My career in addiction treatment has spanned almost four decades and during that time there’s been an extraordinary evolution of thought within this field. The growth of the behavioral health field is a testament to that evolution. Perhaps most telling is the development of the terms treatment providers use to refer to addiction and surrounding issues. We've gone from citing “alcoholism,” “substance abuse,” and “chemical dependency” to recognizing “substance use disorder" in this year's release of the DSM-5.
E.M. Jellinek published The Disease Concept of Alcoholism in 1960, and we have moved from treating this disease primarily with a medical, acute model of care to believing that the liver had more to do with the physiological part of the disease, to now recognizing it as a brain disease that is chronic, but for which treatment and recovery are possible.
From the beginning, some had the insight to recognize addiction as a three-fold disease—one that is physical, emotional and spiritual in nature. Those three components need healing in order for a lifelong journey of recovery to be truly realized. The term “dry drunk” or dry addict, which refers to someone who may have "cleaned up" physically and chooses not to use, but seems to remain an unhappy or emotionally unhealthy individual, speaks to the necessity of incorporating all three components into the recovery model. With that realization there has come a push in the last decade to really take a look at improving this "sixth sense" or "third spectrum," that spiritual aspect of our being, in the treatment of chronic diseases.
What strikes me is that the sense of spirituality so aptly described in Alcoholics Anonymous, better known to those in recovery as "The Big Book,” has survived through all text revisions since its first publication in 1939. So from that day to this, people who work in this field and offer recovery models foundationally steeped in the 12 Steps of Alcoholics Anonymous have fundamentally believed that spirituality is a cornerstone to the lifelong journey of recovery. On page 64 we find, "When the spiritual malady is overcome, we straighten out mentally and physically."
This allows us to find a life that is “happy, joyous and free” (p. 133). However the Big Book also indicates that the road to happiness is one that must be "trudged." Doing the work to have this spiritually satisfying and fulfilled life while living successfully through a chronic illness isn’t necessarily easy, but it yields great rewards. A 2010 study published in the journal Alcoholism: Clinical & Experimental Research, found a strong connection between regular attendance at AA meetings, a greater sense of spirituality and fewer instances of alcohol use. A study published in 2013 in Occupational Therapy in Mental Health found "a more positive sense of spiritual well-being" in patients upon discharge from a residential treatment program.