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---
title: What Does it Mean to Recover from Addiction?
description: Most people who are addicted to drugs or alcohol recover without any treatment or self-help groups, and many don't quit entirely.
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author: Maia Szalavitz
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article:modified_time: 2026-10-14T09:15:16.194Z
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og:title: Rethinking What it Means to Recover from Addiction
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twitter:title: Rethinking What it Means to Recover from Addiction
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# Rethinking What it Means to Recover from Addiction

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## Video: TIME & Mic Present: Life After Addiction

[Watch (HLS stream): TIME & Mic Present: Life After Addiction](https://cdn.jwplayer.com/manifests/p030rjYP.m3u8) (18:30)

![TIME & Mic Present: Life After Addiction](https://cdn.jwplayer.com/v2/media/p030rjYP/poster.jpg?width=720)

_Published 2017-11-08. Following decades of dependency, one fateful overdose led to a chance at redemption._


by 

[Maia Szalavitz](https://time.com/author/maia-szalavitz/)


## Maia Szalavitz


Sep 29, 2021 6:43 PM UTC

by 

[Maia Szalavitz](https://time.com/author/maia-szalavitz/)


## Maia Szalavitz


Sep 29, 2021 6:43 PM UTC

When I kicked cocaine and heroin in 1988, I was told that there was only one way to get better: abstain forever from psychoactive substances including alcohol—and practice the 12 steps made famous by Alcoholics Anonymous. The only alternative, counselors and group members said, was “jails, institutions or death.”

My addiction was so extreme that by the end, I was injecting dozens of times a day. So I grabbed the lifeline I was thrown and attended the traditional 12-step rehab program recommended by the hospital where I underwent withdrawal.


But once I began to study the scientific data on addiction, I learned that these claims were not accurate. In fact, research shows that [most people](https://www.nytimes.com/2018/08/31/opinion/addiction-recovery-survivors.html) who meet full diagnostic criteria for having an addiction to [alcohol or other drugs](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227547/) recover without any treatment or self-help groups—and many do so not by quitting entirely, but by [moderating](https://pubmed.ncbi.nlm.nih.gov/15733237/) their use so that it no longer interferes with their productivity or relationships.

There is no “one true way” to end addiction—and the idea that “one size fits all” can be harmful and even deadly in some cases. Until we recognize this and celebrate the variety of recovery experiences, September’s National Recovery Month and similar efforts to promote healing will fail to reach millions of people who could benefit. During an overdose crisis that [killed more than 90,000 people](https://www.cdc.gov/nchs/pressroom/nchs%5Fpress%5Freleases/2021/20210714.htm) in 2020 alone, a better understanding of how people really do overcome addiction is essential.


Unfortunately, rehab hasn’t improved much since I attended in the late 20th century. At least two-thirds of American addiction treatment programs still focus on [teaching the 12 steps](https://www.samhsa.gov/data/sites/default/files/reports/rpt35313/2020%5FNSSATS%5FFINAL.pdf) and promoting lifelong abstinence and meeting attendance as the only way to recover. (The steps themselves include admitting powerlessness over the problem, finding a higher power, making amends for wrongs done, trying to improve “character defects” and prayer—a moral program unlike anything else in medicine.)

Moreover, despite the fact that the only treatment that is [proven to cut the death rate](https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2780655) from opioid addiction by 50% or more is long-term use of either methadone or buprenorphine, only about one-third of residential programs even [permit](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2760443) these effective medicines, and [around half](https://www.samhsa.gov/data/sites/default/files/reports/rpt35313/2020%5FNSSATS%5FFINAL.pdf) of outpatient facilities use them, typically short-term.

Worse: when they do allow medication, most treatment centers also push people with opioid use disorder to attend the 12-step program, Narcotics Anonymous. That creates what can be deadly pressure to stop the meds. The group’s [official literature](https://www.na.org/admin/include/spaw2/uploads/pdf/pr/2306%5Fna%5Fprmat%5F1021.pdf) says that people on methadone or buprenorphine are not “clean” and have only substituted one addiction for another.

I have been contacted by more than one family who lost a loved one to overdose because their relative had rejected or prematurely ended medication based on this view. If we don’t start to view recovery more inclusively, we are denying hope and healing to those who benefit from approaches other than the steps.

So, what does a more accurate and expansive view of recovery look like? To me, one of the most helpful definitions was devised by a group known as the Chicago Recovery Alliance (CRA), which founded the Windy City’s first needle exchange. CRA was also the first organization in the world to widely distribute the overdose reversal drug naloxone—and train drug users to save each other’s lives by using it. Naloxone (also known as Narcan) is a pure antidote to opioids: it restores the drive to breathe in overdose victims but must be given rapidly to be effective. (If used in error, it is safe: it won’t hurt people with other medical problems and typically works even if opioids have been combined with other drugs.)


