The starting point of an addiction often comes long before the first drink, pill, hit or encounter with the object of addiction.
For Renee Rutledge, it was at eight years old when she saw her little brother, who was seven, hit and killed by a car. She felt like she was somehow at fault and struggled with feelings of guilt.
"I tried to become this perfect child for my parents, became very people pleasing," she said.
Renee grew up as a "good girl," straight-A, honor roll student, but when she moved out of the house at 18, overwhelmed by sudden freedom and rebellion, she fell into alcohol abuse.
When she met her husband Brad Rutledge a few years later, he introduced her to drugs as well. Brad had begun dabbling in recreational alcohol and drug use with a friend during his early teens, raiding the medicine and liquor cabinet of his friend's parents. When he was 14, his father passed away from cancer, and instead of dealing with the grief from that and other incidents in his life, he began using drugs more heavily.
For the first five years of their marriage, the Rutledges admit they used and abused alcohol and drugs together. Renee finally decided she had had enough, largely because their 5-year-old daughter was becoming aware of their lifestyle. They separated on their fifth anniversary.
"I did love him very, very much. I just didn't like him," said Renee. "I was mad at the world and mad at him. Then he started going to church, and I got mad at that because it was this holy-poly thing."
But she could see that Brad was making real changes in his life. Newly sober, they got back together six months later and threw themselves into church to replace their old lifestyle and addictions.
Looking back, Renee said, she realized they were sober but not in recovery. "Sobriety and recovery are two different things. If you don't seek recovery, your past will sneak up on you," she said.
Renee's past caught up with her after eight years of abstinence when she took a drink that led to two years of closet drinking.
Those two years were more miserable than the first five years of open addiction, she said, because she was living two lives: one as a mother, Sunday school teacher, and active community member, and another as an alcoholic.
She's been sober now for the last seven-and-a-half years. But more importantly, she's in recovery, thanks to the Celebrate Recovery program that she directs and participates in with Brad at the Eastridge Community Church in Covington.
"It's very, very different living everyday being in a recovery program," she said. Through the program, she finally began dealing with the anger, hurt, resentments, shame and other issues that she had stuffed away before. "It step-by-step leads you out of those things."
Celebrate Recovery was started 16 years ago by a recovering alcoholic Christian, John Baker, at Saddleback, the mega-church in California, as a Christ-centered 12-step addiction recovery support group, similar to the Alcoholics Anonymous model but openly religious and based on the eight principles of the Beatitudes.
To date, Celebrate Recovery has opened more than 3,000 ministries nation-wide and about 5,000 world-wide, according to National Director Jim Kirchner. The program is free for churches and ministries to implement, but they are requested to stick to a standard format and set of lessons. There are more than 60 Celebrate Recovery ministries in Georgia and more than 550 weekly meetings in the eight-state Southeast region, according to Brad, who serves as the Southeast Regional Director.
The program at Eastridge started in 2001 as one of the first Celebrate Recovery programs in the state. It now has about 170 participants, with an average of 130 attending the Thursday night small group sharing sessions for adults, teens and kids. There are additional 30 who participate just in weekly "step-study" sessions, where attendees of all issues go through reflection-intensive weekly lessons.
In that first year, the Rutledges and the other program organizers were - and still are - as much participants as leaders since they had never gone through a formalized recovery process where they could address the accumulated issues and injuries.
"We kind of entered into the recovery process without even knowing it or understanding what was going on," said Brad, of their sobriety after the Rutledges got back together. "The only problem with that was we were missing the tools which you gain by being in the recovery process. Tools that you carry with you every single day, not to just fight off the disease of addiction but to grow."
Celebrate Recovery is somewhat unusual because applies the same 12-steps and eight principles used to overcome addictions to a host of other "hurts, habits, and hang-ups" as well. These include divorce, co-dependency, abuse, financial difficulty, overeating, anger management and other issues.
