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While addiction is deadlier than ever, research shows most Americans heal


Would you like some good news? Yeah, me too. We've been reporting on the epidemic of drug deaths in the U.S. More than 100,000 fatal overdoses last year alone. Here's the good part. This morning, we're going to turn to a surprising and hopeful part of the story. Research shows most people with substance use disorder survive and heal. Even after using hard drugs for long periods of time, many people recover to lead good, full lives. NPR's addiction correspondent Brian Mann reports.

BRIAN MANN, BYLINE: This is a story with a happy ending. In fact, it has millions and millions of happy endings. But to get there, we have to start in a pretty bleak place.

ANNA MABLE-JONES: My sophomore year, I started experimenting with crack cocaine. And that just took me for a total downward spiral.

MANN: That's Anna Mable-Jones. She's a Black woman who lives in Laurel, Md. She dropped out of college, wound up incarcerated. The next decade was hell for her and her family, who often didn't know if she was alive or dead.

MABLE-JONES: The agony, the scared, like my mother calling the morgues or putting - she didn't just do it. She'd call my sister and say, hey, you need to call. I haven't heard from Anna.

MANN: Travis Rasco also lost a decade of his life to addiction. He's a white guy who lives in Plattsburgh in upstate New York.

TRAVIS RASCO: Heroin became my drug of choice pretty quick. Struggled with that for 10, 11 years, time I'll never get back.

MANN: Rasco hit bottom over and over, overdosing twice. Like Anna Mabel-Jones, he kept trying to stop and kept relapsing.

RASCO: Hopeless despair, that's a good way to describe it. Like, you know, I wanted to quit, I just couldn't, you know? I would get emotional before I would use, you know? Like, I don't want to do this, but I can't not do this.

MANN: This is what a lot of us see when we think of people with substance use disorder, overdoses and deaths, drug crime, people slumped in doorways. We think of our own family members doing painful, ugly things because of their addiction. But a growing body of research, including a national study published by a team at Harvard Medical School and Massachusetts General Hospital, shows this isn't a complete or accurate picture. In fact, roughly 75% of people with addiction - three out of every four - they get better.

JOHN KELLY: This is really good news, I think, and something to be - to share and be hopeful about.

MANN: Dr. John Kelly teaches addiction medicine at Harvard and heads the Recovery Research Institute at Massachusetts General. Their peer-reviewed study, published last year, found more than 20 million Americans are living now in recovery. They experienced some form of substance use disorder, everything from alcohol and cocaine to opioids and methamphetamines. And then they got well again.

KELLY: That's huge. We are literally surrounded by people who are in recovery from a substance use disorder, but we don't know it.

MANN: Anna Mabel-Jones is one of those people. If you met her now, you'd say her life and her home look pretty normal.

MABLE-JONES: This is our living room, right? Honestly, we're getting ready to do the whole thing, you know, the fireplace, and put the TV over here. So we're in the process of renovating.

MANN: Mabel-Jones last used drugs more than 20 years ago. She's married now, has a career helping other people in recovery. She says life is awesome.

MABLE-JONES: Things that I thought I would never gain again, through the process of recovery, I have them all, you know? Today I'm a homeowner, you know? I own a car, you know? I've started my own business. Those things, I never, ever thought I'd do.

MANN: This wasn't easy. After finally giving up drugs, she said, she also had to learn to feel emotions again. She rebuilt trust with her family and her mom.

MABLE-JONES: When she passed on, she saw that she had a daughter. She - I was there for her. I was there to go with her to her appointments, take her to the doctor.

MANN: Experts say recovery rates from addiction aren't the same for all people. Studies show racial bias makes it harder for Black and Hispanic Americans to find treatment. People who have more financial resources and support recover faster, as do people with milder forms of addiction. But Dr. David Eddie says, across all those groups, even for people using harder drugs, recovery is the norm.

DAVID EDDIE: That 75% number, that includes, obviously, people at the more severe end of the spectrum, not just the people at the lower end of the severity spectrum. So there's absolutely hope.

MANN: Eddie also teaches at Harvard and treats patients with addiction at Massachusetts General. He says their study found people don't just survive once they stop drinking or using drugs, they often thrive. They tend to get happier year by year. They reconnect with family and enjoy measurable economic success.

EDDIE: They've been to hell and back. And, in fact, you know, they go above and beyond. And maybe they end up achieving things they wouldn't have achieved if they'd never been through the hell of addiction.

MANN: So if this kind of happy ending is the norm for people with addiction, why don't we see it that way? Why is there so much stigma and hopelessness? Kelly and Eddie say one factor is the challenging nature of this illness. It's hard to treat. It usually takes years for people to get better. Multiple relapses, often five or more, are a normal, if painful, part of the process. This is also a moment when addiction is more dangerous. Studies suggest people are drinking more during the pandemic. And many street drugs are contaminated with the deadly synthetic opioid fentanyl, which is driving the big surge in overdose deaths. Eddie says one takeaway from their research is the need for harm-reduction programs that help people survive until they can heal.

EDDIE: Nobody recovered from addiction dead. My feeling is if we can keep people alive long enough, we know that, eventually, the majority get recovery.

MANN: Travis Rasco in upstate New York is a good example of someone who did survive long enough to turn his life around. After two near-fatal overdoses, he's been drug free nearly four years. He says life is good. He's married, reconnected with his family and has a career.

RASCO: That stuff all comes back. I mean, now it's back in tenfold.

MANN: The morning we met, Rasco was on his way to a good-paying job at a factory. But what he really wanted to talk about was his new baby.

RASCO: We just had a newborn daughter.

MANN: Congratulations. That's wonderful.

RASCO: Yeah. Thank you. Thank you. Yeah, we're trying to buy a house right now. You know, it's something I never thought would be possible and something I didn't really think I deserved for the longest time.

MANN: Everyone we talked to for this story agreed, because of fentanyl, this is a uniquely dangerous time for people with addiction. But they also said it's important people with this disease know there's hope. Most people will recover, especially if they get the care and support and the time they need.

Brian Mann, NPR News.

(SOUNDBITE OF SOULAR ORDER'S "MERIDIAN") Transcript provided by NPR, Copyright NPR.

Brian Mann is NPR's first national addiction correspondent. He also covers breaking news in the U.S. and around the world.