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Long-term addiction recovery has a beginning (or many beginnings), a middle, and an end. Nearly all our national resources allocated to addiction are devoted to the first of these stages, even as efforts of the past 15 years have pushed a vision of support into the mid-life of personal and family recovery. All of these are noble efforts, but they leave unanswered the questions generations have faced in the final chapters of their lives. After living a life in recovery, how does one face death in recovery? Recovery must be managed in this last context or be lost after being hard-earned and so carefully sustained and protected.
There is some attention paid to the addiction vulnerabilities of older adults, but one can find few scientific studies and little experiential knowledge captured within mutual aid literature about the final stages of one's life as a person in recovery. This is regrettable in that these final stages offer threats to, but opportunities within, the recovery process.
Aging poses all manner of challenges that can destabilize recovery: innumerable indignities, acute and chronic pain from illness and injury, the progressive erosion and loss of functions long taken for granted, disengagement from personally fulfilling roles and activities, the loss of loved ones and other important people, strain as family and friendship are subsequently reconstituted, and even the loss of those who guided one's own recovery initiation--all combined with a growing awareness of the shortness of time. And for those who enter recovery but who face the threat of a life cut short by addiction-related disease, there is the haunting self-accusation that that one has thrown one's life away and, given that, the question of whether going out in a blaze of self-destruction is preferable to end-of-life recovery.
It should not be surprising in these contexts that recovery can be weakened to a breaking point. Sadly, the very support structures that played such an important role in early recovery initiation and in recovery maintenance may have eroded by the time a person needs them most during these final chapters of recovery. Even when stability is sustained, the meaning within and beyond recovery may need to redefined during these final chapters of recovery.
And yet there is potential richness in this last edition of the "what we are like now" part of our personal stories. There is often a shedding of trivialities, embracing a quietness of spirit, the deep pleasure of having "cheated the beast", and a valuing of one's legacy. The "searching and fearless moral inventory" conducted by many in early recovery may have far deeper meaning when such accounting is done toward the end of one's life. Such final accounting can be a source of deepening spirituality (meaning and purpose) and service.
If there is a final legacy of recovery--and a final opportunity, it may well be in the more complete healing of our families and the deepening recovery of others touched by our words of hope and guidance. There can be a very real sense that those so touched will extend our own lives in unseen ways into the future. If we have done this well and been very blessed, we will see generations coming behind us who will start a new cycle free of the burdens we have carried. Then new personal, family, and community futures begin. The slightest glimmer of such futures can bring a final smile. That's a smile worth our efforts to earn and make possible for others. The goal is the ability to take a sober last breath, not with regret, but with gratitude and release.
This blog is an invitation to reflection for those interested in addiction recovery. It's an invitation for research scientists, addiction professionals, recovery support specialists, mutual aid leaders, and family members to explore how we can best help people write these final chapters of recovery.