Does Geography Impact Recovery?

By Christopher OConnor

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rural urban The addiction treatment field and 12-step fellowships are rife with language that feels contradictory. In the latter, we might hear phrases like “progress not perfection” followed up with “half measures avail us nothing.” Or we might be told that we shouldn’t make any major decisions in the first year of sobriety, yet Step Three states, “Made a decision to turn our will and our life over to the care of God, as we understood Him,” perhaps one of the biggest decisions a person can make. The antithetical language makes it easy for skeptical alcoholics to poke holes in the program. However, once an individual has an experience within the Steps, it may allow him or her to comprehend the real meaning behind the hackneyed lingo.

The addiction treatment field has its own set of clashing ideas that can make recovery confusing and impalpable. When alcoholics recall a radical move they made to escape their addiction (to no avail), we often here the disparaging term “he/she pulled a geographic.” Yet when residents at an inpatient facility approach the end of their treatment stay, continuing care often suggests relocating. This is usually to prolong care at a step-down facility, but often professionals suggest relocating to avoid the people, places, and things that used to enable using. The same professionals may also suggest “no major changes for the first year,” as an individual embarks on a totally new life in a different part of the country. It can all be very confusing, and it may leave the addict wondering whether the advice they are receiving is sound.

Much like 12-step vernacular comes alive with experience, treatment field suggestions hold weight when they come from professionals who have experience. So does geography impact recovery? It might. I am of the belief that a person can get clean and sober anywhere, but relocating could be a good idea, especially when an individual’s history indicates certain areas are slippery slopes.

Take myself for example. Towards the end of my using I was a street addict- the type of person who bought drugs in metropolitan areas, and found a peculiar satisfaction in the hustle that accompanies such a life. After a stay in a rural treatment center, continuing care made a few suggestions for aftercare. One of the potential referrals was for a facility located in New Haven, CT. Although the facility does great work and is highly regarded, it was not the best fit. Slipping into my old habits would have been very easy; in other words, the type of people I used to associate with were a mere bus ride or walk away. Instead, I stayed in the area, living in a sober house far removed from any city, and walking to work for six months. By the time I got a car and could more easily access the areas that used to call to me, cravings were less of a reality and I was entrenched in a recovery-oriented lifestyle that would ultimately fully relieve the obsession to put substances in my body. Had I gone to New Haven, there is a chance I would have stayed sober, but there is also a chance I would have deserted the facility and set out on foot to get high in a moment of despair, as I had done dozens of times before.

In closing, I do believe geography can assist recovery, but a dangerous conclusion would be that geography equals recovery. If this were true, “pulling a geographic” wouldn’t have a negative connotation; changing one’s surroundings would be sufficient treatment in itself. Location is one piece of many pieces that may aid someone in the process of finding recovery.

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