Natural Recovery

The concept of natural recovery is not a new one in the addictions field and is synonymous with terms such as self-change, spontaneous remission, maturing out, and natural remission. Collectively, these terms refer to the resolution of addiction without formal treatment. There has been continued debate among addictions experts about the utility of promoting natural recovery as an alternative to formal treatment or support groups. Traditionally, the disease model approach dominated the field and proponents asserted that in the absence of treatment, addictions were progressive and irreversible. Advocates of natural recovery argue that many people quit addictions without seeking help. Moreover, they argue that abstinence-based philosophies deter many people from seeking treatment and promote a false belief [Page 627]that moderation is not possible. In the past decade it has generally been acknowledged that natural recovery is not wholly inconsistent with the disease model approach. Empirical evidence has demonstrated that the effectiveness of a recovery program (self-initiated or treatment based) is dependent partially on the level of addiction severity, with more extreme cases benefiting more from formal support. The addictions field has started to embrace different styles of initiating and maintaining recovery. This growth and diversification in addictions treatment has led to the burgeoning of self-help books and brief intervention initiatives. Notwithstanding these facts, controversy still exists among addiction experts. Even at the most basic level, disagreement exists about what constitutes addiction, resolution, or formal treatment.

Despite the evidence that the majority of people recover from addictions without any professional help or other formal assistance, the concept of natural recovery has met with resistance. There are three phenomena that have contributed to this opposition. First, addiction counselors generally see severe cases where individuals seek help because they have been unsuccessful in combating the problem on their own. With these cases, treatment providers have historically had more success with an abstinence-based approach. Second, up until the 1990s, the preponderance of research in the addictions area focused on clinical cases. In these cases, the success of formal treatment over self-help was generally well supported. Once again, these are extreme samples that do not represent the spectrum of addiction severity. The third reason that natural recovery has been overlooked is the continued adherence to the disease model in viewing addiction as a dichotomy. The American Medical Association defines drug dependency, including alcoholism, as a disease. Polls have demonstrated that the majority of Americans also hold this belief. People all over the world have successfully quit drinking with the help of the abstinence-based principles of programs such as Alcoholics Anonymous, and many residential treatment programs, such as the world-renowned Betty Ford Clinic, similarly support a disease model approach to treatment and recovery. Although some would argue that natural recovery is in opposition to the disease model, the following points should be considered. Supporters of self-change recognize the utility of formal treatment and would agree that it increases the prospects of recovery, particularly for those with more serious problems. Moreover, the issue is resolved semantically because advocates of abstinence-based philosophies would contend that if an individual is able to quit on his or her own, the individual was never truly addicted in the first place.

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