“He’ll never get better, not until he hits rock bottom,” that’s what they said me in 2010 when my brother first went to rehab in Utah. At the time he went into treatment Pete looked like a man without a soul, a zombie with slurred speech and sunken eyes, his six foot frame had wasted away to 130 lbs. Even then, when I first heard those words, they were difficult for me to swallow. Why is it they say someone has to hit rock bottom before improvement? I found out the answer the hard way after my own roller coaster ride on the drug train concluded in 2014.
What makes the rock bottom theory work is that it’s what it takes for some people. In reality in order for sustained betterment to occur something’s got to give, something inside of us has to break. The reason for this is simple, it teaches acceptance. All of life’s greatest periods of growth occur once we’ve been fractured. This isn’t just applicable to psychological growth it’s biological, think about what happens when you work out, you tear your muscles and they regenerate. It’s how we become stronger.
Wait a Minute…
The people telling you addiction is a progressive disease, by definition getting worse over time, are the same people saying to sit around and wait for someone to bottom out. Does that seem a little contradictory, or at the very least counterintuitive, to anyone else? “Yup, assuredly it’s only going to get worse but all you can do is hang in there till the poor addict gets so bad that they’re unable to handle it anymore.” This seems like downright idiocy to me. Would you tell a cancer patient not to start chemotherapy until the disease has spread to other organs? Of course not! So why do we take a different approach to addiction? I’ve concluded that the notion someone has to rock bottom- while it can be effective- is kind of bullshit; and here’s why.
- The rock bottom myth makes it easier for the addict to rationalize use as recreational.
- It creates genuine doubt in an addict’s mind that they don’t have a problem.
- The premise implies that an addicts loved ones have no power to encourage wellbeing
- It discourages those suffering to seek treatment.
Where Did the Idea Come From?
In part, this can be contributed to 12 Step being the staple curriculum for substance abuse rehabilitation (touched on here). Claiming an addict can’t/won’t get help until they hit rock bottom implies that use is not a problem until a person reaches rock bottom. Even when we know there’s a problem we’re resistant to help. I can’t be an addict, not if I’m working full time and I keep bringing in fat commission checks. That’s what I thought while at Quicken Loans, turns out I was wrong.
Most everyone has this preconceived notion that a drug addict is some homeless miserable soul with no family who lives under a bridge. I know that’s what I thought. In reality that’s a false narrative, the byproduct of preaching rock bottom as a prerequisite to being a drug addict. I’ve heard it so many times before, I can’t help them if they don’t want to change. It’s a defeated thought that I had as my brother went into treatment the first time.
If Not Rock Bottom, then What?
I’ve done a good amount of research on addiction and drugs for that matter. Of all the approaches that I’ve gained familiarity with I believe the CRA/CRAFT Approach is most effective. The approach got its beginning from treatment innovations during the 1970s, specifically a group of researchers led by psychologist Nathan Azrin out of Illinois. The group developed the Community Reinforcement Approach (CRA). To date it’s one of the most effective behavioral treatments for substance users.
The group expanded their findings to aid families in cases where loved ones refused help thereby developing Community Reinforcement and Family Training (CRAFT). “CRAFT has three goals: 1.) to teach you skills to take care of yourself; 2.) to teach you skills you can use to help your loved one change; and 3.) to reduce substance use, period, whether your loved one gets formal treatment or not.
Why Should We Avoid Rock Bottom?
Labels do more harm than good, and labelling all recreational drug users as addicts is a recipe for disaster. Stigma is one of the major obstacles preventing people from pursuing the help they need because in most cases doing so would mean to accept the label of addict. It’s the reason why people have to hit rock bottom before they begin recovering and it’s an unnecessary evil. The truth is this, addiction isn’t black and white like rock bottom implies. I truly believe that a breaking point can be encouraged to develop externally.
You can help a loved one with an addiction disorder by helping yourself. In most cases people don’t use because they’re crazy, they use because they get something they like out of it. It might be that it makes socializing easier or that it makes depression go away, whatever the case may be understanding the reason behind why people do what they do gives us a much better chance to help. You can help someone with an addictive habit by getting out of the way, thereby letting them realize the consequences of their behavior. Rock bottom can be avoided by setting healthy boundaries, avoiding codependency, and approaching with compassion rather than anger.