ADDICTION, RECOVERY, AND PERSONAL CHARACTER – Bill White- February 16, 2018


The devastating effects of addiction on physical/emotional health and social functioning have been meticulously catalogued, but far less attention has been given to its toll on character and the role character reconstruction plays in the recovery process. A recent rereading of David Brook’s The Road to Character has spurred this reflection on character and addiction recovery.

All diseases have the potential to distort character—particularly in shrinking one’s world to a state of near-complete self-absorption (as observed by Samuel Johnson in 1783). But addiction is unique within the annals of medical disorders in the extremes to which one’s unique essence is distorted as the disorder progresses. By radically reordering personal priorities, addiction ultimately sacrifices all other personal commitments and aspirations to serve this higher need. It shrinks one’s world and hollows one out, leaving only this insatiable need and the painful consequences of serving it as the center of one’s self.

Addiction medicine—actually all medicine—is ill-equipped to address such pathologies of character and to fill the void once drugs are removed from the center of an addicted patient’s life. The person seeking addiction recovery is left with this same challenge: How does one escape such chemically-induced narcissism within a culture that, not just worships the self, but has itself become a “selfie culture.”

This dilemma is well-illustrated by distinctions between the terms remission and recovery. The former term is used in medicine and clinical research to depict the amelioration of addiction. In short, it says the patient once met, but no longer meets, the diagnostic criteria for a substance use disorder. Remission is further specified by duration of symptom suppression, e.g., early remission (3 months not meeting diagnostic criteria) or sustained remission (more than a year not meeting such criteria). Remission does not necessarily mean that alcohol or other drug (AOD) use has ceased or that all related problems have disappeared, only that any remaining use or problems are now below the threshold of diagnosis. Remission eliminates or reduces AOD problems to subclinical levels but may leave the remitted patient with an overwhelming sense of emptiness and disconnection.

In contrast, the term recovery, used more frequently by those with lived experience of having survived addiction, is often used to suggest a process of change far beyond the removal of alcohol and other drugs from an otherwise unchanged life. It depicts the process of moving through and beyond remission to refill oneself, develop depth of character, and propel one towards relationships and contributions that reach beyond the self. In some recovery circles, remission without “recovery” is even castigated as a shallow level of achievement (e.g. a “dry drunk” lacking “emotional sobriety”). In such circles, remission is viewed as the temporary suppression of symptoms (a process of subtraction) where recovery is viewed as the process through which the surviving person is transformed (processes of addition and multiplication).

Remission can be an act of self-assertion; but recovery, this larger achievement of global health and functioning, often comes through an embrace of one’s limitations and transcendence of self. It involves the acceptance of one’s brokenness (discovering in Kurtz and Ketcham’s language, the spirituality of imperfection); the practice of restraint and moderation in our thoughts, feelings, and actions; and finding a purpose for one’s survival. Recovery in this view requires replacing the “I” language of alienation with the “we” language of human connection—shedding the “selfie culture” and embracing a culture of humility, tolerance, interdependence, and community. It involves, as David Brooks suggests, shifting the focus from the exclusive needs of self to needs of the world, e.g., reframing the question, “What do I want from life?” to “What does life want from me?”

Awareness of imperfection and limitation allows us, through becoming “strong in the weak places,” to use adversities of character to build depth of character. Such depth is about far more than character reconstruction as a monument to self-fulfillment; it is about character in service to the larger needs of the world. To achieve this shift, Brooks suggests the need for “redemptive assistance”—resources beyond the self. The courage to face one’s empty self and the humility to reach out to others are the first steps in seeing ourselves not as the center of the universe and instead discovering how our small story fits into a much larger story. To recognize our brokenness and to heal in this way turns adversity and suffering into a transcendent purpose or sacred calling—finding our place within the arch of history and committing ourselves to “tasks that cannot be completed in a single lifetime” (p. 264).

Such a process requires something quite different than getting “into ourselves” through therapies rife with intrapersonal self-exploration and whose aims are to increase self-knowledge, self-esteem, and self-expression. It may instead require two quite different processes: 1) cultivating self-skepticism, humility, and tolerance; and 2) getting out of ourselves, e.g. seeking resources, relationships, and service activities beyond the self. The former strategy requires recognizing our flawed nature and quieting the roar of our own ego to the extent that we can actually listen to and experience other people—what at its best Brooks calls a “ministry of presence.” The latter strategy involves transforming recovery into a heroic journey that serves a larger purpose, while maintaining distrust of self and avoiding turning even the most righteous cause into a vehicle for self-adulation.

