What Does ‘Hitting Rock Bottom’ Mean for Substance Use and Addiction?

Many people believe that you need to “hit rock bottom” before you seek addiction treatment. However, this is not necessarily the case. There are various things that motivate people to get help, such as their relationship with themselves, their relationship with family, and their spirituality.

In this post, we will cover the history of the phrase “rock bottom,” other reasons why people get help, and how to know if you are ready for treatment. We’ll also cover what you can do to help a loved one who is struggling with addiction.

A history of the phrase ‘hitting rock bottom’ 

People have used the phrase “hitting rock bottom” for more than 50 years. “Rock bottom” refers to a crisis event in your life that makes you realize that you have lost control over your drug or alcohol use. You have fallen and landed on the ground hard and now have nothing to lose. The impact is painful and can motivate you to change. 

Some research has supported the idea of hitting rock bottom. Researchers have found that those with more severe problems as a result of alcohol use were more likely to change their behavior. And some people with alcohol use disorder have reported that hitting rock bottom was one main reason for seeking treatment.

Clinicians used to believe that people had to hit rock bottom before they could change their use of drugs or alcohol. This belief was attached to the moral model of treating addiction. This means that they viewed addiction as a moral failure and believed that people who had substance use disorder needed to be held responsible and judged harshly. As a result, treatment providers would be hostile toward patients to make them hit a psychological rock bottom. However, scientists now believe that addiction is a brain disease over which those with substance use disorders often have no control.

Alcoholics Anonymous (AA) has made “rock bottom” a common term that is still used today. But is it still relevant? 

Do you need to hit rock bottom to recover from addiction?

No, you do not need to hit rock bottom to recover from an addiction. Also, “rock bottom” is not a very useful term because each person has a different definition of rock bottom for themselves. For one person, “hitting rock bottom” might be getting a DUI, while for another, it might mean that their partner leaves them because of their addiction. For some people, hitting rock bottom is a wake-up call. Others may get treatment long before they get to that point. 

There are many other reasons that people may seek addiction treatment.

Internal motivators

One type of reason that people get addiction treatment is an internal motivator. This refers to personal reasons for wanting to change, which drives you to get help.

Several research studies have asked individuals what got them into addiction treatment. While some did report hitting rock bottom, other common reasons included:

• Concern about alcohol use disorder worsening

• Concern about physical and mental health

• Desire to recover self-esteem

• A spiritual awakening

External motivators

External motivators are another type of reason why you might go into treatment. This is something outside of yourself that is affected by your substance use disorder. In research studies, people have reported that the following external motivators got them into treatment:

• Impacts of their drug use on their family

• Impacts of their drug use on their job

• Desire to reconnect with family

• Desire to reconnect with society

• Experiencing a traumatic event, such as seeing a friend overdose

• Legal issues

Therapy as a motivator

Being in treatment itself can also motivate someone to work toward recovery. That is what about 40% of participants in one study said happened to them. 

Motivational interviewing is a therapeutic approach that might be a part of your treatment. Your therapist helps you sort through your conflicting feelings about drug or alcohol use to help motivate you to change. This includes weighing the benefits of substance use against the costs and exploring how your substance use goes against your values and goals. Rather than convincing you to change, they gently guide and support you. 

How do you know when you’re ready for addiction treatment?

There are signs that you can look for to find out if your alcohol or drug use is a cause for concern. Ask yourself:

• Has someone told me they are worried about my use?

• Have I had times when I ended up using more than I planned to?

• Have I wanted to cut down on my substance use but couldn’t?

• Do I spend a lot of time using or being sick from using? 

• Have I wanted to use alcohol or drugs so badly that I couldn’t think of anything else?

• Has my use or being sick from use gotten in the way of responsibilities such as work, school, or family?

• Do I continue to use even when it causes problems in my relationships?

• Have I cut back on activities that I used to enjoy so I have more time to use?

• Have I used substances in dangerous situations, such as driving or operating machinery while intoxicated?

• Do I need to use more of the drug now to feel the same effects that I used to feel?

• Do I continue to use even though it causes me mental or physical health problems?

• Have I experienced withdrawal symptoms when I stopped using (shakiness, restlessness, nausea, vomiting, sweating, racing heart, depression, anxiety, etc.)?

• Have I used in order to avoid withdrawal?

If you answered yes to any of these questions, that means that your substance use may be a problem. Even if you technically could not be diagnosed with substance use disorder, experiencing any one of the above situations in the past 12 months is cause for concern. By seeking treatment as early as possible, you can help keep your use and the consequences from getting worse. 

How can you encourage someone to get help?

It can be sad and distressing to see a loved one struggling with substance use. And the idea of approaching them about your concerns can feel difficult and overwhelming. However, you can do it if you prepare. 

Gather information ahead of time

Gather contact information on treatment centers and 12-step programs, such as AA, in their area. Gather pamphlets with descriptions and contact information that you can give your loved one.

You can also call a local mental health or addiction treatment center and talk to a provider. You can ask them for assistance on how to approach your loved one. 

Be direct

Talk with your loved one in person and while they are sober. And ask them to meet you in a neutral place, such as a park.

It is best to be direct. Say something like, “I’m worried about you. Please consider getting professional help” or, “I was scared that we almost lost you when you overdosed. I love you and am here for you. Can I help you make an appointment?”

Be empathic

Remember that substance use disorder is a disease, and though it has been hard on you and your relationship with your loved one, it is also hard on them. Listen patiently and nonjudgmentally. Avoid blaming and shaming.

Be prepared for a negative response

It is common for people struggling with addiction to get defensive. They probably have regular internal battles with themselves about their substance use. It’s important to remain calm and not argue back, as that can make them even more defensive.

Seek support for yourself

You don’t have to be your loved one’s therapist or always know what to do. If you have already tried to talk with them, seek help from your local mental health or addiction treatment facility. It might be time to do a formal intervention, during which one of the therapists at the center can be present.

Also, remember that it is important that you take care of yourself. Your loved one’s substance use disorder may impact you and your relationship with them. You might consider seeking therapy so that you can get support for yourself.

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Written by:

Mona Bapat, PhD, HSPP

Mona Bapat, PhD, HSPP, has 15 years of clinical experience providing therapy. She is a licensed clinical psychologist in Indiana and Illinois with treatment experience in individual, couples, family, and group therapy modalities.

Reviewed by:

Emily Guarnotta, PsyD

Emily Guarnotta, PsyD, is a licensed clinical psychologist and certified perinatal mental health professional with over 10 years of clinical experience.

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