After my husband had heart surgery, I was told, “He’s in recovery,” meaning that he was recovering from the actual surgery. He was then moved to the Cardiac ICU, then a regular floor before he was released to go home. But was he fully recovered when he was moved from “recovery”? Of course not; nor was he fully recovered when he was released to come home.
So what is “recovery”? The Substance Abuse and Mental Health Services Administration’s (SAMHSA) working definition of recovery is “A process of change through which individuals improve their health and wellness, live a self-directed life (sic), and strive to reach their full potential.” (https://store.samhsa.gov/sites/default/files/pep12-recdef.pdf)
The National Institute on Drug Abuse (NIDA), however, says, and the emphasis is THEIRS, that
“Recovery is a process of change through which people improve their health and wellness, live self-directed lives, and strive to reach their full potential. Even people with severe and chronic substance use disorders can, with help, overcome their illness and regain health and social function. This is called remission. Being in recovery is when those positive changes and values become part of a voluntarily adopted lifestyle. While many people in recovery believe that abstinence from all substance use is a cardinal feature of a recovery lifestyle, others report that handling negative feelings without using substances and living a contributive life are more important parts of their recovery.” (https://nida.nih.gov/research-topics/recovery)
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) says that
“Recovery is a process through which an individual pursues both remission from alcohol use disorder (AUD) and cessation from heavy drinking. An individual may be considered ‘recovered’ if both remission from AUD and cessation from heavy drinking are achieved and maintained over time. For those experiencing alcohol-related functional impairment and other adverse consequences, recovery is often marked by the fulfillment of basic needs, enhancements in social support and spirituality, and improvements in physical and mental health, quality of life, and other dimensions of well-being. Continued improvement in these domains may, in turn, promote sustained recovery.
“Remission from alcohol use disorder (AUD), as defined by DSM-5 criteria, requires that the individual not meet any AUD criteria (excluding craving). Remission from AUD is categorized based on its duration: initial (up to 3 months), early (3 months to 1 year), sustained (1 to 5 years), and stable (greater than 5 years).” (https://www.niaaa.nih.gov/research/niaaa-recovery-from-alcohol-use-disorder/definitions)
There’s a good list of the AUD criteria from VeryWell Mind here: https://www.verywellmind.com/dsm-5-criteria-for-substance-use-disorders-21926
And this is where we run into trouble. For someone suffering from addiction, one drink is too many, and 100 drinks isn’t enough. Can a person be in remission or recovery while ceasing “heavy” drinking or use only? Not for me to decide, but I bet you know what I’m thinking. And, while I’m at it, what does “heavy drinking” even mean? Yes, I know what the government says it means, but what does it really mean to the heavy drinker? Is he counting drinks accurately? Is she pouring them properly? Unlikely. So one person’s “heavy drinking” becomes another’s “moderate drinking,” and voila, that’s recovery…or remission. Or maybe even both!
To add even more complexity, are people with addictions “recovered” or are they in “recovery”? Well, according to the 12-step programs, where this language first emerged, no one cares. They acknowledge that addiction is incurable, as it is a disease, but whether a person wants to consider himself “recovered” or “in recovery” is a personal choice.
So let’s consider anyone who suffers from a disease. Remission from cancer, for example, is defined as “the signs and symptoms of your cancer are reduced. Remission can be partial or complete. In a complete remission, all signs and symptoms of cancer have disappeared. If you remain in complete remission for 5 years or more, some doctors may say that you are cured.” (https://www.cancer.gov/about-cancer/diagnosis-staging/prognosis)
“People with type 2 diabetes should be considered in remission after sustaining normal blood glucose (sugar) levels for three months or more, according to a new consensus statement from the American Diabetes Association.” (https://diabetes.org/newsroom/international-experts-outline-diabetes-remission-diagnosis-criteria)
As much as addiction is a disease, it is one like no other. Yes, it is chronic, progressive, and lethal, because it’s incurable, but if recovery is possible and stable remission is the goal, is abstinence a requirement or not? I don’t have the answer. Do you?
Guided by Guida 
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