Extreme narcissism, self-will run riot in language of Alcoholics Anonymous, is the essence of addiction regardless of whether one sees this trait as a cause or consequence of addiction, regardless of whether that entrapment in self is manifested in grandiosity and acts of exploitation or in self-hatred and self-harm. It is a paradoxical entrapment that combines self-absorption and self-inflation on the one hand with self-hatred and deteriorating self-care on the other. Escaping these Janus faces of addiction may require the shift from getting deeper into oneself to finally getting out of oneself. That journey from the abyss to the world is what builds character. That journey is the essence of recovery and what distinguishes recovery from remission. We are learning a lot about the prevalence and pathways of remission through advances in addiction research; the processes of recovery have yet to fully arrive as a subject of scientific investigation. Many of our addiction treatments, including an expanding menu of medications, can facilitate remission; few of those treatments offer hope for the long-term process of character reconstruction to achieve recovery. Men and women seeking the latter must look to other contexts for such support.

Post Date February 16, 2018 by Bill White

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A Counselor and Patient in Long Term Recovery

A Counselor and Patient in Long Term Recovery
Out of the shadows-By Jamie Lebish BS, CADC, RC
What would life and work be like for a long-term MAR (medication assisted recovery) patient, whom is also a drug and alcohol counselor? Stigma dictates that life would not ever be predictable. Logic dictates that there will always be barriers.
Imagine going through part of your life addicted to opiates, by no choice of your own, but everyone still thinks to themselves differently, perhaps with distaste. ‘You made bad choices’.
Imagine actually getting better, becoming clean and having to use a medication to stay clean. This is called MAT or medication assisted treatment. There are millions of us around the world at this very moment.
Now, imagine that you have made it through almost 10 years of recovery and trying your best to go from methadone (oh no! not methadone) to Suboxone. “Not only have some of you stopped reading, but others still have that uncomfortable pit in your throat”. I know. I am one of you and I am one of them. Long term Suboxone patients that are not able to taper lower than 2mgs. There is science behind this Long Term recovery phenomenon.
I am a person that lives in a divided world. One in which some would say, counselors don’t use Suboxone, and certainly not medical marijuana. But we do exist. Not only exist but thrive, and have a true passion for life and helping others get better. We as counselors in recovery know what it is like to be addicted to opiates, and better yet, we know that you can get better. We believe in you.
There is no road map for life, and there certainly is no road map to recovery from Drugs, alcohol or any other addition. You have to want to get better and you find a path that works for you. That is what I did to get better. Along the way many people in the rooms (AA/NA), and in treatment said that “if you want to recover you have to do X, Y and then Z. Well, real recovery does not happen quite like that. To get right with yourself is the hardest part, because you have already written yourself off. Becoming human and learning to like yourself again.
I have to tell you that recovery is not a secret, and most of us that get better, find a path that works for them. The first thing that I did want was; to not have to take opiates as a medication for pain ever again. I am terrified of opiates, as I was in a horrific auto accident and spent 1 month in hospital (the start of my addiction to opiates), and when I started to get older, pain from arthritis came in. I learned to use every alternative, but take opiates. That is where Medical Marijuana came in. For me, it is a vastly safer and effective as an anti-inflammatory and mild pain reliever, and a very effective anti-anxiety alternative. Certainly, you get that? No?
Ok, so I may have to get some more qualifiers in this text for you to believe me, but in the 19+ years since using any illegal narcotics or alcohol, I can safely say that I am a good human being, and I am a good counselor, and I get it. If you or anyone you know who is struggling with addiction, or the stigma associated with MAR or MMJ, please comment on this blog? Let’s get a conversation going for the rest of us that want to come out of the shadows. I am sick of hiding.
We are effective, high-quality people that deserve to live and work alongside others without hiding, and wondering why some of you think it’s ok to drink and drive, instead of relief through MMJ. That’s a whole other debate. If you want to change the status quo, we need to effect change. Leave your comment and let’s talk?

January 12, 2018 -Bill White- RECOVERY SUPPORT FOLLOWING OVERDOSE OR OTHER MEDICAL EMERGENCIES (BILL WHITE, REBECCA ALLEN, AND PHIL VALENTINE)


Missing in the media coverage of the unrelenting legions of drug overdose deaths in the United States is an equally important but less heralded story. What subsequently happens to people who experience a drug overdose but are successfully rescued through emergency medical intervention? What is their fate after they leave the hospital or other emergency care setting? New grassroots recovery community organizations (RCOs) are collaborating with first responders and hospitals to influence such outcomes.

