As those around an individual in recovery from a substance use disorder celebrate that person regaining sobriety, it’s important for loved ones and practitioners alike to recognize that the person is simultaneously experiencing a loss, Derrick Johnson, LCMHC, LCAS, MAC, NCC, executive and clinical director of NorthStar Clinical Services in Charlotte, told attendees in a Sunday session at the Cocaine, Meth & Stimulant Summit.
The process of recovery creates an unexpected question: Should the loss of an addiction be grieved?
“When something is lost or goes away, that grieving process is about finding another way to be present, so to speak,” Johnson said. “It’s important to understand the culture we live in sometimes isn’t sensitive to losses, and those losses we are sensitive do not include the losses that [an individual with addiction] has suffered.”
More specifically, individuals in treatment are parting ways with a relationship with illicit substances that often served as their mechanism for coping with difficult situations. For individuals with substance use disorders whose past patterns of using to cope with emotional pain, accepting that pain, anger and depression and processing emotions drug-free can be difficult, Johnson said.
Clinicians should be cognizant of a patient’s stages of change, Johnson said:
- Pre-contemplation: The individual does not realize they have a problem
- Contemplation. The individual recognizes the problem
- Preparation: The individual seeks out find help
- Action: The individual completes tasks to change problematic behavior
- Maintenance: The individual does what is necessary to stay sober
It’s important to understand that a patient might slip, Johnson said, adding that a relapse is not indicative of the individual reverting back to the pre-contemplation stage or that everything they’ve learned in treatment has been thrown away.
“Do they tell you what happened? Do they show back up?” Johnson asked attendees. “That tells you that you have a great therapeutic relationship and that honesty is present. That is how you help someone get and stay sober.”