Academic journal article Research and Theory for Nursing Practice

Journeys from Addiction to Recovery

Academic journal article Research and Theory for Nursing Practice

Journeys from Addiction to Recovery

Article excerpt

Addiction affects us all. It has wide-reaching consequences for the individual, the family, and society as a whole. This article attempts to assist providers and addicts in understanding the road to recovery. Transformation from addiction to recovery is best explained by recovering addicts themselves. In this qualitative study, nine participants describe their experiences with long-term recovery. The transtheoretical model of change (Prochaska & DiClemente, 1983) was combined with Mezirow's (1997) transformative learning theory to structure a framework that highlights the transition of these individuals as they moved from addiction to recovery. This new combination model can be used to anticipate behavior, support, and encourage patients in the change from active addiction to a healthier lifestyle without drugs and alcohol.

Keywords: recovery; substance abuse; drug treatment; abstinence; drug and alcohol addiction

Journeys toward recovery from addition may be thwarted by the overwhelming and devastating nature of the problem. This may be seen in the United States where addiction has reached epidemic proportions. While Americans represent only 5% of the world's population, they consume more than 60% of the world's illicit drugs (Shrum, 2004). According to the Substance Abuse and Mental Health Services Administration (2007), an estimated 22.6 million persons (9.2% of the population ages 12 and older) may have had either substance abuse or dependency problems in 2006. Only 2.5 million people, however, received substance abuse treatment at specialty facilities that year. Dependence on drugs and alcohol affect mortality rates as well; at any age, alcoholics have almost three times higher mortality rate than for nonalcoholics (Day & Best, 2006). Yet, some addicts do overcome their addictions. The purpose of this study was to document the recovery experiences of nine participants (pA-pR) who had been in recovery for many years.

Drug dependence is a chronic, progressive disease (Laudet, 2007; Leshner, 1999) that causes neurochemical changes in the brain (Sutherland, 2001; Sylvestre, 2004; University of Utah, 2006). According to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) (American Psychiatric Association, 2000), three of seven criteria must be present for a diagnosis: (a) increasing tolerance; (b) adverse symptoms with withdrawal; (c) consuming greater amounts, more frequently, over a longer period than intended; (d) unsuccessful efforts to reduce or control use; (e) excessive time spent obtaining the drug or recovering from it; (f ) reducing important activities because of substance use and effects; or (g) continued use of the substance despite persistent physical or psychological problems.

Schaub and Dossey (2000) help to define the 7th criteria of the DSM-IV (American Psychiatric Association, 2000) by referring to the early, middle, and late stages of addiction, and the different cycles within each stage. In the early stage, the addict begins to develop a pattern of getting rid of undesirable feelings by using substances. In the middle stage, the feelings have been successfully repressed by the substance use, and the addict is now only conscious of discomfort and the need to use more substances for relief. By the late stage, physical instability replaces the emotional instability of the previous stages, and the addict tries to use substances as often as necessary to achieve a state perceived as normal. Sobriety becomes an intolerable and abnormal state to the addict, while lack of sobriety (chemical overload) creates a myriad of physical and psychological (nervous system) symptoms. These nervous system symptoms are often sensed by the addict as paranoia, confusion, mental instability (such as memory problems), and hallucinations. The addict also distinguishes these disturbances as intolerable and again, tries to suppress them with the substance.

This vicious cycle is what Alcoholics Anonymous (AA) (1984) describes as a "mental obsession and a physical compulsion" (p. …

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