If we wanted to understand what it takes to win a Super Bowl, we definitely would be listening to what seven-time winner Tom Brady has to say.
We also would listen to teams that lost. Their experiences matter, too. But it would seem strange to study who wins football championships without spending considerable time talking to the people who actually won them.
To understand cancer survivorship, we listen not only to oncologists and researchers but also to people who have survived cancer and gone on to live healthy, rewarding and meaningful lives.
So why is addiction recovery different?
There are thousands of Canadians living in sustained recovery. Some have been in recovery for decades. Yet we still know too little about what their experience can teach us about achieving and sustaining recovery.
The voices of those still using matter.
But so do the voices of people who stopped using and found their way out of addiction.
This raises a question that has puzzled me for years: If recovery is one of the outcomes we are trying to achieve, shouldn’t we be intensely curious about the people who have achieved it?
What did they do? What helped? What didn’t? What finally made change possible?
And perhaps most importantly: What do we actually mean by successful recovery?
We can measure cravings. We can count days of drug use or abstinence, overdoses, emergency-department visits and retention in treatment. Those are important measures.
But are they sufficient?
What about rebuilding a relationship with a spouse or child? Establishing a career or beginning an entirely new one? Returning to school? Regaining the trust of family and friends? Becoming financially independent? Helping another person recover? Volunteering and contributing to a community? Developing friendships, responsibility, purpose and meaning?
Does this not warrant study? Recovery means more than a reduction in symptoms. It means rebuilding a meaningful life.
There actually is evidence from Canada that demonstrates this.
In 2017, the Canadian Centre on Substance Use and Addiction released the first national Life in Recovery from Addiction in Canada survey, based on responses from 855 Canadians in recovery. The results looked far beyond drug consumption. They examined housing, employment, family participation, finances, community involvement and quality of life.
The findings were striking. More than 90 per cent of respondents described their quality of life in recovery as good, very good or excellent. Participation in family activities increased dramatically compared with life in active addiction. So did steady employment, paying bills, volunteering and planning for the future.
The study also found that people followed many different pathways into recovery, drawing upon professional treatment, informal supports and mutual-support groups.
I recently participated in another Canadian Life in Recovery survey. Its results are not yet available but filling it out reminded me how important these questions are.
Do we give the answers to these questions enough weight when we decide what recovery should look like?
I have spent nearly 27 years in abstinence-based recovery. That pathway worked for me. I do not believe it should therefore be imposed upon everyone else.
But neither should it be pushed to the margins as though it were an anomaly or a historical curiosity.
There is no doubt that medication has a legitimate role in addiction treatment. Methadone and buprenorphine help many people. Harm reduction can keep people alive long enough for change to become possible.
However, medication is a treatment tool. It is not, by itself, a definition of recovery.
Why does so much of the contemporary discussion begin with medication while abstinence, mutual support and long-term peer recovery appear secondary, if at all?
Where are mutual-support organizations such as Alcoholics Anonymous and Narcotics Anonymous in our larger discussion of recovery? Where is peer support from people who have sustained recovery for 10, 20 or 30 years?
The evidence exists. The original Canadian Life in Recovery survey found that people used many different resources along their recovery journeys. Recovery was not one treatment, one medication or one philosophy.
That should make us more curious, not less.
One pathway should not be substituted for another.
We should become more curious about all of them.
Imagine someone who cannot conceive of getting through a day without drugs sitting across from another human being who once believed exactly the same thing but has subsequently built a meaningful life.
That person offers something no prescription, clinical guideline or policy document can provide on its own: another human being saying, in effect, I was where you are. This is what happened to me. And this is what my life looks like now.
That is not nostalgia for an outdated model of addiction treatment.
It is lived experience.
Keeping somebody alive matters. So do stabilization, medication, housing and treatment for mental-health disorders.
But these should not exhaust our imagination about what is possible.
We ask the question, “How do we reduce someone’s drug use?”
But we should also be asking: What kind of life is this person capable of building?
Clinical research remains essential, and no individual’s recovery story should become somebody else’s prescription. Lived experience is not a substitute for evidence.
But it can certainly help us determine what other questions the evidence should investigate.
So, ask us.
Ask people in sustained recovery what worked and what failed. Ask what finally made change possible. Study medication, abstinence and treatment. Study Alcoholics Anonymous and Narcotics Anonymous. Study peer support, family, spirituality, education, employment and community.
But go further.
Measure repaired relationships, careers rebuilt or begun. Measure education, independence and contribution to community. Measure purpose, hope and helping others.
People in sustained recovery are not evidence that everyone can or should recover the same way.
We are evidence that recovery happens.
The research has begun. The stories exist. The people are here.
The question is whether our experience will be treated as something central to understanding recovery, rather than something interesting at its margins.
If we truly want to know what recovery can look like, don’t just count us.
Don’t just acknowledge us.
Study us.