CRA’s approach is called [harm reduction](https://www.nytimes.com/2021/07/23/opinion/harm-reduction-covid.html), and it defines recovery as making “any positive change.” This means that anything from starting to use clean needles to becoming completely abstinent counts. From this perspective, if someone quits smoking crack, gets a job and reconciles with her family, she counts as being in recovery—even if she stills smokes marijuana daily.

Or, if someone goes from drinking a bottle of Scotch a day to having a daily glass of wine—or from drinking daily to binging only on weekends—these too are positive changes, not just “active addiction.” Here, recovery is a process, not an event. It’s difficult to learn any new skill without trial and error, and this includes developing coping skills to manage or end drug use. For most people, even with behaviors short of addiction, big changes take time.

This broad definition obviously includes people who take addiction medications. Doing so is a positive change because it dramatically reduces the risk of death, even for those who continue to take other substances.


Moreover, those who do quit nonmedical use and [stabilize](https://www.nap.edu/resource/25310/032019%5FOUDhighlights.pdf) on an appropriate dose of these meds can drive, connect with others and work as well as anyone else. They are not intoxicated or numb—just like people taking other psychiatric drugs as prescribed.

While patients on methadone or buprenorphine remain physically dependent on medication to avoid withdrawal, they no longer meet criteria for addiction. According to psychiatry’s diagnostic manual and the National Institute on Drug Abuse, [addiction](https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction) must include compulsive behavior despite negative outcomes—it’s not simply needing something to function.

Of course, for people steeped in traditional abstinence-oriented recovery, CRA’s “any positive change” definition can be challenging. In the 12-step world, members who have maintained continuous abstinence for many years are revered—the longer their time away from alcohol and other drugs, the higher their status tends to be. The lure of such social acclaim helps some avoid relapse. Granting the status of “recovering” to those who have not quit entirely seems unfair from this perspective.


However, it could save lives. In 12-step programs, people who break continuous abstinence—even for just one day after 20 years—are seen as returning to square one, and their “sober time” and its associated status is completely erased. Research shows that having such a [binary](http://content.time.com/time/health/article/0,8599,1868965,00.html) view of recovery can actually make relapses more dangerous. That’s because people figure that, since they’ve blown it already, their small slip might as well be a massive spree.

Since most people do relapse at least once, moving away from the idea that only continuous abstinence matters—not quality of life, not the ability to maintain relationships and contribute to society—would likely be healthier for everyone.

But there’s another way to reconcile conflicting views of recovery, which preserves traditional ideas for those who prefer them. That is, simply define it for yourself and let others do likewise. If you’ve heard someone identify themselves by saying, “I’m a person in long-term recovery and for me, that means abstinence,” you’ve seen this idea in practice.


My own perspective has changed over time. From 1988 through 2001, I was continuously abstinent from drugs other than caffeine, including alcohol. Since then, I have used alcohol and cannabis responsibly, without difficulty. However, I have no illusions that I could moderate either cocaine or heroin use—so I continue to avoid these drugs and count myself among the recovering.

Now, though, I suspect that my recovery probably started before my abstinence—when I was taught to use bleach to clean my needles in 1986 and began to fight to get HIV prevention information and equipment to other injectors. That positive change likely helped prepare me for further transformation, including seeking rehab. It almost certainly helped me avoid AIDS.

What really matters is not whether someone recovers via medication or moderation or 12-step programs or anything else. It’s that, like me, most people do get better. And even more of us can if we recognize and support many roads to recovery.


## Transcript

What wrong with these folks? He found some good dope. Hold on, that good ****. The video has been shared hundreds of thousands of times. It happened in the medical district yesterday afternoon. Police say the two snorted heroin inside the bathroom at a nearby Walgreens. I could have died on the side of that road, very easily. Two white males and a female down. Injured. Man, that folk ain't moved. Heroin takes you to a stage of nirvana. It's that type of deal. Nothing matters, nothing, absolutely nothing. [ MUSIC ] My name's Carla, and I'm from Memphis Tennessee. Hi Carla. 40 year opiate addiction.

In the last eight, a stray hair one. And I didn't wanna die, I wasn't ready to die. I've I always felt like there was something better and there was. I'm Ronald Philip Hiers from Memphis Tennessee, I was born in 1955 and I'm 61 years of age. I was addicted to heroin from 1972, To October of 2016. I have a picture of me in diapers, and there's no way that that little baby in diapers thought that 60 years later, they would be overdosed in the middle of a city on a bus bench. And that's what drugs and alcohol will due to you, it'll take you places you can't imagine [ BLANK_AUDIO ] When I got to high school at 13 years old I ran into a life- long friend of mine.

