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Is Hitting “Rock Bottom” Necessary? Turning Points in Addiction

This entry was posted in Addiction Treatment on .

Dr. Edward A. Selby, Ph.D.

Woman Holding Her Head - Addiction

What would it take for you to realize that drugs have ruined your life? Would it involve getting arrested or losing your job? Or would it be a divorce or estrangement from friends or other loved ones? Each person has different values and will tolerate different levels of life destruction arising from drug use before they finally realize how bad things have gotten. This point is often referred to as hitting “rock bottom.” Historically, and mistakenly, it was once that people had to hit rock bottom before they would agree to get help. Yet, attempting to define an individual’s personal rock bottom experience can be a challenge because what might be a disaster for one person (e.g., getting fired) might not be the worst that can happen for someone else. The rock bottom concept is also misleading because ANY negative outcome arising from drug use represents an opportunity to get help! Thus, while traditional wisdom regarding addiction treatment suggests that people need to hit rock bottom before they can stop using drugs and change (Wilkens & Foote, 2019), in reality, we want people to get drug rehab BEFORE drugs have seriously damaged their lives! So, if you or a loved one is having problems with drugs, don’t wait for addiction to cause worse problems, get evaluated and treated as soon as possible.

Is Hitting Rock Bottom Really Necessary on the Road to Recovery?

The old saying of hitting rock bottom was originally meant to help get people with addiction to recognize the damage drugs have done to their lives. The rock bottom concept has become a major problem today because many people now mistakenly believe that hitting rock bottom is necessary for someone to finally seek treatment. However, it turns out that this is untrue, and most people addicted to drugs consider seeking treatment at various turning points as their substance use disorder progresses (Bellaert et al., 2022). Sometimes an individual is not ready to seek help; but other times they may feel a desire for treatment but they are nervous, ashamed, or discouraged to seek help and delay seeking treatment. This is where the rock bottom concept was meant to help, to give an addicted individual some perspective, especially in cases where someone’s life is so destroyed that they have no other options left but to seek help. While some people may get to this stage before realizing they need help, we don’t want to encourage people to wait this long for help since recovery can be challenging for anyone, and even more so for someone who has really hit rock bottom.

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There are additional problems with waiting to hit rock bottom before seeking treatment. As noted earlier, rock bottom doesn’t look the same for everyone, and what may be one person’s worst-case outcome may be well above or below another person’s worst-case scenario. Because of this individualized experience with addiction, even when someone hits what others may call rock bottom, that person may still not be ready for treatment at that point. On the other hand, some people are ready for treatment earlier in the stages of addiction, but because they haven’t hit rock bottom they may downplay the seriousness of their addiction problem. Despite what people may see in media or movies, rock bottom is neither as clear as is depicted nor is finding rock bottom essential in the treatment process!

Turning Points in Addiction

I would encourage anyone struggling with addiction to drugs to seek treatment as soon as possible, instead of waiting for a rock bottom or other serious drug-related events to occur. The reason for this recommendation is two-fold: 1) mental health treatment is most successful when implemented earlier on before new behavioral patterns take hold and someone’s life becomes severely impaired, and 2) sadly, many drug-addicted individuals never hit rock bottom because they die from an overdose event before that occurs (Rudd et al., 2016). Addiction is also highly connected to suicide death because, for some people, addiction destroys their life so much that they mistakenly think their life is beyond repair (Yuodelis‐Flores & Ries, 2015). No matter how bad things are, people who get help can always rebuild their lives, but recovery is more effective and faster when treatment is pursued sooner than later – before someone’s life is in ruins.

Instead of thinking about hitting rock bottom with addictions, I would encourage readers to think about Prochaska’s Transtheoretical Stages of Change Model (Prochaska & Velicer, 1997). In this model, people are viewed as existing at different stages regarding readiness to acknowledge a problem and seek help. Someone in the Precontemplation Stage may not yet have considered getting help, and while such an individual is unlikely to read this post, their friends or family might be! Next, the Contemplation Stage is when people start to think about quitting drugs or seeking help, but their ambivalence or unsure if this is what they want or if they will be successful. I’m guessing some readers here will fall into this category. Following the Contemplation stage comes the Preparation Stage, in which someone begins to build a strong resolve to stop addictive behavior and seek help. Finally comes the Action Stage, in which the individual actually enacts plans for treatment and change, which is where I want to try and nudge potential readers to if possible! Realistically, people will move back and forth between these stages, but that also means that people can move quickly from Precontemplation to Action if they really want to. It’s your life, you can always choose to change as fast as you’d like!

If you are reading this and struggling with drug addiction, or you know someone who is, don’t wait for a major rock bottom event, get help for yourself or encourage others as soon as possible. Drug detox and rehab treatments are effective and the best way to ease the unpleasant feelings of drug withdrawal. So, although rock bottom events are indeed a wakeup call to get treatment, instead of waiting for rock bottom, patients and families should consider other negative addiction factors as signs of change being necessary, like adverse drug-induced experiences, upcoming major life changes (e.g., becoming a parent), and disengagement from family and friends as major turning points for entering long-term drug rehab (Bellaert et al., 2022).

 

Get Treatment Now – Don’t Wait for Rock Bottom! Call our Confidential Help Line.

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If you or a loved one is struggling with drug addiction, it’s always better to get help sooner than later. In fact, treatment earlier on in the course of addiction, before addictive behaviors and patterns become severe, is typically associated with better outcomes and a lower relapse rate (Schellekens et al., 2015). Therefore, when it comes to addiction, don’t wait for drug use to get out of control or a rock bottom event. If you’ve been considering treatment for drug addiction then there are many good reasons to explore and enroll in a long-term drug rehab program. These programs are effective (de Andrade et al., 2019) and can help patients reduce and avoid the lasting damage typically caused by long-term drug use.

 

 

References:

Bellaert, L., Van Steenberghe, T., De Maeyer, J., Vander Laenen, F., & Vanderplasschen, W. (2022). Turning points toward drug addiction recovery: contextualizing underlying dynamics of change. Addiction Research & Theory, 1-10.
de Andrade, D., Elphinston, R. A., Quinn, C., Allan, J., & Hides, L. (2019). The effectiveness of residential treatment services for individuals with substance use disorders: A systematic review. Drug and Alcohol Dependence, 201, 227-235.
Kosten, T. R., & Baxter, L. E. (2019). Effective management of opioid withdrawal symptoms: a gateway to opioid dependence treatment. The American Journal on Addictions, 28(2), 55-62.
Prochaska, J. O., & Velicer, W. F. (1997). The transtheoretical model of health behavior change. American Journal of Health Promotion, 12(1), 38-48.
Rudd, R. A., Aleshire, N., Zibbell, J. E., & Gladden, R. M. (2016). Increases in drug and opioid overdose deaths—United States, 2000–2014. Morbidity and mortality weekly report, 64(50 & 51), 1378-1382.
Schellekens, A. F. A., De Jong, C. A. J., Buitelaar, J. K., & Verkes, R. J. (2015). Co-morbid anxiety disorders predict early relapse after inpatient alcohol treatment. European Psychiatry, 30(1), 128-136.
Wilkens, C., & Foote, J. (2019). “Bad Parents,”“Codependents,” and Other Stigmatizing Myths About Substance Use Disorder in the Family. In The stigma of addiction (pp. 33-53). Springer, Cham.
Yuodelis‐Flores, C., & Ries, R. K. (2015). Addiction and suicide: a review. The American Journal on Addictions, 24(2), 98-104.

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