BLOG & NEW POSTINGS August 26, 2016Bill White RECOVERY WITHIN RURAL AND FRONTIER COMMUNITIES


A confluence of historically unprecedented forces has driven addiction-related disease and death into the very heart of rural and frontier communities in the United States. It remains to be seen whether this perfect storm can be met by the development and mobilization of expanded recovery support resources for individuals, families, and communities.
Rural and frontier communities vary widely in their characteristics, vulnerabilities, and resiliencies, but they do tend to share some distinguishing features: geographical isolation, individualism, religiosity, cultural and political conservatism, a distrust of outsiders, and recent decades of economic distress (e.g., declines in rural farming, manufacturing, and mining) and out-migration of young adults. The perfect storm that brought rising rates of addiction-related death and disease (e.g., HIV, Hep C) must be viewed within the context of these larger strains on rural community life. In 2009, in our book Methamphetamine: Its History, Pharmacology, and Treatment, Dr. Ralph Weisheit and I suggested that drug surges could ignite rapidly within conditions of high drug availability, the absence of drug controls, a vulnerable population, and a climate of cultural demoralization, mass unemployment, poverty, or mass migration. We further went on to predict that methamphetamine could be the Trojan Horse that would lead to the rise of prescription opioid and heroin use and increased sedative addiction in rural communities that had long been immune to opioid addiction.
That sequence of cultural, family, and personal vulnerability and the transition from methamphetamine, oral use of prescription opioids, and the migration to heroin use is the perfect storm that now bears the aftermath of overdose deaths and outbreaks of HIV infection and portends potentially enduring increases in alcohol and sedative dependence in these communities. (A rarely noted fact in coverage of the surge in opioid addiction is that the majority of overdose deaths result from combinations of opioids with alcohol and other sedative drugs—particularly benzodiazepines).
There are all manner of responses to the alarms rising in rural communities over surges in opioid addiction. Most focus on drug control measures, harm reduction measures aimed at reducing overdose deaths, and expanding access to treatment—particularly medication-assisted treatment. These are all important efforts, but the question remains whether supports for long-term personal and family recovery from opioid addiction will be included within these strategies. Such supports would involve shifting the lens through which we examine rural areas from a pathology or intervention paradigm to a solution-focused recovery paradigm (See my 2011 paper). It will require, as it will for the whole country, shifting from models of acute stabilization (serial episodes of brief treatment) to models of sustained recovery management and creating recovery landscapes within which long-term recovery can flourish. It will require mobilizing assets within the rural community—including individuals and families in recovery, recovery mutual aid organizations, new recovery support institutions, and new technology-based recovery supports to create such models and such recovery spaces.
One of the obstacles to achieving this vision is that we have so little scientific research on addiction recovery within rural and frontier communities. Lacking such guidance, we must rely at the moment on a growing body of experiential knowledge drawn from the heart of rural communities facing this crisis. We need venues to bring professional and lay leaders within these communities together to share their experience, strength, and hope—and to share the most effective recovery support strategies. For those on the front-lines of this crisis, I urge you to share in whatever ways you can what you are learning. The future of many rural communities may well rest on how quickly such lessons can be learned and exchanged.

Post Date August 26, 2016 by Bill White

BLOG & NEW POSTINGS August 9, 2016 -Bill White- BEYOND HISTORICAL TRAUMA: APOLOGY FOR ABUSES AT U.S. INDIAN BOARDING SCHOOLS


