By Dr. Taylor Tomlinson, Director of Addiction Medicine, Northern Nevada HOPES
One of the most meaningful aspects of my work in addiction medicine is witnessing the courage it takes for people to come back.
Substance use disorder is a chronic medical condition, yet many people living with it carry an overwhelming burden of shame. Society often frames addiction as a personal failure when, in reality, relapse can be part of the course of a chronic, relapsing illness. Some of the strongest advocates for this truth are my patients themselves.
One patient’s journey has stayed with me.
After spending years incarcerated, they worked tirelessly to rebuild their life. Through treatment, including medication for opioid use disorder, they achieved remission from opioid use. They found stable employment, reconnected with family members, and began creating a future that once seemed out of reach.
For a time, things were going well.
Then they missed a few appointments.
When they eventually returned to clinic, they sat down and quietly told me, “I messed up.”
They had returned to use. They had lost their job. Relationships with loved ones had been strained, and they were carrying deep feelings of guilt, disappointment, and regret.
Many people might see that moment as a setback. As an addiction medicine physician, I saw something else.
I saw incredible bravery.
Despite the shame they felt, they walked back through our doors. They chose to be honest about their struggles. They chose to ask for help. Most importantly, they chose to start again.
That decision is not easy. It takes tremendous strength to face challenges head-on and re-engage in treatment when it feels easier to disappear.
Every month at Northern Nevada HOPES, more than 15% of new addiction medicine visits are from patients returning to care after time away. These individuals are not failures. They are people living with a chronic illness who continue to fight for their health, their families, and their futures.
My goal is to create programs and clinical spaces where people feel safe returning, regardless of where they are in their recovery journey. When patients know they will be met with compassion rather than judgment, they are more likely to seek care when they need it most.
Recovery is not a single destination or a straight path. It begins with access to lifesaving treatment and continues through countless daily decisions, challenges, and victories. For many patients, recovery is defined not by perfection but by persistence.
The patient who told me, “I messed up,” could have stayed away. Instead, they came back.
That simple act of walking through the clinic doors reminded me of something I see every day: recovery is built on courage. And sometimes the bravest thing a person can do is begin again.
