Imagine that a person is caught in a horrific fire that leaves them with third degree burns all over much of their body. An ambulance brings them to the ER, where surgeons perform multiple excruciating skin grafts. Then they’re onto the ICU, where they spend a week coming in and out of consciousness, hooked intravenously to a heavy drip of morphine.
Eventually, they are able to come home, where, bottle of Percocet in hand, they spend much of the next few weeks lying on the couch, watching the entirety of the “X-Files” on Netflix and eating a large amount of Chunky Monkey ice cream and delivery Chinese food. Eventually, they are able to return to work, this time with some Extra Strength Tylenol with Codeine, kept securely in the glove compartment of their car, which they use on and off for years, whenever their pain flares up.
Here’s the question – when did that person’s “recovery” begin?
I think we might all say that they began to recover from being burned as soon as they were wheeled into the ambulance and brought to the ER. Everything after that was just a stage in that “recovery.”
Person number two grows up in an unsafe home where they are frequently neglected and abused, sometimes sexually. As they grow up, their suffering only increases. They run away from home, only to end up trapped in a situation even worse than where they came from. Now they are forced to have sex with violent strangers just to survive.
Eventually, they are able to make it out, first into a shelter, then into subsidized housing, but the trauma of having been sexually trafficked leaves them with such unbearable nightmares that they end up using heroin heroin again just to find solace from the pain. They use dirty needles. They contract Hepatitis C. It’s bad. At one point, they go through a publicly funded detox, but within a week, their panic and shame are so crippling that they once again find themselves shooting up, now worse than ever.
Then somebody introduces them to a needle exchange where they can get clean needles, Narcan and a free STD test. They’re still severely traumatized (and still using), but at least now they’re dealing with that trauma in a way that’s substantially less likely to kill them. Then they have the opportunity to start taking Suboxone – at first it’s pretty overwhelming to be making it through each day without getting high, but at least they don’t have such intense cravings torturing them around the clock any more.
Then they do an intensive outpatient program where they participate in group therapy for a few hours a day for several weeks, learning a range of coping mechanisms that help them deal with their trauma in healthier ways. They find a sober place where they can live with other people who support them, a job that they enjoy where they’re treated with dignity, a community where they feel loved. Eventually, they thrive.
So, same question, when did this person’s “recovery” begin?
I think, to answer this question accurately, we need to understand what it is that person number two is recovering from. Clearly, what they’re healing from isn’t just the drugs – it’s also the crippling impact of all the “trauma” they’ve experienced.
Surviving child abuse, rape, sex trafficking, homelessness, losing one’s family, being humiliated on a daily basis, the list goes on – these things all leave a person traumatized. And, in addition, constant drug use can cause a form of trauma all it’s own, especially in a society like ours where our government has spent almost 90 years at “war” both with a variety of drugs and with the people using them. The net result is that an alarming number of people in our society are now suffering. They’re terrified and shaking. It’s as if they’ve been terrorized.
How does a person begin moving away from feeling like that and start making progress toward actually feeling happy and comfortable? What does it take for a debilitatingly damaged person to become healthy again?
In neither case is it really about the drugs.
If you were to focus exclusively on how many pain pills the person who survived the fire was taking, without even looking at how their burns were healing, you’d never know if the person was actually recovering from their injuries. Likewise, if the phrase “in recovery” is to have any real meaning at all in this context, we can’t just use it as shorthand to denote people who abstain from using drugs and alcohol.
Being in recovery has got to mean something more than that. It’s got to mean transitioning from suffering in self-destructive misery to cheerfully living your life to the fullest. It can’t be as black and white as whether or not people are using certain drugs.
At a fundamental level, people use painkillers because they’re in pain. Recovery begins when we start to heal.