Raising The Bottom: Does a person have to hit “rock-bottom” before seeking treatment?

Many of us have heard the phrase “hitting rock-bottom.” But what exactly does it mean as it relates to addicts and alcoholics? Is it a prerequisite to entering treatment? The stereotype of “rock-bottom” is someone on skid row. It is the homeless vagabond, intravenous drug user living under a bridge, crack-addict prostitute or career criminal facing a long-term prison sentence. To be sure this is definitely the picture of rock-bottom for some. However, there are those who believe that if these events have not happened to a person, then that person has not truly hit rock-bottom. That is a myth and this post has been designed to dispel it.

One does not have to be on skid row to hit “rock-bottom”. Nor do they even have to lose their jobs, find themselves in financial duress or legal calamity. Rock-bottom is simply this; WHEN YOU SAY ENOUGH IS ENOUGH.

There are some who make a distinction between hitting “bottom” and hitting “rock-bottom.” The former meaning that one has hit a low point in their lives, but not to the degree of physical, immediate life-threatening dangers present for those whom have hit “rock-bottom.” This is just a game in semantics. A game not worth playing. The terms “hitting bottom” and “hitting rock-bottom” are used interchangeably.

So when is enough enough? What does a bottom consist of? How does one get there? How long does one stay there? Is it the same for everyone? Are there individual differences? I will attempt to shed some light on these questions below.

First, a bottom is created by consequences. Consequences and pain. A person has reached their personal bottom once they have experienced enough consequences and emotional pain resulting from their addiction to the point where they decide they have had enough. Your bottom IS WHEREVER YOU STOP DIGGING.

Rock-bottom is not a predetermined point. It is not some magical destination way off in the future. You do not need to continue using drugs and alcohol until you somehow, one day hit that predetermined point of “rock-bottom.” Rather, you have reached your personal bottom the day you say, “I have reached my personal bottom”. There is nothing unique or special about this day (other then the fact that it is the day you declared having hit bottom). It does not have to fall on your birthday, or New Year’s Day, Hanukah, Thanksgiving, your child’s birthday, etc.

It is a mistake to draw a comparison with people whom appear to have suffered more severe consequences and then conclude that you have not hit bottom yet. Any bottom can get lower. And if we were all in the habit of doing this, then we’d all probably be dead as we measured against each other in the process. Some people hit bottom in the midst of a thriving professional career and at a point of financial abundance. There are those who hit bottom with millions of dollars in their bank accounts and not a single pending legal issue or infraction with the law. Some may even be otherwise living the American dream in a home with a two-car garage, golden retriever and white picket fence. You get the point.

How this can be the case? The reason why is because a bottom is EMOTIONAL. Everything else described above are merely external consequences. External consequences which are of little value without the emotional component. You can lose everything material including your freedom and it will be of little value if you do not care. If the consequences do not hurt emotionally, than they are not really consequences are they…

The real consequences are internal. The psychological anguish, desperation, shame, guilt, sadness, depression, lack of hope and despair. These are the true motivators. All of these emotions can be experienced without the material loss, loss of freedom, etc. The catalyst may be as simple as going against your own personal values and moral code. Maybe just knowing that you are not achieving your full potential due to drug use or that you are hurting yourself and others through your behavior is enough to elicit the aforementioned emotions. That is fine. That is ok. And more importantly, that is ENOUGH.

One does not have to continue using more. You do not have to lose more. You do not have to hurt more. If today is the day that you say, “I have had enough! This is my bottom and I no longer want to use anymore.” Then guess what? That is your bottom. And you have just taken one of the very first steps towards recovery. Welcome. A future filled with hope and opportunity lay ahead of you. Welcome. The road you have traveled has been a long one. This is true whether the journey took 20 years or 20 months. For pain cannot be measured objectively. It is a subjective experience. Lord knows every addict has experienced days, which have lasted years, and years, which have lasted a lifetime.

In particular for teenagers and young adults we can and must raise the bottom. Many of them have not been using long enough to experience many of the more severe life-threatening consequences, which later serve to help someone make the admission of having a drug problem and motivate them for recovery. It is our responsibility to them as parents and caring adults to help raise the bottom and facilitate their experience of consequences. In other words, we are not to enable. We must allow them to experience the natural consequences of their drug use and we are ourselves to impose heavy consequences for use. Consequences, which the patient will care about and make a life without drug use more appealing then the current life path they are on.

Hitting bottom is a blessing. It is from this point that we are able to surrender and make the admission that we are no longer in control and are unable to cease drug use without aid. It is a position of defenselessness. It permits us to lower our guard and reap the benefits of the goodwill and aid available to us for the difficult work that lays ahead. It is a starting point. A beginning. And it is an indispensable one. The paradox: that only by surrendering and admitting powerlessness over our addiction are we to regain the power to heal and recover.

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2000 South Dixie Highway., Suite 104

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Miami substance abuse treatment
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