Ask 100 people how they maintain long term sobriety, and you will likely get 100 different answers. A heated area of debate is in regards to total abstinence. On a public health level, addiction is often treated with Medication Assisted Treatment (MAT). The concern is less with a total life change, and more about less harm to the addict/community.  Someone taking maintenance medication such as methadone or Suboxone is less likely to “cause trouble”.  They are less likely to commit crimes to obtain money to pay for drugs. For families and the addict, they are less less likely to overdose or experience the pain of withdrawal. Simply take the medication, and go about your life. So with this option available, why would anyone want to do it any other way? Most 12-step recovery programs, as well as treatment centers, believe that total abstinence is the best way. In our brains, we have a reward system called the “limbic system”. Our brain rewards us by releasing chemicals like dopamine when we do something beneficial to our species: eat Mcdonald’s (lots of calories!), win a hand of black jack (lots of resources!), have sex (make more of us!). The drugs and alcohol that we were addicted to release the same chemicals. The argument for total abstinence is: When we continue to feed our reward system with medication management drugs, we never let our brains heal.  We still stay dependent on that reward system. We still remain prisoners to “feel good chemicals”.  Sobriety is more about changing the way we think, feel and act.  It is a total change of life.  Total abstinence rewards those in recovery with an unimaginable freedom. Some making the change from medication management to abstinence find true peace.  They also no longer have the desire to use, they no longer remain a prisoner to the suboxone doctor or the methadone line. How did you get clean? Do you think abstinence is the only way?

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