He's dead now. He died in my closet from an overdose. We began sniffing paint at 13 and smoking pot and drinking Boone's Farm wine. In the 11th grade I got myself Kicked out of school, my circle of influence was compromised to say the least. I met Ronnie at a party at his mother and dad's house when I was sixteen. So, I had met him early on but we didn't get together til my thirties. Things were never normal. We were always going to jail for something. It would either be him or me, and we were always strung out. She was tough enough to go to the [ UNKNOWN ] and take chances on getting shot. And you'd get shot at.

I said that's my kind of girl. I'll tell you that was my kind of girl there. And we committed a lot of crime together. That's how my life was to me, was one big party. Because I didn't want to deal with any feelings. But every situation I was in and the four kids I had I walked away from. Who does that ****? A man person. Where are they? You don't know? It's awkward for me to say dad at times. It's more comfortable for me to say Ron. I don't have like really any memory of him. Like, Being, you know what someone would think of as a father. For a long time he wouldn't see him. I mean he was in jail sometimes, and then he would just pop in and we would see him just very infrequently.

He was drunk or high a lot. He Would hide needles, not like unused needles, he would hide them in my drawer in my room. When you get those collect calls from jail, I'm talking to him and he's telling me how hungry he is, or whatever, and you feel, I felt bad for him and I was sad. And I was scared for him. I thought he was hungry or colder or like somebody was gonna beat him up. So I would go to bed. And I would, [ BLANK_AUDIO ] I'm sorry. [ BLANK_AUDIO ] I worried about him a lot. [ BLANK_AUDIO ] And back then, like I did want him to get better. You just make yourself callous, like, you get to where it hurts too bad to keep worrying about his livelihood or his self, his being, because nothing you do can help him.

Like, I couldn't do anything, like he was always gonna choose. Drugs over health, over family, over friendships. He was gonna choose drugs no matter what. I was diagnosed with third stage throat cancer. And I think Late February or March of 2016, I was in a sad place, I was in a dark place. I was in a depressive place. More than any other point in my life. 48 years of addiction. 48 years of going to jail. 48 years going to prison, forty- eight years of watching people die, forty- eight years of watching people get killed. 48 years of watching them be robbed. 48 years of living life in addiction prompted to start suicide, start attempting suicide.

If I had written a hand written obituary And put it in my wallet. [ BLANK_AUDIO ] And then the back of it is Ronald Phillip Hiers passed away. I mean, of course the date's blank because we never know when we're gonna put out the game I get in that point in my life. And whenever you get to that point, you're certainly not happy. The video has been shared hundreds of thousands of times. It happened in the medical district yesterday afternoon. Police say the two snorted heroin inside the bathroom at a nearby Walgreens. Millions saw. Overdosing on heroin with his wife on a sidewalk in the medical district the dope boy that we were copping from is in close proximity, so, if you call us one of those, let's hurry up and do it, ya know?

And I'm one of those, no And we need to go home and do it. No, let's do it now! So, and she always wins out. I remember coming up out of it, and it was like, [ SOUND ], noise. And it's like you just come up out of from water, I guess you're drowning. I heard somebody ask me, that was behind me, do you know what happened to you? And he said, you overdosed on heroin. And I'm like heroin? Heroin? You know I couldn't think. I couldn't think what had happened. I went to jail that evening And I was there for 30 days. ****. Hey look. I didn't know that was on tv. I didn't know it was in a newspaper. I was shocked.

I didn't want to look at it. It was humiliating When I seen Carla, that's when my heart poured out. I realized, I signed on to be there for her. Hell, I couldn't be there for me and she was in a bad way. Two white males and a female down. Injured. Man, that fool ain't move. [ LAUGH ] Especially when she tried to get up a couple of times. That really hurt. I mean, [ BLANK_AUDIO ] Being out of her house, it was in public. She was being publically humiliated. I saw the video on my birthday and it was right before we were supposed to go out for my birthday dinner and I remember making fun of him. I was like, there's Ron's 15 minutes of fame.

You know, I was like, great, here we go. And then I started to think, I have to help him. And the only thing I can attribute that to is just God put in on my heart that I had to do something. I called the number at the back of the news story. And if you or a loved one is struggling from addiction go to our website at wrga. com and click on this story. We put a 24 hour I didn't really think about it. I just picked up the phone and called, you know, and I was crying and I said the man who OD'ed In Memphis, that's my dad. And they said well, you know, if you can get in touch with him then we want to give him a scholarship to get treatment.

I got an email, it started out with an email. The email just kind of stated that there had been a video and that That we wanted to help this person. Ron was in a very very very bad shape. I didn't know if he would make it. I'll be honest with you, I didn't know. We just took him straight to his bed and got him in. Just to get him in the facility to get him safe. I woke up in a bed on the second floor of this facility. I had enough conversations to let me know where and what this place was about. Easy does it, you know? One day at a time type ****, you know? So I started to leave. I began to look for the way out.

