It’s more common to hear about recovery in the context of physical disorders than mental ones; the phrase “recovering from a hip injury” rolls off the tongue easier than “recovering from opioid use.” What creates this stigma around the discussion of mental recovery? One reason may be that struggling with mental health has yet to be fully normalized in society; another reason may simply be the lack of research on recovery from mental disorders, even among those with immediate physical consequences such as drug addiction.
With this seismic population of recovered individuals in the United States alone, the existing body of knowledge on recovery should be made more accessible and arguably as commonplace as knowledge on the side effects of the disorder.
The metrics used to measure the impact of substance abuse typically encompass the burden of disease, disability, and premature mortality — examples include number of deaths, overdoses, relapses, and monetary losses. What’s interesting about these statistics is that they are all measured pre-recovery — as deficits rather than surpluses, relapses over recoveries, and burden over benefit. The literature on the successful resolution of alcohol and other drug (AOD) problems is limited, which could unintentionally frame our understanding of AOD abuse with negative outcomes only. Contrary to this assumption, in 2018, it was estimated that 22.35 million American adults had recovered from previous AOD problems. With this seismic population of recovered individuals in the United States alone, the existing body of knowledge on recovery should be made more accessible and arguably as commonplace as knowledge on the side effects of the disorder.
Research on the potential for recovery is generally hopeful across various types of substance abuse, though severe damage may be irreversible. For instance, a 2012 study examining chronic inhalant abuse found that impairments were fully reversed after 15 years of abstinence. However, those with lead encephalopathy (lead poisoning), a severe consequence of chronic leaded petrol abuse, saw little recovery. The lack of cognitive improvement following both 2 and 15 years of abstinence likely indicates irrevocable neurological damage.
Stunningly, these healthy cells occur at a fourfold higher frequency in ex-smokers compared to current smokers — suggesting that not only does stopping smoking prevent the accrual of more lung damage, it has the potential to ‘reawaken’ these hidden communities of healthy cells.
In another study regarding the use of benzodiazepines — a class of drugs mainly used to treat anxiety, panic attacks, and depression that include Valium and Xanax — researchers found that long-term benzodiazepine users saw improvements in all cognitive categories after discontinuation. The study suggests that even after more than 10 years of benzodiazepine dependence, previous users are able to experience positive changes in visuospatial, attention, and problem-solving abilities after just three months of abstinence. However, the data still indicates a significant impairment in most areas of cognition compared to control groups, even following discontinuation. The study concluded on two schools of thought, stating that while some aspects of recovery are certainly possible, long-term benzodiazepine use creates permanent deficits or deficits that take longer than six months to recover. The researchers urged “extreme caution” in the long-term use of benzodiazepines and implored professionals and patients to weigh the potential clinical benefits against the possibility of dependence and cognitive impairment.
Another study published in January 2020 revealed the fascinating regenerative capacity of the lungs of ex-smokers. A groundbreaking discovery they made was of a distinct niche of healthy bronchial cells hidden in ex-smokers’ lungs, even those who had smoked for multiple decades. This population of healthy cells was reported to be near-normal in its mutational burden (i.e., number of cell divisions), exposure to tobacco carcinogens, and telomere length (sequences at the ends of chromosomes that deteriorate over time), despite neighboring tobacco-affected, highly mutated cells.
…the restorative capacity of the lungs is undoubtable.
Stunningly, these healthy cells occur at a fourfold higher frequency in ex-smokers compared to current smokers — suggesting that not only does stopping smoking prevent the accrual of more lung damage, it has the potential to “reawaken” these hidden communities of healthy cells. The low mutational burden and long telomere length of these healthy cells suggest that they could be recent descendants of stem cells, protecting against lung cancer by slowly replenishing the cells exposed to tobacco carcinogens. Though it is not yet understood how these cells avoid the high rates of mutations seen in neighboring cells and why they proliferate after smoking cessation, the restorative capacity of the lungs is undoubtable.
The body’s ability to bounce back from both cognitive and visceral harm is expansive, limited only by irreversible damage. Though research has a ways to go in understanding the full scope of AOD abuse recovery, current research elucidates the possibility of meaningful rehabilitation for substances ranging from tobacco to clinical antidepressants. New research on the potential of recovery is not only empowering for individuals for whom recovery can become a science-backed, realistic goal but also an important step toward including the role of recovery as a key metric in future addiction-related research. Addiction (2013). DOI: 10.1111/add.12124
Archives of Clinical Neuropsychology (2004). DOI: 10.1016/S0887-6177(03)00096-9
Nature (2020). DOI: 10.1038/s41586-020-1961-1
Drug Alcohol Depend. (2017). DOI: 10.1016/j.drugalcdep.2017.09.028
Addiction (2013). DOI: 10.1111/add.12124