In April of this year, Don Coyhis, leader of the Native American Wellbriety Movement, and I penned a communication to the field entitled Intergenerational Healing: Recognition, Resistance, Resilience, and Recovery. In that communication, we suggested that: 1) addiction in oppressed communities was fed by historical trauma and its residual remnants within contemporary life, and 2) the healing of historical trauma and its legacies involves distinct processes of personal and cultural renewal: Awakening and Collective Commitment; Mass Mobilization; Personal and Collective Mourning; Forgiving the Unforgivable; Achieving a New Harmony; Acts of Empowerment, Service, and Advocacy; Cultural Revitalization; and Acts of Celebration. These culturally indigenous processes must be accompanied by a reconstruction of the relationship between the oppressed group and the dominant culture. A central step in that process is for the dominant culture to fully acknowledge its historical actions and seek to make amends for these acts. The principle is one of restorative justice—healing the breach between wounding and wounded parties.
One of the darkest chapters in the history of the Indigenous Peoples of North America is that of the forced removal of Indian children from their homes and their internment in Indian Boarding Schools. The prolonged wounds wrought on the lives of Indian children, families, and tribes was a product of a policy whose explicit purpose was to: “Assimilate American Indian children into the American culture by placing them in institutions where they are forced to reject their own culture.”
White Bison has launched a petition to ask the U.S. Government to offer a public apology for the Abuses at U.S. Indian Boarding Schools. The petition reads as follows:
We the People ask the Administration to give a public apology for the abuse of Native American children in US Indian boarding schools. We ask that our President take the next step in the Native American Apology Resolution S. J. RES. 14 Section I, which he signed on December 19, 2009. The US government-funded 500 boarding schools for Native American children in order to integrate them into dominate culture. Children were taken away from their families and stripped of their identities and their cultures and were mentally, emotionally and physically abused. The trauma they faced has been passed down from generation to generation. This intergenerational trauma is directly connected as a cause for many social issues today.
I encourage everyone to SIGN THE WHITE HOUSE PETITION for the Apology for Abuses at US Indian Boarding Schools before the August 27 deadline. 100,000 signatures are needed. Be sure to log into your email after signing to confirm, so your signature will count. You may sign the petition at the following link:
https://petitions.whitehouse.gov/petition/apology-abuses-us-indian-boarding-schools
Please share this with your friends and colleagues so we can all be part of this healing process.

Post Date August 9, 2016 by Bill White

BLOG & NEW POSTINGS August 5, 2016 -Bill White- THE FUTURE OF RECOVERY SCHOLARSHIP


Is it possible we are seeing the rise of a new generation of scholar activists who combine the experiential knowledge of addiction recovery, academic excellence, and a desire to give back through recovery-focused research, writing, teaching, and advocacy activities?
Over the past decade, I have interviewed many of the pioneers who made major contributions to the modern scientific and historical study of addiction recovery. All of these pioneers brought impeccable academic credentials to their work, but many withheld their personal or family recovery status or only disclosed that status late in their careers when they felt such disclosure would not damage their career opportunities or professional reputations. (See HERE and HERE for examples of the latter). Such secrecy or delays in disclosure were the result of the social stigma attached to addiction. Major efforts to reduce recovery-related stigma may make it easier for a new generation of scholars to pursue the study of the personal and family recovery experience while living openly as people in long-term addiction recovery.
Six factors will influence this future. First, the levels of education of people in recovery is increasing due both to the number of people with advanced education who are seeking recovery and the number of people in recovery choosing to pursue continued education as part of their recovery process. As examples, nearly 20% of AA members work as professionals, health professionals, or educators; 41% of surveyed NA members report having a college or graduate degree; and 47% of SMART Recovery members report having a college or graduate degree. Second, resources have expanded via the growing network of collegiate recovery programs through which people in recovery can pursue advanced education in a recovery-supportive academic and social environment. Third, there are now more than 280 colleges and universities offering formal addiction studies programs that academically prepare people to work within such areas as policy, administration, research, harm reduction, prevention, treatment, and recovery support services (Click HERE for a full list of such programs). The number of recovery-focused studies within Master’s theses and doctoral dissertations is increasing exponentially. Fourth, people are entering recovery at younger ages, with a growing contingent of politically aware and articulate young recovery advocates, some of whom are being drawn to academically prepare themselves for a career in the addictions field. Fifth, this emerging generation of recovery advocates has a seasoned vanguard of recovery role models working as addiction professionals, including at the highest levels of policy development and service delivery, as well as strong associations representing addiction medicine specialists and other addiction professionals. Sixth, recovery mutual aid organizations are themselves getting more involved in historical research and in collaborating with academic and private research organizations in the conduct of recovery research. Collectively, these forces are motivating people in recovery to further their education and extend their avocation of volunteer service work into a vocation within the addictions field.
This is all a way of saying there are ways that those who have been part of the problem can be part of the solution and that this influence can be exerted locally, nationally, and globally. Perhaps this invitation is being written for you. Perhaps you have changed your own life for a purpose that remains unclear to you. Perhaps that purpose is to help change the world—to help us understand the personal and family recovery processes in new ways, to elevate the quality of addiction treatment, to widen the doorways of entry into recovery, or to help find ways to break intergenerational cycles of addiction. Yes, such contributions will take a profound commitment, sustained preparation, and tenaciousness that will test you beyond measure. But from one who has followed this path, I invite you to accept the torch extended to you from my aging generation of scholar activists. Combining recovery-grounded experiential knowledge with the most rigorous historical and scientific methods of inquiry might indeed reshape the future of addiction and addiction recovery. Is that vision something that calls to you? Is it time to begin or take the next step in your preparation for this calling?

