"People with addiction need to hit rock bottom before they'll recover."
The Tired Narrative:
"Hitting rock bottom" is a common recovery slogan. It implies that people with addiction must face dire consequences that result in great suffering and humiliation before they are ready for treatment. Compassionate efforts by family and loved-ones to help is regarded as "enabling" and prevents someone with addiction from "hitting bottom," further delaying the recovery process.
Only after hitting this nebulous bottom are people ready for treatment services. The guiding principle is that immense suffering and severe consequences will motivate people to change.
The Informed Narrative:
There is no scientific evidence that backs up the idea that "hitting rock bottom" or experiencing extreme negative consequences is what prompts recovery. "Rock bottom" is a narrative device, not a scientific concept, because it can only be determined retrospectively. If someone relapses, a new bottom needs to be found, which can occur repeatedly.
In fact trying to create or simply allow negative consequences to affect a loved one can be a dangerous practice. Families are sometimes instructed to cut ties with loved ones or call the police to have them arrested so that they can “hit bottom.” Instead of recovery, this can just as easily lead to worsening addiction, even death.
Hitting rock bottom is a tenet of old-school recovery paradigms. The trope has also made its way into clinical settings and is popular among addiction counselors, especially those who may have recovered themselves after experiencing terrible consequences.
While "hitting bottom" might be true to some people's experiences, there is no evidence to suggest that living on the street or going to jail is a necessary condition that leads to recovery. Evidence-based approaches, such as The Community Reinforcement Approach and Family Training (CRAFT), rely on empowerment and compassion, which directly contradict the notion that more suffering leads to behavior change. Since addiction is defined as compulsive behavior that resists change from negative consequences, the idea that there is a "rock bottom" is questionable.