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“No one made me come to treatment – That’s good, right?” – I hear this all the time. Patients who come to us for help say this frequently. They are convinced that because they are coming for help voluntarily, it will make them more likely to stay clean and sober for the long term. I usually say to them – somewhat jokingly, “Well, good for you … but that won’t help you at all … unless you also do the necessary work to stay in recovery.” I tell them that wanting to come to treatment is just like wanting to go to the gym. Wanting to go to the gym only does you any good if you actually do go to the gym and work out! Wanting is not enough. Only putting in the time and doing the work will count.

I have been asked to give a talk at the Annual Virginia Judges’ Conference in Norfolk in May. I will be giving the Judges an update on the current Opioid Epidemic and what we can be done to minimize the damage. A big part of my message is going to be that Judges can have a large influence on how many people get clean and sober, and how many stay in recovery for the long term. Judges across this country have already helped numerous people get clean and sober as a result of drunk driving offenses. The truth is there are hundreds of thousands of people who are now clean and sober because they received a DUI and were forced into treatment. These people didn’t want to stop drinking, but they were forced to attend treatment in order to keep their driver’s license. Because they had to stick with their program over a protracted period, many of them came to appreciate and enjoy being sober and they are still sober today.

We also see this phenomenon in health care professions. Physicians and nurses generally never come into treatment programs because they wanted to stop using. They most likely come to treatment because they have had a major problem and the problem came to the attention of the authorities. They went to treatment in order to save their medical license and to keep their careers intact. What happens is that, over time, they start to really see just how bad their problem is. They begin to see and experience reality. Most begin to fully appreciate that the drugs and alcohol were causing most or all of their problems. They start to appreciate that they will have a happier life if they stay clean and sober. By being forced to practice these new behaviors over a long enough period, they learn new habits. Studies of physicians who get treatment for their addictions show a long-term success rate of over 90%!

There is plenty of evidence that people who are coerced into treatment – and monitored – actually have a better success rate for long-term recovery. This doesn’t make much sense until you start to think more about it. It turns out that doing recovery actions – practicing recovery behaviors – is actually more powerful than having good intentions. There are a couple of sayings in Alcoholics Anonymous. One is – “if you bring the body the mind will follow!” The second one is – “You can’t think yourself into good actions, but you can act yourself into good thinking”. Both slogans are saying the same thing. If you do the actions long enough it will begin to change the way you think about yourself. If you do the actions of a person in recovery - by going to support groups, making new sober friends, making amends for your past behaviors, helping others, etc., then you will become that person in recovery, and you will begin to see yourself in a new way. It is like learning to ride a bicycle. If you keep getting back on a bike, you will learn to ride it. How can you not? And, if you keep riding a bike and hanging out with other bike riders you will start thinking of yourself as bike rider. Think of the places you can go on your bicycle. Think of the places you can go with your new-found freedom!

Peter R. Coleman, MD

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