Post Date August 5, 2016 by Bill White

BLOG & NEW POSTINGS July 29, 2016 -Bill White- RECOVERY AT THE TABLE (A MOMENT OF CELEBRATION)

There were many policy and service agendas that came out of the 2001 Recovery Summit in St. Paul, Minnesota—the formal launch of the new recovery advocacy movement in the U.S., but none more central than increasing recovery representation at the tables where decisions are made affecting the lives of addicted and recovering individuals and their families. We embraced the mantra of the disabilities movement—“Nothing about us without us!”—in calling for recovery representation at all levels of the field—from the highest national and state policy venues to the governing boards, staff, and volunteers of local service organizations. It was a grand vision we had in 2001, and recent weeks have reminded me just how far we have come in achieving that vision. First was a photo sent to me of three men—Michael Botticelli, Tom Hill, and Tom Coderre—who live openly as persons in long-term addiction recovery and who serve in national policy advisory positions. Michael Botticelli is Director of White House Office of National Drug Control Policy (ONDCP) where he has led historic reforms in national drug policy, including elevating recovery as a new organizing paradigm for policy and service delivery. He earlier served as Deputy Director and Acting Director of ONDCP and before that served as Director of the Bureau of Substance Abuse Services at the Massachusetts Department of Public Health. Tom Hill, after earlier positions with Faces and Voices of Recovery and Altarum Institute, was appointed to serve as a Senior Advisor for Addiction and Recovery for the Substance Abuse and Mental Health Services Administration (SAMHSA) and Acting Director of the Center for Substance Abuse Treatment (CSAT). Tom Coderre serves as a Senior Advisor and Chief of Staff at SAMHSA. He formerly served as the Chief of Staff to the Senate President in Rhode Island and as National Field Director of Faces & Voices of Recovery. Michael, Tom, and Tom are among a growing legion of professionals in long-term recovery who serve in key national policy development and policy advisory positions. Recovery representation is similarly increasing at state, regional, and local levels.
Recovery at the Table
Second was a photo sent to me of Justin Luke Riley of Young People in Recovery (YPR) participating in a forum with a listening President Barack Obama. YPR leaders have rapidly gained access to some of the most important decision-making venues within the addictions field. (See http://www.williamwhitepapers.com/blog/2016/04/ypr-a-new-generation-of-recovery-advocates-bill-white-and-justin-luke-riley.html). Those of us at the 2001 Recovery Summit shared our hopes of a new generation of recovery advocates that would bring youthful zeal and creativity into the recovery advocacy movement, but none of us could have predicted the speed with which this vision would be fulfilled.
Third was the recent news of passage of the Comprehensive Addiction and Recovery Act (CARA) in the wake of a national mobilization of recovery advocates supporting this landmark legislation. It is not an overstatement to suggest that this legislation would not have been written and passed without the preceding cultural and political mobilization of people in recovery and others personally affected by addiction. CARA was signed by President Barack Obama on July 22, 2016 as he challenged Congress to provide increased funding to realize CARA’s potential healing influence on individuals, families, and communities.
The vision in 2001 was to bring the lived experience of recovery and the voices of the affected into policy development and the design, delivery, and evaluation of prevention, harm reduction, addiction treatment, and recovery support services. What is now transpiring is more than we could have dreamed in 2001. And that is cause for celebration and renewal of the commitment to create a sustainable recovery advocacy movement in the United States.

