A need for change?
Addiction is a chronic condition but is treated as if it was an acute disorder. Treatment has become disconnected from the longer processes of recovery. Hence is there a need to redesign “treatment” to address the reality that recovery is a long process, not something that can be treated in weeks or months? Should there be a greater focus on interpersonal and family relationships, especially as they are demonstrated to be a major reason for relapse.
Toward a new Recovery Paradigm?
What do we know about this thing called recovery?
First we have to define recovery, so let’s start with “What is recovery?” Do we need to move from a pathology and treatment paradigm to a recovery paradigm? Although it is feasible that these paradigms could be interlinking? Or at least considered more than at present.
At present we focus almost exclusively on what is wrong with addicts not how they get better via recovery and the ways in which they get better too? We need more research to evaluate the processes in recovery, the different types of recovery, we need research into the success of recovery, i.e. how many people actually recover, the durability of recovery etc.
We need to clearly say where we are headed and what we can hope for by coming into recovery!
We could fill libraries with what we know about the neurobiology of addiction but barely a library shelf with what we know about recovery from addiction.
What exactly do we know about the neurobiology of recovery?
In recovery are there any ways recovering persons can help with altering vulnerabilities, such as developing the verbalising of emotion, to help with emotion processing and regulation which we know have a aetiological influence of the risk of later addiction?
In short can we affect the epigenetics of addiction (how genes are expressed in environments) by recovery? Can we reduce the stress that potentiates dopamine and reward and acts as a vulnerability to adolescent drinking which in itself is linked to later alcoholism? Can we counter the child maltreatment and insecure attachment that propels addiction?
So many questions remain unanswered. Can the people who suffer addiction, in recovery, be the most potent agents in actually affect vulnerability to later addiction? Can certain, seemingly unavoidable eventualities be addressed and changed?
Can our recoveries help our at risk children? Can we modify the effects of genetic inheritance? Is it inevitable that addiction occurs, can it not be “treated” in early childhood. Can we intervene to disrupt or alter the course of addiction?
This is the research question of the next decade?