He snuck through the “out” doors on the bus, unseen by the driver. Wearing a suit, no tie, at first glance the man appeared to simply be flouting the rules. As the bus rolled on towards Paddington, his head leaned against the window and I had my first inkling all was not well. He rose to exit at the next stop and I glimpsed the tell-tale absent stare, that vacant look of someone under the influence. A whiff of alcohol trailed in his wake and my suspicions were confirmed. I watched him walk down the street, pass a cafe, narrowly miss several collisions with fellow pedestrians, before he turned, predictably, into a pub. 

Having just completed a two day workshop with Dr. Gabor Maté, trauma and addictions specialist, this was an ironic encounter. I reflected on the age-old saying “there but for the grace of God go I” and recalled times in my past when I’m not quite sure how I got home. And my thoughts turned, as they always do, toward what distinguishes those who quit from those who don’t; those who manage sustained sobriety over decades from those who cannot achieve any kind of long term abstinence. 

We already know there’s a connection between Adverse Childhood Experiences (ACE’s*) and the later development of addiction. But what do we know about those who get sober and stay sober? It seems, not so much. Funding is more suitably applied to those earlier in their recovery it seems, few are doing anything other than anecdotal reporting on those with long term sobriety. 

Omar Manejwala M.D. has recently reported: 

“The most thorough attempt to understand what happens to addicts and alcoholics who stay sober is an eight-year study of nearly 1200 addicts**. They were able to follow up on over 94% of the study participants, and they found that extended abstinence really does predict long term recovery. Some takeaways from this research are:

  • Only about a third of people who are abstinent less than a year will remain abstinent.
  • For those who achieve a year of sobriety, less than half will relapse.
  • If you can make it to 5 years of sobriety, your chance of relapse is less than 15 percent.” 

He goes on to say those with 10, 20, 30 or even 40 years sobriety can and do relapse “but the incidence is very low.”

Based on my personal and professional experience, here’s what I know. By the time someone has a decade or so of sobriety, they have developed new habits, interests, and literally thousands of repetitions of the practices which keep them sober. (This in stark contrast to the practices which kept them drinking or using). In a sense, it’s simply a matter of success breeding more success. The long-termers have gone from embodying active addiction to embodying recovery. And what are the components of long-term recovery? The obvious ones like abstinence, community support, alternative coping mechanisms, managing stress, addressing shame, healing historical wounds (especially trauma), some sense of spirituality and perhaps the less obvious ones like attention to replenishment, creativity, self-expression, self-compassion and empowerment. A tall order? Yes. And speaking from personal experience, worth every ounce of the effort. 

If you’re interested in knowing more about achieving the embodiment of recovery, please be in touch. I will be offering a workshop for those in long-term recovery later in the year.

*https://www.cdc.gov/violenceprevention/acestudy/about.html

**https://www.ncbi.nlm.nih.gov/pubmed/17986709

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