental illness also might need hospitalization or residential treatment for respite from their usual responsibilities and possibly for separation from toxic relationships. Medication frequently helps their thoughts, feelings, and behavior to become more manageable.

Effective outside help also comes from non-professionals in the community, particularly those who have coped with similar problems and are willing to share how they did so.

We know that the most powerful resource promoting recovery is not medication but respectful interpersonal relationships.

When involved in such relationships, people with addiction and mental illness can absorb the acceptance of others, which helps them become less critical of themselves, more open to authentic communication, and better able to increase resilience and coping skills.

As recovery progresses, their actions align with their values. They repair damaged relationships.

* * *

Without a doubt, the COVID-19 pandemic complicates this process.

Prospective patients fear not only exposing the truth but exposure to infection. Inpatient and residential programs have slowed admissions to test for the virus. Many outpatient services have closed, at least until they could convert to virtual encounters.

Mutual-help groups such as Alcoholics Anonymous, Narcotics Anonymous, SMART Recovery, and Refuge Recovery have largely stopped in-person meetings.

COVID-19 has made the mutually respectful interpersonal relationships that are central to recovery harder to come by. Yet alcohol, other drugs, and despair remain available.

As stress and isolation increase, so do alcohol sales, overdose deaths, and thoughts of suicide.

* * *

Despite the threats and inconveniences of COVID-19, individuals who have “had enough” can continue to establish and maintain recoveries from substance-use disorders and mental illnesses.

With a mixture of hope and tenacity, they wait for their COVID-19 test results before entering a hospital or rehab facility.

They’re open minded about the benefits of medication, and they adapt to technology that helps them obtain care from professionals or peers without leaving their homes. Some even find virtual groups a better fit than in-person groups.

Friends and family remain available by phone or video chat. Health-care providers, peers, and mutual-help groups have increased their online accessibility. Books and videos promoting recovery remain widely available.

For many, the process of recovery deepens a sense of connection to the Universe or Higher Power of their understanding.

The slowing down of life imposed on many by COVID-19 might actually enhance that aspect of personal growth.

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Originally published in The Commons issue #579 (Wednesday, September 16, 2020). This story appeared on page C3.

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