When we say "they should just get better" what do we really mean?

I find myself at times, even as a person in recovery and someone who has suffered massive trauma in my life, saying the same thing I hear from others "they should just get better".  Or, I find myself saying, "Well, they must not want it bad enough."

Each time I do this, or, I hear others do it, I have to catch myself and walk through the entire process in my mind. I have to ask myself if they had access to all the resources one might need to "just get better" and stay in recovery from a substance use disorder.  

Take a walk with me if you will on what those resources are:

Treatment:  

    If someone has went to treatment once or a few times should they be able to "just get better". Well, it's not that simple. Treatment is good and can be very helpful. Personally I went through inpatient twice in my time, both, times were the 21-28 day model. Is that enough though?  Not usually. In all too many cases people need long term care. I was fortunate my second time in treatment that I was able to go to another facility for 90 days after that initial 21-28 treatment; I needed that.  This was back in a time when this was funded.....in our state it isn't anymore. I know many who need long term care can't get it. Insurance companies fight to keep people out of treatment, not in treatment in a large majority of situations.  In todays treatment environment it is very difficulty for someone to find treatment.  

    Now, we must talk about the treatment that is available. The vast majority of treatment centers are running on an antiquated model for treatment based out of the 50's. This treatment model, the Minnesota Model of Treatment may work for some, but, it doesn't work for all.  And when it doesn't work for some, shouldn't they have other options? What tends to happen is it doesn't work for them, they return to use, and end up back in the same model of treatment. Seems odd doesn't it?  If you went to your doctor for an illness and they treated you, the treatment didn't work, wouldn't you want them to try all treatment methods possible?  Of course you would. It should be the same with substance use disorders.  There are some treatment agencies shifting from the "one way or the highway" treatment model and are truly giving individualized treatment, but we are a long way from this happening as a norm. 

    Access alone is a major issue in this arena. Our state changed the entire funding model and it has only worsened the situation for those needing treatment. The bureaucracy is massive and people are dying because of it. And for those who do have insurance, it isn't much better.  Treatment providers have to fight to get insurance companies to allow people to stay in the treatment they desperately need, but, insurance companies only worrying about profits over true care, deny people the care they need. 

Recovery Supports:

    This is a key area that isn't discussed enough when we are talking about individuals "just getting better". We say, "well they got treatment, they should be good now."  Not even close to that simple....not even close. Recovery supports after treatment are huge and can make or break a persons success when they return home after treatment.  Let me explain. We know now that many people, the vast majority, have underlying issues that must be addressed.  Mental health disorders due to childhood trauma (A.C.E.S), housing, physical health, employment opportunities, and community connection are all vitally important ares people in early recovery need support in after treatment.  

    The term "co-occuring disorders" is in place for a large percentage of people in recovery.  Personally, it was in early recovery, for the first time in my life, that I was told I had PTSD, Depression, and anxiety disorders. Now, imagine someone getting that vitally important 21-28 days of treatment, and not getting help for co-occuring disorders.  What do you think that person might do if they have a strong desire to not drink and use drugs, but, have zero access to mental health professionals to address diagnosis of the kinds I was facing?  I KNOW I am fortunate and was in early recovery at a time when I had access.....very fortunate.  I also remember times when I didn't.  And not due to any fault of my own.  In early recovery I was working jobs where I didn't have health insurance and had zero access to mental health care. I know for many in early recovery this is the case. We can NOT expect someone to "just get better" if we don't help them address mental health disorders hand-in-hand with addressing substance use disorders.  We also can NOT blame them for returning to use when they were only given a 21-28 day stint in treatment that did nothing to help them with years long mental health disorders that didn't get addressed outside of that 21-28 day window.  We MUST do better in this area in all ways.

    Housing is major when talking about people in early recovery. I get calls and messages and talk to professionals working in the field who attest to this again and again. We say "just get better", yet, many people in early recovery leave that 21-28 days in treatment and have no place to go that will support their desire to live a life in recovery. Imagine having to go back to a living environment where there is still use happening, and you want desperately to not use yourself.  Add to that the fact that you just learned that you also need help managing depression or anxiety, but have no insurance or funds to pay for that care. Now, add to that what is a fact for many in early recovery and was the case for me in those early years, you have a criminal record and no landlord will even talk to you because of this. It doesn't really set someone up for success does it.  Now, read below for the next barrier many in early recovery face. 

    For many of us in early recovery, and I was in this same scenario, we carry with us a criminal record.  Now, mind you, once a person finds a life in recovery, criminal behavior stops. We have zero interest in continuing a life of crime.  This was the case for myself and I know for many others.  Yet, you have a record. Now, guess what happens when you apply for a place of your own to live or a job?  Many do a background check and we don't even get a chance.  Almost all rental application require a background check.  Many jobs require the same. While I am at it think about a credit check; yet another barrier for people in early recovery.  Even if we wanted to get our own place we can't.  The barrier in the realm of housing and employment are massive for people in recovery. 

    Access to recovery supports of all kinds is not just a needed part for a person in early recovery; it is critical. Communities must wrap their arms around people in recovery and find ways to get them the resources they need. Why?  Well, when we do these things the results are amazing.  People who are fully connected to all the resources necessary become integral parts of the communities they live in.  They, and their families are reunited.  Cycles of generational substance use and. mental health disorders can be interrupted for their children and grandchildren.  They become some of the best employees and many open their own businesses.  They become tax paying citizens who help to shape the future of the communities they call home. The list, for the positive aspects of what happens when someone is truly supported, could go on forever. 

    My ask of you is this.......the next you find yourself, or hear someone else say something to the effect of "they should just get better", go through all of the above and ask the question. Were they truly supported in all ways? Were they truly given a fair chance at the life you are living as a person in recovery?  Did they get access to the same resources you did to make your life whole?  Ask yourself, if the answer is no, what you can do to get involved in a way that can change that for the better.  I strongly believe that big change begins in communities. If each of us work to effect change in our communities it will spread.