Is He Really in Recovery?

GiveittoLord1 poses a question about her Loved One. He's going to the clinic daily for methadone, but occasionally lapses with opioids. Overall, he is progressing in various aspects of his life, but it seems that addiction still has a grip on him. Is is fair to say he's in recovery?

If a person is going to a methadone clinic daily, after one year, and is still using, is this considered recovery?

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After more considerate thought about this question, I think I have to consider how far my LO is progressing in other areas. His attitude is changing, He is becoming much more calm, he is working on cleanliness, all in a positive way. Going to the clinic each day is a great improvement. He is finally participating in the counseling that is being provided. These are great improvements. He asks for increases periodically. I have to think that the behavior (getting himself together) is more important right now.
I can see that his usage is decreasing but at times it is worse. I am hoping that this is how it is suppose to work.
He is highly addicted to fentanyl, opioids, uses cocaine and constantly smokes marijuana. Most I know are highly illegal.
The CRAFT program helps me but am I taking it too far?
I sectioned him once but it did not help. His Mom tried to section him again but it did not work.
Thank you

Your son is being treated with methadone for a serious opioid disorder. He also uses cocaine and marijuana. The methadone is definitely helping, but he continues to use opioids and the other drugs periodically. You ask if this is considered recovery.

Recovery has many definitions. In her book Sober for Good, journalist Anne Fletcher interviews people with 5 years of recovery from alcohol. Those interviewed describe a range: some including abstinence from all drugs, while others just note abstinence from the alcohol. There are those who feel they are successful in moderating alcohol and therefore consider themselves to be in recovery. For others still, they’d only consider someone to be in recovery unless they were actively addressing and healing the emotional part of the disorder. This may be through various forms of self-exploration, such as a therapeutic process or a program like AA.

In short, you will find many definitions of recovery.

From your description, your son is pulling himself out of a deep hole of addiction. For now he is doing this by taking methadone. His record isn’t spotless with the methadone. He still uses Fentanyl occasionally, and I would guess he still uses the cocaine sometimes as well. He also smokes marijuana heavily. Despite these lapses, his behavior has improved. He is caring for his hygiene and is choosing to attend the therapy at the Clinic. He takes his daily dose of methadone, which has been increased periodically in response to the occasional use.

As a parent, you are probably digging down deep for ever more patience as you watch your son’s slow, bumpy journey in recovery. Recovery is a process; when does it start? Does it begin when are you “in recovery” or does it begin before that? Your question has touched on a debate that will likely continue to unfold for some time.

Your son is trying. That is the very good news. For now he is addressing the Fentanyl and other opioids with methadone.

Taking methadone is rarely enough to resolve all addiction. Counseling in methadone clinics is brief – therapeutic caseloads can easily include over 40 clients a week. Counselors must also decide when to cut privileges like a take-home dose. This makes trust and the therapeutic alliance difficult to maintain for both the therapist and the client.

We have written about the importance of Medication Assisted Treatment. For your son, the methadone is likely THE critical ground under foot in his journey. It takes away the craving, the withdrawal, and the unending daily grind of opioid use. When it doesn’t and your son uses an opioid, the methadone dose increases. The goal is to find the dose that gives your son the best chance not to use, making that choice as clear as it can be for him. And embedded within that process is the opportunity for your son to sit with a counselor and explore HOW not to use.

So, as we outline in this article on MAT, the medication alone is not the solution. It is one – often critical – component of a dynamic solution that requires true engagement in the therapeutic process, and solid support from the treatment providers. Here are a number of other posts we’ve written addressing MAT in the context of other family members’ specific situations.

I am glad you came back with the second comment in which you list the positive changes you have seen in your son. This is extremely important and encouraging that you are able to hold this perspective, despite the picture of his use not being black and white at the moment. On this journey, it rarely is. Focusing on these things is good for you, the family member. When you see these positive signs – even seemingly small ones – you can reward them, and thus encourage the behavior. This is the lesson of Learning Module 5.

When you feel you can, perhaps you can look into additional recovery activities your son could attend. Think low-barrier activities like peer groups at the local Recovery Center or additional therapy outside the methadone clinic. Please see this resource we created with a wide variety of online support options to encourage during the pandemic. Watch Learning Module 8 for instructions on how to suggest these activities.

Even if he’s not ready yet, I’d also consider working a few alternative options into the list – ideas for activities that can propel him into an environment in which he is pursuing new (or old) interests, developing talents and even being of help to others. You never know what might open up in him when he can expand his vision of what he really wants from his life. Perhaps you save some of these conversations/ ideas for a time when he’s progressed a little further along this path, but before you plant those seeds, think about what else could go on that list as he becomes more and more ready for a change.

There are so many terms we use in this field: sobriety, recovery, abstinence, “clean” and “straight” – but for today, your son is moving towards healing and self-care. This is what matters most. I hope these suggestions help give you a framework for assessing your son’s situation, as well as the role you can play in this process. You pose a very good question. Thank you for writing in and sharing you situation with us.