Artur Szczybylo @123rf
Those of us with a personal or professional stake in the alcohol and other drug problems arena find ourselves questioning the differences between:
1) people who use alcohol and other drugs (AOD) without developing a substance use disorder (SUD) versus those who develop such a disorder of great severity, complexity, and chronicity;
2) people who resolve AOD/SUD problems without formal participation in recovery mutual aid groups and/or addiction treatment versus those who benefit from significant involvement with such resources;
3) people who resolve alcohol or opioid use disorders without medication support or only a brief course of such support versus those who require prolonged medication support for successful recovery stabilization and maintenance; and
4) people who resolve AOD/SUD-related problems by decelerating AOD use versus those who are able to achieve successful recovery only through sustained AOD abstinence.
At a personal level, understanding these distinctions is critical to assessing one's own SUD risk and for identity/story construction within the recovery process. For those seeking recovery, such understandings provide answers to such questions as:
How did this happen?
What must I do to escape this situation?
How do I prevent getting in this situation again?
At professional, peer, and family support levels, understanding the nuanced answers to such questions enhances our effectiveness as helpers.
I have returned to these questions on numerous occasions in my books, monographs, and articles. Newly published reviews of the scientific literature, one led by Kelly Green and another by Angelica Morales, summarize advancements in assessing and predicting SUD risk. Drawing on a lifetime of clinical observation, my previous writings, and the Green et al and Morales et al reviews, I created a checklist that highlights key SUD risk factors. That checklist and a discussion of SUD risk factors and their role in sense-making and recovery story construction are contained in a newly posted paper on my website. Those wishing to review the checklist and discussion may do so by clicking HERE.