Who need's recovery?

In the addiction treatment community recovery means use of a program, usually a 12-step program involving taking, and eventually giving, support from/to others similarly afflicted, or maybe some kind of counseling. We have tended to assume that every addict needs recovery, but some recent observations have led me to question that assumption.

First consider that possibly most addictive drug, nicotine. Does every nicotine addict need a recovery program?

What about opiate addiction? Even with methadone maintenance it seemed that without recovery as a lifelong process, the addict could never achieve or maintain a positive outcome. But in the 11+ years I have prescribed buprenorphine for opiate addiction I have witnessed numerous individuals who almost from the beginning functioned quite well in all spheres of life. Many, but certainly not all, almost immediately gave up the need to get high.

I harbor no illusion that buprenorphine maintenance patients could maintain those changes after discontinuing the drug, even with a recovery program. On the other hand many who have never suffered from addiction could probably benefit.

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