It's a misperception that Celebrate Recovery "is just for drug addicts and alcoholics," said Brad. "That's not the case at all. It's for the entire family."
At Eastridge, the "Life Hurts, God Heals" program for adolescents and the "How to Be With Your Attitude" program for elementary-aged kids teaches skills for handling everyday frustrations and conflicts with lessons that run concurrently to the adult step-study curriculum.
"It's very proactive. We call it precovery, actually," said Brad. "It teaches them to talk it out rather than bottle things up."
While Celebrate Recovery is open to people with a wide variety of problems, the leaders and organizers emphasize that they are not licensed counselors or therapists and do not attempt to "fix" people. Participants with more serious problems are referred to professional counselors or therapists, such as the two licensed counselors on staff at Eastridge.
Faith-based programs like Celebrate Recovery often work in conjunction with faith-based and secular treatment programs, such as individual or group therapy with licensed counselors, and secular support groups, such as Alcoholics Anonymous and Narcotics Anonymous. Participants will sometimes attend both AA or NA and Celebration Recovery meetings, especially in the early stages of addiction recovery, said Brad.
"There are many ways to get help with addiction. The key is matching the person to the treatment," said Becky Vaughn, president of the Georgia Council on Substance Abuse.
Most programs, whether they are faith-based or secular, recognize addiction as a chronic disease to be managed rather than cured. They also focus on internalizing good decision-making.
"That's the key word: choices," said Suzan Bryceland, director of the Newton center of the Gwinnett-Rockdale-Newton County Community Services Board. "For the adolescent population, for the adult population, it's really guiding them through making good choices and making those decisions that are going to be healthy and positive ones for their lives."
The substance abuse treatment programs offered by the GRN CSB take a holistic approach by addressing the personal issues underlying the addiction and any co-occurring problems such as mental health issues, according to Gina Hutto, director of addictive diseases for the GRN CSB. They also teach practical life skills such as financial management, anger management and conflict management.
A key difference between faith-based programs and secular programs is, of course, religion. While most 12-step treatments do have a spiritual component, programs receiving federal funding are limited in what they can address, said Jay Cory, director of the Potter's House, an inpatient treatment center with the Atlanta Union Mission for chemically dependent Christian men. "There is a tremendous need to address spiritual needs in addiction treatment. I think there's a lot of people who feel hamstrung; there's a lot of clinicians who feel like they can't really go there."
Another recent development in secular addiction treatment world is the use of evidence-based therapies, tested methods that have proved to be effective.
Cory feels that it's the other way around: scientific studies are now validating the lay-wisdom and methods that have been used by faith-based addiction ministries for years. The Potter's House has a six-month abstinence rate of 77 percent, said Cory.
Conclusive data measuring the effectiveness of addiction treatment programs are hard to come by, but studies suggest one-year relapse rates as high as 60 percent are not uncommon.
The popularity and acceptance of addiction ministries like Celebrate Recovery also seem to reflect society's growing understanding of the addiction epidemic.
Brad and Renee still occasionally come across unwelcoming attitudes.
"In approaching churches about starting Celebrate Recovery, sometimes you'll hear pastors say, 'I don't have those kind of people in my congregation,'" Brad said, his face tightening. "We just stop and say a little silent prayer and tell them they can keep sending them to us."
But for the most part, congregations' attitudes towards addiction have made an about-face in recent years, according to Cory.
"It's night and day," said Cory. "Twenty years ago, it was few and far between that any church had any kind of outreach ministry to the addicted. You didn't hear of churches having support groups. (Now) you have all these churches that have counselors on staff. The Christian community has become much more responsive to needs of people than it was before."
"I think the church world has become aware how big a problem it is," he said. "There is hardly a family today that has not had a personal experience with addiction."
In the end, both secular and faith-based professionals say that any support group, counseling, or treatment program is only as good as what the participant puts into it.
A saying that's often repeated by Celebrate Recovery members sums it up best: "The program works if you work it."