Our children relapse. We are warned “relapse is part of recovery.” But I don’t think most of us believe it. By the time your child has a few years under their belt you get comfortable. You see a person emerge that you haven’t seen in years. Someone who is genuinely happy. Focused. Funny. Confident. Surely this person is here to stay.
But the fact remains. A mom I know confessed to returning to the days of sending canteen money to her son after his recent relapse landed him back in jail. She ended her dark missive with “why, why, why?”
It’s a rhetorical question I suppose. We know why. Giving up anything for a lifetime is a pretty monumental task. Giving up something you once loved more than life itself must be harder. Then throw in the added bonus of having an addictive personality or a mood disorder. Those are some pretty good whys. Sometimes I am amazed at the fortitude required to obtain 2-3-4 years of complete sobriety. It feels like a miracle. But I don’t want to think this way. I don’t want my daughter’s future to be dependent on a miracle.
Last week my daughter called me from detox. It was her third attempt in ten days. Her voice was hopeless as she numbly reported “only 1% of addicts ever make it mom.” I also have heard this number quoted. And I don’t like it.
We know statistics are manipulated to present a particular point of view. Is this one in existence because historically we haven’t cared enough to get the math right? Or has it been cultivated to justify poor spending on treatment?
This number was ringing in my head when I sat on an opioid forum last week. Beside me sat the head of a Massachusetts hospital emergency room department. He confidently stated that “involuntarily committing addicts to treatment is not recommended because we are setting them up for a higher rate of overdose death.” I am presuming his reasoning was based on the premise that this population is not interested in quitting drugs and therefore would return to using. I don’t question that deaths are higher among the involuntarily incarcerated vs. the voluntarily committed when treatment ends. It makes logical sense. But the data is flawed. The data is flawed because of “patient selection bias.” The doctor failed to include those who were NOT included in the data: those not forcibly committed to treatment. I venture to say that most of them are dead – or will be dead. Look at it this way: it’s like playing Russian Roulette with people who don’t want to quit the game. If you take away the gun some may eventually go back to playing with the gun. But if you DON’T take away the gun… well everyone is going to die. It’s that simple.
Are there better stats regarding relapse? Unfortunately there is a dearth of long term data. One of the few long term NIH funded studies followed 1,162 addicts for eight straight years. Published in the Journal of Alcohol and Drug Abuse it revealed that as the length of time in sobriety increases, so do the odds of continued sobriety. Those with less than a year have a 33% success rate. Those with over a year increase their odds to 50%. And those who achieve five years can expect an 85% future sobriety success rate. Data just doesn’t exist for those with 20 or 30 years of recovery time; but those who work in residential centers find their reappearance rare.
So we know clean time breeds more clean time. I remember joking a few years back with a local officer. I asked him to handcuff my daughter to her bedroom radiator to prevent her from scoring. He smiled, but then seriously replied “yeah, I can’t do that…and neither can you.”
Since that day I have been searching for a legal means to success. That searching even led to attendance at a spiritually based reading group (disclaimer: it is an act of desperation for me to turn toward faith for any sort of answer.) What I found was that many of those in attendance were living a life of successful sobriety. History, science, and society have not been kind to those suffering from the disease of addiction so we can not blame them for remaining in the shadows. AA and NA use “anonymous” for a reason. But by sharing their status this group become a living example of hope and, even better, a room full of positive odds!
It is still going to take a lot of unbiased research to get us solid numbers to stand upon. Faulty statistical analysis, unfunded federal research, a lack of evidence-based treatment, and social stigma have led us to this unsettling place. To live within the world of addiction is to stand on shaky ground.
For now I will tell you what I can do. I can share a whole new set of facts with my daughter when I visit her at the hospital. I can tell her with confidence that the 1% success rate is inaccurate. And I will tell her with even more confidence that she matters 100% to me.
These are the only true numbers at my disposal and, for today, we are relying upon them.