Post Date July 29, 2016 by Bill White

BLOG & NEW POSTINGS July 13, 2016 -Bill White- CALLING ATTENTION TO OPIOID-AFFECTED FAMILIES AND CHILDREN (WILLIAM WHITE AND DR. DENNIS C. DALEY)

Fresh proposals to respond to rising opioid use/addiction/deaths arrive daily, but are striking in their collective silence on the needs of affected others—parents, siblings, intimate partners, children, extended family members, and social network members. Neglect of affected families has deep historical roots within the history of addiction treatment and recovery. Historically, family members were more likely to be viewed by addiction professionals as causative agents of addiction or hostile interlopers in the treatment process than people in need of recovery support services in their own right. Overcoming such attitudes has taken on added urgency due to the rising prevalence, morbidity, and mortality of opioid addiction in the United States and its rippling effects upon families and communities. In this brief communication, we offer some reflections on this issue and how we might use the current social crisis to forge a new chapter in the nation’s response to addiction-affected families and children.
Scientific research on the effects of opioid addiction on children and families is robust and its findings are unequivocal. Opioid addiction of a family member exerts profound consequences on the physical, emotional, and financial health of other family members and the family as a whole. Opioid addiction dramatically alters family roles, rules, rituals, and the family’s internal and external relationships. Its effects are observed across all family subsystems—adult intimacy relationships, parent-child-relationship, sibling relationships, and the relationship between the nuclear family and kinship networks.
The emotional life of opioid-affected families is rife with denial, shock, anger, verbal confrontations, confusion, guilt, humiliation, shame, fear, fleeting glimmers of hope, frustration, anticipatory grief, and feelings of extreme isolation and helplessness. Such feelings are exacerbated in the presence of an addicted family member’s threatening behavior, physical violence, lying, manipulation, failed promises, pleas for money, and damage or theft of property. Affected family members often report role disruption across generations (e.g., grandparents or aunts and uncles raising children of an addicted parent), a restricted social life, financial distress, a reduced standard of living (from the direct effects of opioid addiction, legal expenses, and repeated episodes of addiction treatment), and a progressive, stress-related increase in their own alcohol and other drug use. The presence, severity, and duration of these effects are mediated by multiple factors, such as the type, severity, complexity, and duration of the opioid addiction and the internal and differences in the external resources available to be mobilized to respond to the addiction crisis.
Many reports note the significant increase in the use of opioids and opioid-related deaths, with much of the focus on prescription practices, the specific opioids used, and the epidemiology of overdose in various communities. Yet, each OD death affects many people left behind. The loss of a loved one through death, incarceration or incapacitation causes immeasurable suffering for the family and other concerned people. One of the authors recently attended a Vigil of Hope in which family members honored the memory of a loved one lost to addiction. Over 130 attended this event. Photos of lost family members lined a table, most of them of young adults. The majority of participants lit a candle and made a statement about losing a loved one (a few lit candles to express gratitude that their loved one is in recovery). One little boy said “I light this candle in memory of my dad who died when I was 3 years old.” A man lit a candle in memory of “two brothers and a cousin who died from drug overdoses.” Several couples and families lit candles as a group in memory of their lost loved one. Tears flowed throughout this Vigil as members shared their sadness and grief. We must all remember that there is a person’s story behind every case of addiction. There are also multiple family stories behind each case of addiction. Addiction truly is a family disease affecting us all. Death by overdose and incarceration from criminal behaviors caused by addiction affects us all. And our pain as family members may persist for years after losing our loved one.
Research and our combined clinical experience on the effects of opioid addiction on children (beyond the effects of prenatal opioid exposure) and the effects of parental opioid addiction on the parent-child relationship are equally unequivocal. Children of opioid-addicted parents are at increased risk of developing attachment, mood (including suicide risk), anxiety, conduct, and substance use disorders and experiencing problems in school adjustment and performance. These effects tend to be gender-mediated with female children experiencing greater mood and anxiety disorders and male children experiencing more disruptive and substance use disorders. These risks are exacerbated when the parental intimate relationship is marked by conflict, violence, and cyclical patterns of engagement, abandonment, and reengagement. Studies of the effects of parental opioid addiction on parental effectiveness and the parent-child relationship note cyclical patterns of disengagement, neglect, abandonment, and guilt-induced over-protection, over-control, and over-discipline—combinations that often leave children confused and rebellious.
