Individuals make decisions to initially try drugs and/or alcohol for a variety of reasons, and with prior knowledge about substances varying from person to person. The abuse of alcohol and other drugs does have effects over time on brain functioning that interferes heavily with the decision-making systems of the brain. When these systems start to malfunction, we see a clash between a person’s desired behavior and their actual behavior. What looks like voluntary behavior to others and also may be also understood as outward signs of a brain dependent on a substance. Due to this “wearing down” of the decision-making abilities of the brain by continued substance dependence, a person’s actions may be a very poor reflection of that person’s real hopes and desires.
There is not much information available to support this idea. Many, and some would argue most, people seek treatment in response to pressure from loved ones, employers or the legal system. Individuals in such circumstances often establish a lifestyle free of alcohol and other drugs.
Medication assisted therapy is recognized by state and federal officials as a viable treatment option. Whether or not to participate in medication assisted therapy is a decision each individual can make for themselves with the help of information and recommendations made by professional staff. It is one of many ways in which a person may pursue recovery. The method of treatment is only one aspect of recovery from addiction. We believe it is more important to affirm an individual’s choice to make a move toward recovery, regardless of the particular treatment path one chooses to take.
A person may seek and experience success in treatment for many reasons without first “hitting rock bottom” (experiencing great consequences or losses as a result of substance use). Again, individuals pursue recovery for a variety of reasons. There are always negative consequences to be recognized and this recognition may aid a person in recovery. It is not evident, however, that the choice to pursue or succeed in recovery depends upon having experienced a loss of functioning, possessions, relationships, etc. AA speaks about this concept of “rock bottom” in chapter one of “The Twelve Steps and Twelve Traditions of Alcoholics Anonymous,” indicating that they discovered this premise to be false over 50 years ago! They observed that the recognition of the possibility of future losses and one’s ability to accept the reality of addiction’s inevitable consequences (jails, institutions and death) enabled many to find freedom from alcohol and drugs.
Many diseases involve a reoccurrence of symptoms. Likewise, addiction can be chronic and involve a relapse of symptoms. It is not necessarily a sign that treatment is not working nor that the person in recovery has failed or lacks commitment to recovery.