What are the chances of staying sober without treatment?

alcohol
mental-health
#1

We are going through marriage counseling but he gets none on his own. He knows that if he starts drinking and it gets to the point again that he kicks me out I am gone. He has kicked me out 3 times in the last 18 mos, yes he was drinking. I told him I was gone next time. We have separated before because I just couldn’t deal with his drinking but I took him back. I am just wondering what my chances are?
Thanks in advance.

#2

Hi there @Beth - really glad to see you here & to hear that you’re going through marriage counseling with your husband!

The short answer is that there is a chance of staying sober without (traditional) treatment. There are many paths to change and none are a one-size-fits-all.

Some alternatives to traditional treatment may be to taper off slowly or take the path of restriction vs. abstinence. (I’m not a med professional - so please take this as opinion and not fact!)

What I do know is that the biggest determinant in this kind of change is that life outside of substance use must become more fulfilling and less stressful. As concerned family or friend, we have the power/influence to help create conditions for healing that go deeper than the substance use itself.

So my question to you is - how can you engage your husband in deep connection (free of shame and guilt), in his purpose (a reason for existing on this planet), and/or in his physical well-being (exercise, healthy eating and sleeping, meditation, etc.)?

You’ve given him an ultimatum that you’re gone if there’s a ‘next time.’ Want to offer up this thread and this one as additional reading. Some good stuff in there about boundary setting & communication.

Would love to hear others perspectives here, too! Thinking of you @Beth…

#3

Hi @Beth, welcome! While I can’t answer the exact question of “What are the chances of staying sober without treatment?” I can provide you with many different types of treatment that can be helpful. For starters, you’re in marriage counseling! In some capacity he in some type of treatment, dealing with underlying issues and needs not being met, this is a plus from my perspective!

My brother got sober from fentanyl and heroin not by going through traditional “treatment” (28 day inpatient), rather he found a therapist who worked with him to process and release trauma from the past, as well as an addiction psychiatrist for medication management. He had been to treatment centers in the past, but he found most success in an alternate treatment path.

Here are some principles for effective treatment:

  1. Addiction is complex, but treatable. It affects brain function and behavior, so therapeutic approaches need to address the rewiring patterns in the brain and give strategies to change behavior.
  2. Repeated substance use that disrupts life needs to be addressed as soon as possible.
  3. Effective treatment addresses more than just substance use. It get’s at what is going on underneath the surface that is compelling a person to reach for drugs as a way to soothe the discomfort.
  4. Staying in treatment for an adequate amount of time is critical.
  5. Medications can be an important element of treatment when combined with intensive therapies.
  6. Needs will change. A treatment plan must be assessed and modified continually to make sure those needs are being met.
  7. Many people who struggle with substance use are (unknowingly) self-medicating because of underlying mental distinctions that have gone unrecognized and undiagnosed. (remember, compassion).
  8. Detox alone does very little to change long-term use.
  9. Drug use during treatment needs to be monitored, as relapse is common.

Here are different treatment options (both traditional and non-traditional):

  • Outpatient Services: Both group and individual behavioral interventions and medications when appropriate. Services can be offered during the day, before or after work or school, in the evenings or on weekends. Typically, outpatient programs are considered appropriate as the initial level of care for individuals with a mild to moderate substance use disorder, or as continuing care after completing more intensive treatment. Outpatient programs are also suitable for individuals with co-occurring mental health conditions. (Months or years).
  • Residential Treatment: organized services in 24-hour setting, but outside of a hospital. These programs typically provide support, structure, and various evidence based clinical services. Such programs are appropriate for physically and emotionally stabilized individuals who may not have a living situation that supports recovery, may have a history of relapse, or have co-occurring physical and/or mental illnesses. (Weeks to months)
  • Medically Monitored/Managed Inpatient Care: An intensive service delivered in an acute, inpatient (live in) hospital setting. These programs are typically necessary for people who require withdrawal management, primary medical and nursing care, and those with co-occurring mental and physical health conditions. Treatment is usually provided by an interdisciplinary team of healthcare professionals, available 24 hours a day, who can address serious mental and physical health needs. (Days or weeks).
  • Less Traditionally Recognized Route: For some, the road is long and gradual, not stopping use all at once, but tapering off. The biggest determinant in this kind of change is that life outside of substance use becomes more fulfilling and less stressful. These three factors help in the transition: 1. Involvement in community, 2. Purpose, and 3. Improved physical wellbeing.

Give the links @katie shared a look too - they may help communicate your needs around his use and your desire to leave if it continues.

Thinking of you :yellow_heart: