One thing we all hope for and want to see in our loved ones is long term recovery. Two questions I have been asked many times by both family members and those that are in treatment are: how long will this take and what can I expect? I have identified what I call the four T’s of a high-quality recovery program. 

When I was working directly with individuals in recovery, I would look for signs of their commitment to the process. For example, are they just a good talker? A good actor? Are they doing the work necessary for a high-quality recovery program after rehab, or just going through the motions and heading toward relapse? If you have a strong recovery program, how long before you can reasonably conclude they are on the road to achieving a successful life and a long recovery? Although there are no absolute answers, there are some guidelines and key things to look for. It is important to note that this is to help you be more certain of progress, NOT to criticize the program the person may be involved in and/or a guarantee of success.

So, what I am looking for? I’m looking for the four T’s: Team, Tools, Time and Trust

Team: I look for who they are choosing to spend their time with and learn from. For example, are they learning from counselors, treatment professionals and peers in recovery?  Are they engaged in a support program such as AA or something similar and surrounding themselves with a team that can support their recovery? Or are they going back to old habits and old relationships where their issues with substances began? It is important to see a focus on learning from those that are in the best position to help us: a good team surrounding them.

I'm a PAL mom who started a PAL meeting in my local community. I've been married for 44 years and have two biological children and two “adopted" daughters that call us mom and dad. Between them I'm a grandma of three boys and two girls. A few months ago, we retired and moved to be closer to our grandkids. This was a difficult decision as it meant moving four and half hours away and leaving our son, James, who has SUD.
 
Growing up James was extremely active, popular and kind to everyone. He was involved in sports, Scouts and community service. He used to babysit the DARE officer's children and even helped train the officer’s drug dogs. I knew as soon as he got his driver's license, I would only see him when he was hungry. I was right, but that is also when he began to lose interest in sports and other activities. We noticed his friends changing and we knew he had started smoking pot a little, but all kids go through a phase, right? We didn't have a lot of concern until the end of his senior year. Despite our concern, we knew he would be going away to a trade school, so we figured he would have a fresh start. 
 
When he was 20 years old, he came back home and got a great paying job; however, he was always broke. Right before he turned 21, he lived a few hours away but would come home every weekend (we later discovered that he was homeless, living out of his vehicle but still working). On one of his weekend visits, he asked for help. We immediately got him into treatment and knew he was "cured". Having no history of substance abuse in our family, we knew NOTHING. Cured? What a lesson we were about to learn! 

November 17, 2012  

16th Street and Glendale. Phoenix, Arizona  

I’m barely scraping by. I’ve left the halfway house again in my brazen denial of reality – my utter consumption with staying intoxicated fish-hooking me into another miserable situation. I’m in a McDonald’s bathroom stall shooting heroin. I’m missing veins and leaking blood on the floor, skin deep seams of my circulatory system hardened with thick scar tissue from the self-inflicted abuse. I’m wondering why I continue to do this to myself – why I’ve virtually decimated everything in my life to be in this bathroom right now. I’m trying to recall the circumstances that brought me here and I’m failing.  

I’m wondering what people think of me. I’m wondering if they see my outward appearance and feel a tangible sense of disgust. I wonder if they see me as less than an actual person – another scourge on the street sucking away space mindlessly, listlessly. I’m sweating. Profusely. I’ve got the injection right and am so high I feel like I can’t move from the spot I’m standing in. Somehow, I’m now in front of the mirror, picking my face. I get stuck there staring at myself thinking I can fix the way my destroyed visage is presenting itself to the world. An employee walks in. “Hey man, I’m sorry, but you, like, can’t do that in here.” I nod. Some part of me is grateful he hasn’t called the police. Maybe he has. I don’t know. I walk out of the bathroom quickly with my eyes glued to the floor as I head to the exit. I’m extremely high but it doesn’t matter much these days. I’m still feeling an intense, gut-wrenching level of shame and I don’t want to look anybody in the eye.  

I step outside. I don’t have anywhere to go, nowhere to be, no one expecting me. I have nothing. I start scouring the ground and nearby ashtrays for a cigarette. I find a half smoked nub of a butt in the gutter and run my lighter flame over the filter thinking the heat will burn away the previous owners' germs. I stand on the curb and light up. I exhale a heavy plume of blue smoke and watch it drift lightly on the breeze. It’s stale. Tastes like dirt and sadness. The cacophony that is typically my mind is silent for about 30 seconds. I breathe. Doesn’t last any longer than that – my mind spools up and my chest starts feeling heavy again. I need money. I need heroin. I need to make that 30 seconds last longer next time, by any means necessary. I’m high but it doesn’t matter. I know this’ll wear off and the crushing misery, the all-encompassing pain will return once more just like it does every time. I’m high but it doesn’t matter.