While the above addiction-related effects on families and children have been extensively documented in the scientific and professional literature, that same body of literature offers surprisingly little data about the prevalence of recovery from opioid addiction and how affected families recover as individuals and as a family unit. The neglect of families effected by opioid addiction ignores the damage such addiction inflicts on the family, but it also fails to convey the very real possibility of long-term recovery, and offers no normative map to guide families into and through the recovery process. Below are examples of what family-oriented care would look like within policy, prevention, treatment, recovery support, and research contexts.
*Family members affected by opioid addiction are included within policy and service planning discussions to provide family perspectives on service needs.
*Such representation includes a diversity of family experience, e.g., partner, parent, and child perspectives; families who have experienced opioid-related deaths, families experiencing active addiction, and families in recovery from opioid addiction.
*Targeted prevention and/or counseling services are offered to all children/siblings affected by opioid addiction.
*Where possible, assertive linkage to professional and peer-based family support services accompanies all opioid addiction encounters, e.g., emergency services, point of arrest and adjudication, treatment admission, and mutual help contact.
*Families affected by opioid addiction are provided an independent advocate to help them navigate legal and service systems and to reduce the risk of financial exploitation by helping organizations.
*The basic unit of service within addiction treatment programs and recovery community organizations is reconceptualized from the addicted individual to the family unit.
*Family education and support programs are integrated within all organizations offering opioid addiction treatment and recovery support services. Family education includes (at a minimum) information on the neurobiology of opioid addiction, the very real prospects of long-term recovery from opioid addiction, treatment and recovery support options, the diversity of pathways of recovery from opioid addiction, the effects of opioid addiction on the family and family members (including children), and the commonly experienced stages of family recovery.
*Affected family members (adults and children), including those who have experienced addiction-related losses within their families, are provided safe venues to share their stories and experience mutual support with others similarly affected.
*Family-oriented care within treatment programs spans the functions of assessment, treatment and recovery planning, service delivery, and post-treatment monitoring (recovery checkups), support, and, if and when needed, early re-intervention. Periodic recovery check-ups are continued for a minimum of five years following initial recovery stabilization.
*Every family involved in addiction treatment and/or peer-based recovery support services is exposed to individuals and families in long-term recovery from opioid addiction.
*Affected families are given opportunities to use their experiences as vehicles for community education and policy advocacy.
Of the above actions, none is more important than bringing affected family members into policy development and service planning venues and listening–really listening–to their stories and letting the experiences and needs reflected in those stories shape a family-focused policy agenda. Put simply, national and local responses to opioid addiction are most effective when they begin with the lost art of listening—listening to the raw urgency of unmet needs.
Selected References
Daley, D.C., & Ward, J. (2015). The impact of substance use disorders on parents, Part I. Counselor, 16(2), 28-31.
Daley, D.C., & Ward, J. (2015). The impact of substance use disorders on parents, Part II. Counselor, 16(3), 25-28.
Kirby, K.C., Dugosh, K.L., Benishek, L.A., & Harrington, V.M. (2005). The Significant Other Checklist: Measuring the problems experienced by family members of drug users. Addictive Behaviors, 30(1), 29-47.
Lander. L., Howsare, J., & Byrne, M. (2013). The impact of substance use disorders on families and children: From theory to practice. Social Work and Public Health, 28(0), 194-205.
Nunes, E.V., Weissman, M.M., Goldstein, R., McAvay, G., Beckford, C., Seracini, A., Verdeli, H., & Wickramaratne, P. (2000). Psychiatric disorders and impairment in the children of opiate addicts: Prevalences and distribution by ethnicity. The American Journal on Addictions, 9, 232-241.
Velleman, R., Bennett, G., Miller, T., Orford, J., Rigby, & Tod, A. (1993). The families of problem drug users: A study of 50 close relatives. Addiction, 88, 1281-1289.
White, W., & Savage, B. (2005). All in the family: Alcohol and other drug problems, recovery, advocacy. Alcoholism Treatment Quarterly, 23(4), 3-37.

