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Is abstinence the only answer? Quality of life in addiction recovery.

Contributing author: Chelsea Crow

Abstinence should not be the only standard by which we measure success in addiction recovery.

There’s no doubt that for some addicts, full abstinence is necessary for recovery. Still, it would be hard to deny that even if they can’t stay completely clean, addicts who reduce their use substantially can see great improvement in their quality of life. I think that improvement shouldn’t be ignored.

I’ve been advocating for the use of other measures for success in addiction treatment for a while now, and a recent article gets us a step or so closer to having others consider it.

The study was conducted in New York City. All participants had a history of heavy illicit substance use for at least a year, and all self-reported abstinence for at least one month. The researchers then followed them for a period of two years, using a baseline interview at the beginning, after one year, and at the end. The interviews consisted of participants’ self-reported abstinence, Quality of Life , change in life satisfaction, as well as their commitment and motivation to abstinence.

Not surprisingly, the study found that those who reported greater life satisfaction at the baseline interview were likely to stay abstinent for longer. However, they also found that overall life satisfaction for participants remained high for most. What they didn’t look at was whether or not participants’ life satisfaction decreased with all levels of use or whether a severe relapse was necessary to cause such a reduction.

I think this should be one of our next explorations. I have a feeling that with reduced use comes greater life satisfaction and quality – even if the abstinence is not complete. I think that by beginning to explore that connection, we’ll be able to make much more refined discoveries about methods of treatment that can save lives. There’s no question that even reductions in use can allow the body, and brain, at least a partial recovery from the effects of heavy drug use.

I’ll keep you updated.


Laudet, Alexandre B., Becker, Jeffrey B. & White, William L. (2009). Don’t Wanna Go Through That Madness No More: Quality of Life Satisfaction as Predictor of Sustained Remission from Illicit Drug Misuse. Substance Use & Misuse, 44 (2), 227-252.

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