Keys to Long-Term Recovery from a Clinical Perspective

When it comes to substance use and addiction, we talk a lot about recovery, but what does recovery actually mean? Addiction recovery refers to a process of positive change in which individuals improve their well-being, live up to their full potential, and find purpose. Sobriety, or abstaining from drugs and alcohol, can be just one element of addiction recovery. What separates abstinence from recovery is when a person commits to a self-directed life in which they embrace positive change and make choices and engage in behaviors that are aligned with their values. Taking these steps often requires access to quality care, a safe home environment, a support system, and more.

Essential Elements of Recovery

Here we’ve compiled a short list of some of the key elements of recovery identified by professionals like physicians, therapists, and researchers, and also by people who use drugs and people who are in recovery.

1. Seek Safety or Harm Reduction

Above all else, you need to be safe and alive. This means reducing the risk of overdose by knowing your drug supply, having access to naloxone or Narcan, not using alone, and taking other harm-reduction measures. 

This also means managing anything that is potentially affecting your ability to survive. If you’re severely depressed and suicidal, that calls for emergency psychiatric care. If you’re experiencing psychotic symptoms, hearing voices, or seeing things that others can’t, or your perception of reality is distorted, you need psychiatric care.

If you have a medical condition that isn’t being treated and could land you in the hospital, you need medical care. You should also seek help if:

• You’re in an abusive or violent environment
• You don’t have a safe place to sleep at night
• You’re not getting enough food to eat

If you’re not safe and if your life is too chaotic and dangerous, talking about long-term recovery is just not practical.

2. Get Medication for Addiction Treatment (MAT)

The evidence is clear. Medications for opioid use disorder like buprenorphine or methadone save lives. They decrease the risk of overdose and death. They help you to stop using opioids like heroin, fentanyl, kratom, or oxycodone.

Before anything else, MAT is critical to starting recovery. Unfortunately, getting MAT isn’t always easy or simple (though it should be).

You need to do your part by showing up to your appointments, submitting drug screens, and sticking to anything else required by your MAT provider and the treatment program.

3. Get Treatment for a Co-Occurring Mental Health Disorder

Mental health disorders like depression, anxiety, bipolar disorder, ADHD, and PTSD can all contribute to a person’s substance use. And substance use can contribute to worsening mental health issues.

Some of us have experienced depression or anxiety due to opioid withdrawal. Some of us have misused other substances like benzos, alcohol, or meth to counteract the symptoms of an opioid addiction. In this way, the presence of a mental health disorder along with an addiction can create a vicious cycle that can be difficult to break without professional care.

You might find some people saying you need to manage your addiction first, or you need to manage your mental health first. Ideally, they should be managed at the same time! The idea of integrating treatment is sometimes called dual diagnosis or managing co-occurring disorders.

Overall, these are three important keys to long-term recovery from my perspective as an addiction medicine physician.