Post Date July 13, 2016 by Bill White

BLOG & NEW POSTINGS June 24, 2016 -Bill White- “NATURE WILL FIND A WAY; SO WILL RECOVERY!”

The celebration of multiple pathways and styles of addiction recovery is a central tenet of the new addiction recovery advocacy movement. And yet if one listens carefully to the diversity of recovery stories rising from this movement, there is a striking and shared central thread that forms the connecting tissue across secular, spiritual, and religious frameworks of recovery; across recovery in diverse populations and cultural contexts; and across the mediums of natural recovery, recovery mutual aid, and professionally-assisted recovery initiation. That central thread is a sustained, irrevocable commitment for personal change.
The forms of expression of that commitment vary widely. In Twelve-Step programs, it is rooted in the paradox of strength (action) rising from acknowledged limitation (powerlessness) and the experience of surrender—a paradox Kurtz and Ketcham characterized as the spirituality of imperfection, e.g., change emerging from the acceptance of one’s Not-Godness. Faith-based recovery programs such as Celebrate Recovery share a similar focus on powerlessness and the need for connection to resources that transcend the self. In secular recovery frameworks such as SMART Recovery or Secular Organizations for Recovery, the recovery commitment is centered quite differently in “self-empowerment and self-reliance” and a chosen “sobriety priority.” In recovery frameworks rising from historically-oppressed populations, one often finds the recovery commitment expressed through a similar assertion of self, as found in Dr. Jean Kirkpatrick’s (1986, p. 166) discussion of Women for Sobriety’s First Statement of Acceptance (“I have a drinking problem but it no longer has me. I am the master of it and I am the master of myself.”). Such assertion is also evident in recovery ministries rising within African American communities, such as the first “act of resistance” (“I will take control of my life”) in Glide’s Africentric framework of addiction recovery (Williams & Laird,1992). Today’s recovery advocates offer a similar challenge to action: “Recovery by any means necessary, under any circumstances. No matter what, don’t pick up!”
Whether through transcendence of self or assertion of self, a forged and sustained commitment to change is at the center of recovery initiation and maintenance across pathways and styles of addiction recovery. But what is the ultimate source of such commitment to recovery? We know that such commitment can come in a lightning strike (what researchers have called quantum change and transformational change) or in a much slower staged process of change, but what are its essential ingredients? Multiple factors can interact to set a detonation point of recovery initiation. These can take the form of push (avoidance) factors and pull (approach factors) or constitute a process more aptly described as drifting out of addiction and into recovery. Push factors include personal identity issues, family and significant other concerns, health concerns, economic concerns, legal troubles, fear of future consequences, and a progressive erosion of positive drug experiences. Pull factors include exposure to positive recovery role models (recovery carriers), recovery-specific family and social support, windows of opportunity for lifestyle change (e.g., relocation, job change), and emergence of new beliefs (e.g. religious conversion).
I have argued in my earlier writings that recovery involves a process of reaching critical mass in a synergy of push (pain) and pull (hope) factors. Pain in the absence of hope within the context of addiction drives only sustained drug use and further self-destruction. Hope in the absence of pain in the context of addiction fuels only belief in one’s ultimate invulnerability and continued drug use and related excessive behaviors. It is in a uniquely personal ratio between pain and hope that one finds the spark of recovery commitment igniting into a sustainable fire. That recovery alchemy can come early or late in one’s addiction career, with such timing profoundly influenced by one’s family and social environment. The future of recovery lies in a greater understanding of how these interior and exterior environments can be influenced to spark and sustain recovery commitment.
The growing varieties of conditions from which such pain-hope synergies can be elicited are revealed in acts of recovery storytelling within diverse private, professional, and public settings. What they reveal is that recovery stability in the short-term can be challenging, but that the odds are stacked toward long-term success. As we develop a deeper understanding of the natural world, it does become clearer that nature (life) will find a way. So will recovery, if given the opportunity.
Of Potential Interest
Kirkpatrick, J. (1986). Turnabout. New York: Bantam Books.
White, W. (2012). The history of Secular Organizations for Sobriety—Save Our Selves: An interview with James Christopher. Posted at http://www.williamwhitepapers.com and http://www.facesandvoicesofrecovery.org
White, W., & Chaney, R. (1992). Metaphors of Transformation: Feminine and Masculine. Bloomington, IL: Chestnut Health Systems.
Williams, C. with Laird, R. (1992). No Hiding Place: Empowerment and Recovery for Troubled Communities. New York, NY: Harper San Francisco.

