Why Is Recovery from Substance Abuse So Difficult?

He's an addict, a drunk, a druggie, a pill-popper. Whatever the descriptive term used, the meaning is the same - someone who is a substance abuser, using alcohol, cocaine, crack, marijuana, heroin, amphetamines, or over-the-counter medications to the point of addiction.

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For many people, it's difficult to understand why most people with such a problem can't face up to their substance abuse and just stop. The person made a choice to start using whatever drug it is that he or she is now abusing. Why can't he or she also make a choice to stop?

In reality, people, even the most hard core addicts, do have exactly that choice. And the first step on the road to recovery is making the decision to stop. But making that decision doesn't make the recovery road any less difficult. There are very real reasons why it's easy for many with abuse problems, even those with a real desire to overcome their problems, to fall back again into the pit of their addiction.

One of the biggest challenges facing someone trying to overcome a substance abuse problem is the chemical changes any drug causes in a person's body. These changes interfere with a person's natural ability to feel good, think, be happy, adjust to physical pain, and control emotions. Most abused substances alter the body's basic chemistry, creating a physical need for more of the substance.

As a person attempts to stop using his drug or drugs of choice, his body must fight to get back to operating normally, to returning the body's natural chemistry to operating as it did before drugs. The person attempting to recover from substance abuse finds himself or herself in physical discomfort on a daily basis. Symptoms can include headaches, nausea, sensitivity to sunlight, irritability, and being short-tempered. Users of the most addictive drugs can face even harder and more serious physical reactions. That physical pain is real and a significant temptation to start using the drug again. The person who abused substances has learned that drugs can make pain go away. Returning to the drug is an easy way to remove the pain.

Someone recovering from substance abuse also has to face daily reminders that their drug of choice is readily available. For persons with a legal drug of choice, such as alcohol or over the counter medications, advertising, the neighborhood bar, liquor and drug store are all daily reminders of how easy it is to get and solve the problem of the pain they are feeling. Most illegal drugs are not much harder to find.

The home or social environment can also make the process of recovery very difficult. For those of us who provide addiction treatment, we use the phrase "people, places, and things" to refer to this issue. Being around the same people, the same places, and doing the same things as when the drug usage started makes it easy to once again slip back into the same patterns.

Despite such problems, every day there are those who are able to overcome their substance abuse, but it is always a hard and difficult task.

One important step is seeking out help. There are self-help and other types of recovery-based programs that can offer support and guidance. Finding a program that works and then sticking with it is essential. Local drug clinics and counseling professionals can provide guidance.

Staying abstinent is another important step. For someone with a substance abuse problem, even a little is too much. Quitting means to quit completely.

Another important action is to begin living a healthier life. Eating nutritious meals on a regular basis, along with getting regular levels of appropriate exercise and adequate amounts of sleep can all help someone with an abuse problem feel better and deal with their problems more easily.

Maintaining a recovery program is not easy. Neither is living the life of an addict. The recovering person struggles with a minute-by-minute choice of sobriety or abuse. Nevertheless, as it is said in meetings taking place across this nation, "Keep coming back. It works if you work at it."

Dr. Cyrus M. Ellis is an Assistant Professor of Counselor Education at the University of Tennessee at Martin. Dr. Ellis has over 12 years' experience as a clinician and social worker treating persons suffering from Chronic Mental Illness and Chemical Dependency.