Anything is possible, but that doesn’t make it a good idea.
Physical dependence and substance use disorders are distinct conditions. Physical dependence is not synonymous with addiction. Addiction—or a substance use disorder—is a disease, and physical dependence is characterized by the existence of a withdrawal syndrome due to biological changes caused by the long-term presence of drugs in a person’s system. A physically dependent person might not have a substance use disorder, and someone with a substance use disorder may not currently have a physical dependence.
Addictions are much more than physical dependence or excessive use. Psychologist Mark Griffiths says: “a healthy excessive enthusiasm adds to life whereas an addiction takes away from it.” When a compulsive behavior becomes more of a priority than our responsibilities to others and ourselves, that's a cause for concern.
For the purposes of this essay, clean is defined as being off “hard drugs” and sober is being off all drugs (alcohol included). Accepting these definitions, is it possible to stay clean without getting sober?
Anything is possible, but that doesn’t make it a good idea. Especially if the addiction is to opioids.
The underlying factors that contribute to a person to developing one addiction can lead them into another addiction. Research has found that the majority of people who are in treatment for drug addiction also meet the DSM-IV criteria for alcohol use disorder. Studies have also found that “comorbid alcohol use disorder [with opioid addiction] increases the risk of fatal overdose and hepatic deaths.”
Most people with a non-alcohol substance use disorder first drank alcohol, the real “gateway drug.” Almost everyone who uses non-prescribed opioids first used other drugs, usually alcohol. The earlier (and younger) intervention can occur, the better the outcomes are with less intensive treatment. A lot of folks are dealing with comorbidity (a substance use disorder and one or more mental health conditions) and proper treatment for mental illnesses is critical. Scientific research is finding more evidence that people with dual diagnoses should have their conditions treated concurrently.
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Original published 28 March 2018
Posted here 9 April 2018
By Kristance Harlow