Post Date June 24, 2016 by Bill White

BLOG & NEW POSTINGS June 3, 2016 -Bill White- RECOVERY PATHWAYS ARE NOT ALWAYS A PATHWAY

The addiction recovery experience has been sliced and diced in all manner of categories: secular, spiritual, and religious; natural recovery, peer-assisted, and treatment-assisted; and abstinence-based, moderation-based, and medication-assisted, to name just a few. Recovery achieved through any of these frameworks is often referred to as a pathway of recovery. The growing consensus that there are multiple pathways of long-term addiction recovery marks an important public and professional milestone within the alcohol and drug problems arena.
Progress has been made by recovery-focused research scientists on mapping recovery pathways and noting their distinctive and shared qualities. This classification work is important as long as one does not lose sight of the fact that reality is often far messier than such pristine categories would suggest. Or put another way, “the recovery map does not always accurately depict the territory.”
The image of pathways suggests a crossroads with distinct options that call for clear decision-making or voiced guidance from some GPS of addiction recovery. The image conveys that one must choose A, B, or C—with some advocates of each standing at the crossroads claiming they represent the one true path to recovery. There are millions of people living in recovery within these established frameworks of recovery, but there are also innumerable people in long-term recovery who have crafted a style of personal recovery at or beyond the boundaries of these approaches. Their recovery experiences are metaphorically more aptly described as an evolving patchwork, mandala, mosaic, medley, or hodgepodge rather than through the image of the well-marked path. Their recovery experiences are “dynamically evolving” in the sense that critical ingredients are regularly being forged and exchanged without a predetermined map or fixed point of completion. Their recovery experiences are patchworks, mandalas, or mosaics in the sense that this style of recovery may combine unusual and even contradictory elements, the whole of which may resemble no established style of recovery.
MosaicDoes this mean that individuals may combine a potpourri of ideas and approaches to initiate recovery and that these critical ingredients may change over time? Does this mean that people may initiate recovery within one framework of recovery but migrate to another framework to sustain recovery? Does this mean that some people may simultaneously use two or more frameworks of recovery, e.g., co-attendance at 12-Step meetings and SMART Recovery meetings? Does this mean that some people may initiate recovery without addiction treatment, but later seek professional help to enhance their emotional and relational health? Does this mean that the person using needle exchange services today may in the future be sponsoring others in Narcotics Anonymous? Does this mean that people may concurrently or sequentially combine addiction medications with participation in abstinence-based treatment and mutual aid? Does this mean that one’s secular, spiritual, or religious orientation may change, sometimes quite dramatically, over the course of recovery? YES, it means all of these and far more. As my friend Richard Simonelli suggests, these support options are best conveyed, not as a straight line of menu options, but as resources on the perimeter of the circle of our lives—resources that remain available to us if and when we need to draw on them.
Long-term recovery involves a rebirthing and assertive reconstruction of one’s life across multiple zones: physical, cognitive, emotional, relational, and spiritual health—all unfolding and evolving across the stages of life and within one’s unique personal responsibilities and aspirations. Achieving such reconstruction over time and maintaining balance within and across these zones is for some people far closer to improvisational jazz than to playing scored music written by one’s predecessors.
None of us are in a position to judge how others negotiate this process. We can only share what has worked for us and how what has worked for us has changed over time and circumstances. As a healing community and network of professional helpers and recovery researchers map long-term pathways and styles of recovery, we must not forget those whose recovery experiences do not fit within the boxes we have crafted to depict such varieties of recovery experience. Those outliers are also part of the recovery community, and their idiosyncratic stories must also be heard and celebrated. Many find recovery within a well-trod path, while others find recovery on the road less traveled. Still others will find recovery where no one has traveled before. Such differences do not need to be cast into categories of superiority and inferiority. All progressive movements toward and within recovery are cause for celebration–no matter how different the journey from our own.
A shared experience of addiction is a hollowing out of self, with the resulting sense of extreme emptiness, disconnection, and resulting sense of extreme isolation. How people authentically fill that emptiness and forge new social and intimate connections constitutes the essence of a highly variable healing process. Such varieties are indeed a cause for celebration. As the recovery advocacy movement declares: Recovery by any means necessary under any circumstances.
Post Date June 3, 2016 by Bill White