The path to recovery is a slippery slope. You must maintain contact with each moment to ensure you’re moving away from behaviors that contribute to substance use. This means paying attention to feelings and experiences that can trigger you in recovery. These can be different than the ones that prompted substance use in the first place. Often people start using drugs or alcohol to “feel good,” which may evolve into using substances to avoid “feeling” altogether. Emotional and social vulnerability can be one of the most terrifying experiences while also serving as the key to escaping the locked prison of your mind.
The decision to pursue recovery is usually not made in haste. It’s often a decision that’s entertained, then dismissed for another day. In the world of Motivational Interviewing – a behavioral change approach used in substance use treatment — the stage where people tend to get stuck is called “ambivalence.” Ambivalence about change is a normal reaction when you’ve invested an immense amount of energy, time, and commitment to a behavior — particularly one that’s rewarding at times.
The nine reasons listed below are common themes I’ve seen during my time working with people struggling with substance use disorders and co-occurring mental health conditions:
1. Lack of Coping Skills to Manage Mood and Recovery
People using drugs or drinking alcohol can feel instantly gratified by substance use and see it as a solution to difficulties. The problem is that over time, alcohol and drug use lower your ability to tolerate stress and triggers. This can cause you to feel unprepared to deal with whatever emotional crises or trigger you’re experiencing. The short-term solution of using alcohol and drugs evolves into a long-term problem that’s difficult to change.
In times of stress, your mind attempts to find the quickest solution to the problem. Therefore, in recovery, it’s critical to practice healthy coping skills like mindfulness and other grounding techniques to empower yourself to be proactive and not reactive in triggering situations.
2. Co-Occurring Mental Health Conditions
The co-occurrence of addiction and mental health disorders is the norm, not the exception. It makes sense that if you’re struggling with your mental health, you would look for a way to alleviate the emotional pain. Substance use may initially start out as a way to solve the “problems” associated with difficult feelings, but it may quickly spiral into its own separate problem.
The initial mental health problems that substance use was self-medicating may feel even more overwhelming when you stop using drugs and alcohol. The intensity of the emotional experience can trigger feelings of hopelessness that your situation will never improve. That’s why it’s important to enlist the support of a therapist and/or group in recovery. They can help you identify effective tools to cope with a mental health diagnosis instead of using drugs and alcohol.
3. Medical Diagnosis
Medical issues can be a huge deterrent to seeking addiction treatment, especially chronic pain. If you rely on prescription medication to manage medical conditions, you must find alternative ways to ease pain. Successful pain management for people struggling with drug or alcohol use provides unique challenges for primary care physicians. However, pain control can be successful if physicians follow guidelines by leaders in the industry such as those from the Joint Commission on Accreditation of Healthcare Organizations.
4. Lack of Resources
Identifying a place to get sober from drugs and alcohol can feel overwhelming. Not every community has a surplus of resources dedicated to substance use and dual diagnosis treatment. This leaves very limited options that do not fully address all of your clinical needs. Barriers to attending an addiction treatment program can include:
- Insurance coverage
- Length of service
Often, apprehension is a barrier as well. Not knowing what actually happens at an addiction treatment center can fuel ambivalence about seeking help. This further delays the steps needed to enter treatment.
Internet searches may produce an endless amount of detox facilities and countless drug and alcohol rehab centers. Many of them promising the world yet delivering on very few of their promises. Narrowing the search can feel impossible. The first step begins with picking up the phone to educate yourself on the available resources out there.
People with substance use disorders can feel overwhelmed by shame or guilt. Shame is a chronic feeling that eats away at you, often filling the mind with thoughts like: “I am no good,” or “I will fail regardless of how hard I try.” Feelings and thoughts associated with shame create additional hurdles to overcome in early recovery. Shame robs you of the healing power of self-compassion. Self-compassion is what holds the key to letting you release the pain and suffering that you’ve not only caused others but also yourself. Being present and treating yourself as worthy of recovery has a powerful impact on your journey.
6. Lack of Confidence
Most people do not obtain long-term recovery with their first attempt. The disease of addiction will test you and your ability to believe that you can be successful in your recovery journey. A lack of confidence stops many people from even attempting to pursue recovery, even when they think recovery is something they want.
The overall goal of sobriety can be broken down one day at a time – to focus on the present and what you’re pursuing. Each day in recovery is an additional affirmation that recovery is possible and that you possess the ability to sustain it! In a society where substance use is an acceptable behavior, it can be difficult to view drugs and alcohol as a problem and can discourage people from seeking treatment.
7. Family Dynamics
Addiction is a family disease. When an individual in the family system is in active addiction, it can throw the entire system off balance. Often loved ones of the family member with an addiction compensate for them by making up excuses or “cleaning up” the damage they cause. These relationship patterns can reinforce drug and alcohol use. Likewise, it can be very difficult if you’re trying to stop using drugs or alcohol in a family system that reinforces it. There can be environmental and relational triggers that make it very challenging to abstain and sustain recovery.
8. Lack of Peer Supports
The disease of addiction with co-occurring mental illness can lead you to isolate from friends. Addiction grows in isolation, and the disease has a powerful influence on pulling you away from those that could be your anchors in recovery. Often your social circle is restricted as the relationship substance use becomes stronger. The idea of peer support groups can be seen as a threat to a lifestyle that you’re not willing to remove yourself from.
We can’t talk about the reasons why people use drugs and alcohol despite negative consequences without discussing the stigma attached to substance use disorders. There continues to be a large stigma surrounding people with addictions. Many people believe mistruths like people with a substance use disorder are “to blame,” are “at fault for,” or “lack something,” which contributes to their condition. This is the same notion that “people do not change until they’re ready,” or “they must hit rock bottom first.”
These stigmatizing beliefs impact people reaching out for help. They have resulted in many deaths of people whose loved ones were waiting for them to “hit bottom.” The stigma is costing people their lives and it needs to be recognized for the negative societal impact it’s having. This past year over 100,000 people lost their lives to a drug overdose. Many of these deaths could have been prevented if a compassionate approach had been taken to intervene with those entrapped by the chronic brain disease of addiction.
There are several reasons why people continue to misuse prescription or illegal drugs and alcohol despite the negative consequences beyond these nine I’ve noted. Committing to a recovery lifestyle is a process of change through which you improve your health and wellness, live a self-directed life, and strive to reach your full potential. The goal is to help you transition from feelings of just existing to feeling that you are actively participating in your life. The timeframe in which you or a loved one might be open to seeking help can be small, that’s why it’s important to have a plan in place for when that window of opportunity arises.