I found an elevator and the elevator opened up at the bottom in there and I realized it was co- ed. And that's what I stayed for in there cuz I knew women pretty good. [ BLANK_AUDIO ] Somebody that works in the jail was trying to help me find some place to go when I got out because Ronny was in a rehab somewhere. And then when I found out, I couldn't get in touch with him, couldn't talk to him anyway. I gave her the number. the number that I called, and I said, call them and tell them who you are. They'll help you. They helped him and so she did. It was not even two days, she was on a plane and they had offered her the same opportunity.

Everything happened very quickly. Very fast. [ BLANK_AUDIO ] And I can remember sitting at the airport thinking, and I was by myself now, by myself. [ BLANK_AUDIO ] And I'm thinking, well it's gotta be better than [ MUSIC ] Where you are. There was someone there to pick me up and then they brought me to Swift River. 1200 miles away from anything I had ever known. That was hard. I had to re- learn my thinking. [ MUSIC ] I had to re- learn my dealing with people, to listen to people and I had to re- learn not to be in a hurry all the time. And I found out a lot of things I could still learn and that was a gift that I could still learn.

Somewhere [ INAUDIBLE ] 26 I sobered up and I asked myself 2 questions. That's all I did. I asked myself are you honestly happy. I couldn't answer that with a yes, because I had an obituary in my freaking wallet. A person trying to actually kill his self is certainly not happy. Having answered that [ UNKNOWN ] and I asked myself the next question, do you want to continue to kill yourself? And I honestly didn't. Six months into my recovery and I texted my daughter that I am crying tears of deep sorry for having just now realized What a joy it would have been to raise you and know you your entire life.

It was 2: 30 in the morning. I didn't expect an answer back. And I told him that he didn't miss much cuz I was awkward til I was like 30 [ LAUGH ]. I was like, you didn't miss much. II was trying to lighten [ MUSIC ] I was trying to make him feel better. [ UNKNOWN ] Lightened my burden. What a grounded young lady. And I didn't know this about her, but I know it now. So I know how special she is [ UNKNOWN ]. And that's part of sobriety. You get to see things that you thought you'd never see. And then listening to that, and knowing who she is, and knowing she's so perfect. [ BLANK_AUDIO ] I imagine you feel way better [ UNKNOWN ] lick of heroin I ever did.

Any robbery I ever managed to pull off and get away with. It was just one of the most special things I've ever heard in my life, you know, and I'd have never heard if I hadn't sobered up. Good afternoon everyone. Good afternoon. I'm Ron, I'm an addict and alcoholic [ BLANK_AUDIO ] It's just by the grace of God that I'm here today to even talk to y'all. And I mean that, I can't stress that enough, how much I mean that. But he found some purpose. He wants to help other people who are stuck in addiction. He wants to bring people to sobriety and sober living and I think that's great that he has this passion now, and I think that is what's really keeping him from relapsing.

In the sweet name of Jesus by the blood of Christ, Amen Amen, Amen. [ APPLAUSE ] I am part of his support system, but I have boundaries and I feel like I have to maintain those boundaries for myself. Yes, ma'am, thank you. Good luck. [ INAUDIBLE ] Yeah, good luck. Yeah man. Thank you much. [ INAUDIBLE ] Yeah, thank you. Ronnie was my drug partner. For 21 years. And he lives in Mississippi, and I have no desire to live in Mississippi. Where he lives is just a stone throw from Memphis. I don't know, I just feel like I would be regressing Instead of progress. And I don't want to incorporate myself into his life because this is my life.

And [ BLANK_AUDIO ] I'm happy with my life making my own choices And I don't want anyone making them for me. I don't put any expectations on the future of Carla and I. I just know that I want her to be happy, and I want me to be happy. Now we talk everyday, or at least text. You know, because we got some new stuff to tell each other. She loves telling me about she got her a bed. And he got her some tea. He's getting some LASIK surgery and she finally got them last few teeth removed. He got her some dentures. And all these things are blessings. We went from two trash bags of clothes in a boarding house to I've got some things, and she's got some things.

But the best things that we have is peace. Who is [ UNKNOWN ] out there? Come in, hey, You look 20 years younger than the last time I saw you. I come so far that I really don't give a lot to the future. I'm okay where I'm at today. If you could talk to your 19- year old self now. 19- year old self Knowing what I know now, [ BLANK_AUDIO ] What it made me do is think about what I didn't do, well They came and got me. [ BLANK_AUDIO ] I'd have to tell him that, [ BLANK_AUDIO ] Life shouldn't be taken lightly. [ MUSIC ] It's a gracious gift. [ MUSIC ] Meant to be enjoyed. That's why. [ MUSIC ] [ SOUND ] [ BLANK_AUDIO ]

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