By the time the family gets around to taking action, conditions in the addict’s life have already reached the point where there’s a certain incentive to change.

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Why do addicts and alcoholics quit drinking or using drugs? I’ve heard confusing information about this.”

I’m not surprised. I’ve seen some recent reporting on research that claimed to demonstrate addiction was not actually progressive, on the grounds that if it were, addicts and alcoholics would be less likely to enter recovery as the years passed, when in fact the chances for recovery appear to increase with time.

I find it astonishing that anyone could draw that conclusion from that research. Of course the addict’s motivation for change increases as the years go by. It’s because of a progression in symptoms.

Let me take it step by step:

  1. Active addicts and alcoholics do not secretly long to give up drugs and alcohol. Most consider the radical step of recovery precisely because they’re experiencing problems. Things have progressed in the sense of escalating consequences and decreasing rewards.
  2. That represents a sea change in the addict experience. In the early years, rewards for substance use could be substantial– it makes you feel better, you have more fun, your worries fade into the background, if only temporarily– while at the same time you experience few if any painful consequences. Those come later. Often, accompanied by a sense of betrayal.
  3. If things stayed the same, people would probably just keep on using. It’s working for them, right? But sadly, change comes. As consequences worsen, motivation for recovery increases.
  4. This can happen slowly or over a period of a few months. Once it does, the mystery becomes why, in spite of escalating consequences, the addict or alcoholic still resists change.
  5. The answer: there are barriers in the way. Stigma is one of them. Distorted thinking is another. These barriers are enough tip the decisional balance towards continued use and away from recovery. Change, after all, is hard and scary work. If there were an alternative, most of us would jump at it.
  6. This natural momentum is a big part of why family intervention works. By the time the family gets around to taking action, conditions in the addict’s life have already reached the point where there’s a certain incentive to change. The intervention itself is mainly about overcoming the remaining barriers.
  7. Now– if we just waited long enough, would the addict or alcoholic come to the realization on his own? Quite possibly. But there are risks involved. People sometimes die first. Living with addiction is also quite hard on those who have to put up with it. Sometimes society objects, in the form of criminal charges.

Vaillant talks about the natural outcome of alcoholism with advancing age. Basically, it comes down to two things: abstinence or death. There’s a tiny minority who represent an exception. Read for yourself in his report from a sixty-year study.

I can’t imagine it’s much different for the heroin or meth addict. At some point, there’s a decision to make. Even after the decision to seek recovery, the addict or alcoholic faces many difficult challenges. But at least by that point, he or she is trying.

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