Most people with alcohol and drug addiction survive: NPR

Anna Mable-Jones, 56, lost a decade to cocaine addiction. Now a homeowner, she’s started a small business and says life is “amazing.” Walter Ray Watson/NPR hide caption

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Walter Ray Watson/NPR

Anna Mable-Jones, 56, lost a decade to cocaine addiction. Now a homeowner, she’s started a small business and says life is “amazing.”

Walter Ray Watson/NPR

The US is facing an unprecedented wave of drug deaths, with the Centers for Disease Control and Prevention reporting another grim milestone this week.

In a single 12-month period, fatal drug overdoses claimed 101,623 lives.

But researchers and drug policy experts say the grim number masks an important and hopeful fact: most Americans who experience alcohol and drug addiction survive.

You recover and live a full and healthy life.

“I think this is really good news and something to share and do with hope,” said Dr. John Kelly, who teaches addiction medicine at Harvard Medical School and directs the Recovery Research Institute at Massachusetts General Hospital.

More than a million Americans have died from an overdose during the opioid epidemic

Kelly co-authored a peer-reviewed study published last year that found about 22.3 million Americans — more than 9% of adults — are in recovery from some form of substance use disorder.

A separate study released in 2020 by the CDC and the National Institute on Drug Abuse found that 3 out of 4 people who suffer from an addiction eventually recover.

“So that’s huge, you know, 75%,” Kelly said. “I think it goes against our cultural perception that people never get better.”

Life after addiction is not only possible. It’s the norm

Americans often see the more destructive side of addiction, drug crime, people slumped in doorways, and family members spiraling downward.

Less visible are the people who survive the disease and rebuild their lives.

“We’re literally surrounded by people recovering from substance use disorders, but we don’t know,” Kelly said.

Anna Mable-Jones of Laurel, Maryland is one of those success stories. In college, she began experimenting with crack cocaine.

“That just put me in a total downward spiral,” said the 56-year-old.

An artist and a scientist take on the stigma of addiction

Mable-Jones lost a decade to addiction, entered rehab and repeatedly relapsed. It was a terrible time for her and her family.

“My mother [started] She called the morgues,” she recalled. “She called my sister and said… ‘I haven’t heard from Anna.’ “

But in a pattern that researchers say is common, Mable-Jones’ illness eventually subsided. She found a treatment that worked and has been drug-free for more than 20 years.

“Things I thought I would never regain, I have all through the recovery process,” she said. “Now I’m a homeowner, I own a car, I’ve started my own business.”

A person in recovery from drug addiction looks out of a substance abuse treatment center in Westborough, Massachusetts. John Moore/Getty Images hides the caption

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A person in recovery from drug addiction looks out from a substance abuse treatment center in Westborough, Mass.

John Moore/Getty Images

Addiction is hard to beat, and that leads to stigma

Researchers say this data — and this lived experience — contradicts a common misperception that substance use disorder is a permanent condition and often fatal.

While tragic, last year’s 100,000 fatal drug overdoses actually claimed the lives of a tiny percentage of the 31.9 million Americans who use illicit drugs.

Similarly, the approximately 95,000 deaths attributed to alcohol each year in the US represent only a fraction of high-risk drinkers.

Why is this disease often called persistent and hopeless?

Recovery experts say one reason is the fact that addiction is excruciating and difficult to treat.

“Hopeless despair – that’s a good way to describe it,” said Travis Rasco, 34, who lives in Plattsburgh, a small industrial town in upstate New York.

“I wanted to quit, I just couldn’t,” he said, describing his decades-long struggle with heroin.

Travis Rasco used heroin for a decade. Now he’s four years drug-free, has a career, a wife and a new baby. Brian Mann/NPR hide caption

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Brian Mann/NPR

Travis Rasco used heroin for a decade. Now he’s four years drug-free, has a career, a wife and a new baby.

Brian Mann/NPR

Rasco kept relapsing, causing tremendous pain to his family. “I didn’t want to be that person, but I didn’t know what to do,” he said.

Studies show that people usually recover, but like Rasco and Mable-Jones, the process is slow after multiple relapses.

Even with quality treatment and medical care, it typically takes eight years or more to achieve long-term remission.

Rasco was working two jobs to feed his heroin addiction when he finally found a way forward in 2018.

“I took quite a long ride in the ambulance [after an overdose] and something happened in that ambulance,” he said, describing an emotional pivot that felt different: “That’s not how you live.”

He was also able to convince his health insurance company to take on longer-term treatment.

The frontiers of virtual addiction treatment could soon return, making access to care more difficult

To save lives, overdose antidotes should be sold over-the-counter, advocates argue

“They fought just to keep me in [rehab] for 14 days; They didn’t want to pay for 30, and I knew that wasn’t enough for me,” Rasco recalled. “They didn’t want to put me in half a house. I knew I needed a halfway house.”

It worked this time. He has now been drug free for almost four years, is married and has a newborn baby.

“We’re trying to buy a house right now. Something I never thought was possible, something I never thought I deserved for the longest time,” Rasco said.

Better life after healing

Recovery rates are not the same for all people. There are big differences in how the body and brain respond to alcohol and different drugs.

Studies also show that racial prejudice makes it harder for blacks and Hispanics to seek treatment. People in rural areas tend to have less access to healthcare.

Meanwhile, those with more financial resources or milder forms of addiction often heal faster.

But even people who take harder drugs for a long time usually recover.

So you've seen

“That 75 percent number [of people who achieve remission] obviously includes people on the heavier end of the spectrum,” said Dr. David Eddie, who is co-author of the Recovery Success Study and also teaches at Harvard Medical School. “So there is absolutely hope.”

In fact, most people don’t easily survive addiction. Research suggests they often thrive in long-term recovery, reconnecting with family, and enjoying economic success.

“They end up achieving things that they wouldn’t have if they hadn’t gone through addiction hell,” Eddie said.

Researchers say these hopeful results are significant because they could inspire people to continue trying to recover even after multiple relapses.

“That can be challenging,” Eddie said. “How do you get back on the horse after repeated unsuccessful attempts?”

Is fentanyl a game changer?

People walk past a health clinic in East Harlem that offers free needles and other services to drug users in New York. Spencer Platt/Getty Images hides the caption

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Spencer Platt/Getty Images

People walk past a health clinic in East Harlem that offers free needles and other services to drug users in New York.

Spencer Platt/Getty Images

A troubling question is whether this pattern – multiple relapses eventually leading to recovery – will continue now that more and more street drugs are contaminated with the deadly synthetic opioid fentanyl.

“It kills her on the first try,” said Anna Mable-Jones. “It doesn’t give them enough tries like I might have.”

Some communities are trying to help by providing active drug users with clean needles and making the drug overdose-reversal, Narcan, more widely available.

Overdose deaths are so high that the Biden team is embracing ideas that were once considered taboo

New York City recently opened the nation’s first official safe use clinic, allowing people with substance use disorders to use drugs under medical supervision.

Eddie said her research suggests more needs to be done to keep people alive while the healing process works.

“Nobody has died recovering from addiction. My feeling is if we can keep people alive long enough, we know the majority will eventually recover,” he said.

Travis Rasco of Upstate New York says he’s grateful he’s had enough time, enough opportunities, and enough help to rebuild his life.

“I have all the good things in life that everyone talks about,” he said. “I’m worth it too. Once you get to that place, it’s quite liberating.”

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