How Long Does Recovery Take?
March 19, 2009 by Emily Battaglia
Recovery is a complicated idea, and an equally complicated reality. Recovery from addiction involves change and growth on many different levels, encompassing the psychological, physical, emotional, and social domains.
In a 2006 report by Ernest Kurtz, Ph.D., and William White, MA, titled “The Varieties of Recovery Experience: A Primer for Addiction Treatment Professionals and Recovery Advocates,” the authors provide a concise definition for recovery: “the process through which severe alcohol and other drug problems … are resolved in tandem with the development of physical, emotional, ontological (spirituality, life meaning), relational, and occupational health.” What this definition lacks, however, are the tangible activities that may be included in this process, and the duration of that process.
For an individual entering recovery, the complexity can be daunting and frustrating. A common question among people in early recovery is, “How long will it take?” Unfortunately, there is no simple answer to this question. Although all individuals in recovery have some things in common, the path to and experience of recovery is different for each person.
In “The Varieties of Recovery Experience,” the authors state that alcohol and other drug (AOD) problems “arise out of quite different personal, family, and cultural contexts and unfold in variable patterns and trajectories. These same forces generate heterogeneous recovery experiences.” The authors also state that although there is substantial knowledge about AOD problems, comparatively little is know about the existence and/or efficacy of long-term solutions to these problems. As the authors point out, recovery is amorphous largely because alcohol and other drug problems can take so many forms, including “adverse reactions to a single episode of AOD-intoxication, problems that span only a few months or years, and problems that span significant periods of one’s life.”
In general, physical dependence is more easily quantified – different substances leave the body at different rates, and physical addiction subsides within a fairly predictable period of time. Recovery in the psychological, emotional, and social domains is more difficult to standardize. In an effort to guide individuals through recovery, experts strive to identify clear elements and stages of recovery. Although these descriptions may not perfectly fit the recovery experience of every person, they function as helpful signposts along the path to sobriety and health. The signposts can’t always tell the recovering individual exactly what to do next or how to handle every situation, but they can let the individual know that he is headed in the right direction.
Another variable in the equation of recovery is the family; both the addiction and recovery of an individual occur within the context of a family system. In many cases, the addictive behavior is somehow rooted in and/or facilitated by the dynamics of that system. Experts have even said that families in recovery must suffer a certain trauma in order for the recovery to occur. This means that the family members must often re-learn roles, communication styles, and relationship skills in order to support the recovery of one individual.
Experts disagree about the rates of success for recovery from serious alcohol and drug abuse problems. Some studies and surveys conducted over the past 25 years offer a range of results, all of them significant: 41% (Ojesjo, 1981); 63% (Helzer, Burnam & McEvoy, 1991); 72% (Dawson, 1996); 30% (Schutte, Nichols, Brennan, & Moos, 2001); 59% (Vaillant, 2003); and 48% (Dawson, Grant, Stinson, Chou, Huang, & Ruan, 2005).
Research has shown, not surprisingly, that longer terms of sobriety are correlated with full recovery. Short periods of sobriety or reduced substance use have not been consistently predictive of long-term recovery. Although the length of time required may vary from substance to substance, experts agree that the idea that sobriety stabilizes over time remains consistent. For example, a 1983 study of alcoholic men “found that the stability and durability of addiction recovery increases with length of sobriety, with no relapses … among those who had achieved six or more years of continuous sobriety” (Vaillant, 1983). Research indicates that full recovery from alcohol addiction occurs (becomes stabilized) most frequently between four and five years of continuous remission from addiction.
Recovery from heroin appears to be among the most difficult. Studies have shown that only 42% percent of those abstaining from opiates at a two-year follow-up point were still abstinent at five years (Duvall, Lock, & Brill, 1963). One-third of those who reach three years of abstinence eventually relapse (Maddux & Desmond, 1981), and one-quarter of heroin addicts with five or more years of abstinence later relapse (Hser, Hoffman, Grella, & Anglin, 2001).
In general, individuals who attain five or more years of continuous sobriety are referred to as “recovered,” but many recovering individuals will say that on the level of personal experience and daily living, recovery is a process that lasts a lifetime. Recovery requires ongoing effort and maintenance, and the practice of healthy coping and relationship skills over the long term. Experts agree that post-recovery, also referred to as “advanced recovery,” is indicated by an increased and healthy “capacity for intimacy, serenity, self-acceptance, and public service” (Picucci, 2002; Tessina, 1991).