The Connecticut Community for Addiction Recovery (CCAR) is one of several hundred recovery advocacy and recovery support organizations (RCOs) rising on the American landscape in the last two decades. One of the first RCOs, CCAR pioneered what have since become standard RCO service fare: recovery-focused professional and public education, legislative advocacy, recovery community centers, recovery celebration walks and conferences, recovery support groups, training for recovery home operators, face-to-face and telephone-based recovery support services, family-focused recovery education and support services, and collaboration with research scientists on the evaluation of the effects of peer support on long-term recovery outcomes. As an example of its reach, CCAR’s Recovery Coach Academy curriculum has been used in the training of more than 20,000 recovery coaches in more than 33 states and in such countries as Sweden, Vietnam, Canada, and Spain.

CCAR began piloting an Emergency Department Recovery Coach (EDRC) Program in March of 2017. Through this program, CCAR-trained recovery coaches are on-call for hospital emergency rooms to offer assistance to patients and their families during an emergency room visit resulting from an adverse drug reaction or other alcohol- or other drug-related medical crisis. An evaluation of EDRC services provided between March and November 2017 within four collaborating hospitals revealed the following. CCAR-trained recovery coaches provided recovery support services to 534 patients/families during the 8-month evaluation period with a relatively even distribution of services provided across the four hospitals. Of those served by the EDRC, the majority were in the ER due to an alcohol- or opioid-related condition; 70% were male; and 5% were seen more than once during the evaluation period. Most importantly, of the 534 people interviewed, 528 were assertively linked to a detoxification program, inpatient or outpatient treatment, or community-based recovery support resources.

A more formal and sustained evaluation of the EDRC program is underway in collaboration with Yale University, and the program is now being expanded to an additional four hospitals. Funding support for the EDRC comes from the Connecticut Department of Mental Health and Addiction Services through support of the federal block grant and a Targeted Response to the Opioid Crisis Grant from the Substance Abuse and Mental Health Services Administration.

CCAR’s EDRC program has many distinct features worthy of replication and local refinement. Among the more striking of such features are the following.

* The EDRC program is governed by a formal agreement between CCAR and each participating hospital that delineates the roles and responsibilities of each party.

* The EDRC program is currently staffed by one Recovery Coach Manager and 9 full-time Recovery Coaches (RCs).

* Emergency Department Recovery Coaches (EDRCs) are recruited and screened (2 interviews with background and reference checks) based on desired experience, skills, and a good work history, but also for what our EDRC manager, Jennifer Chadukiewicz, calls “a servant’s heart.”

* All EDRCs go through more than 60 hours of training and spend the first weeks shadowing tenured EDRCs. The training includes the CCAR Recovery Coach Academy© (30 hours) as well as topical trainings, e.g., Narcan (naloxone administration), medication-assisted recovery, ethical decision-making, crisis intervention, and conflict resolution. Hospital specific training includes such areas as fire/general safety, OSHA, blood borne pathogens, infection control, hazardous materials, and HIPPA regulations.

* EDRC Recovery Coaches are employed by CCAR rather than the hospitals and enter the hospitals as service vendors and “guests” who defer to leadership of ER staff.

* The RCs are paid a livable wage ($20-$25/hr. to start plus benefits, health insurance, etc.) that allows them to work full time and support themselves and their families while affording time away for rest and self-care.

* EDRC coverage is provided from 8 am to 12 midnight, seven days a week, 365 days a year.

* Patients have the option of enrollment in enhanced Telephone Recovery Support (TRS) program (i.e., patients receive daily support calls for the next 10 days and then weekly if desired).

* EDRC’s provide assertive linkage and transportation (when needed) to treatment and recovery support resources.

* The EDRCs spend considerable time with community providers and other stakeholders building collaborative relationships that facilitate this patient referral and service linkage process.

* CCAR provides each hospital emergency department with “prescription pad” style resource handouts that can be attached to discharge paperwork and given to patient friend/family member.

There are critical windows of vulnerability and opportunity within addiction and recovery careers that serve to plunge one deeper into addiction or mark the catalytic beginning of a recovery process. The reversal of a drug overdose or treatment of other drug-related medical crises can constitute a recovery tipping point.

The emergency room is not the only critical point of potential intervention to reduce the risk of drug-related deaths and to promote addiction recovery. For persons with a history of addiction, the days and weeks immediately following release from a correctional facility, release from an inpatient or residential detoxification/treatment program without medication support, or cessation of medication-assisted treatment, and even transfer from one medication-assisted treatment provider to another all constitute a zone of heightened risk for re-initiation of risky drug use and death. Altering such risks and tipping the scales toward recovery stabilization, recovery maintenance, and enhanced quality of personal/family life in long-term recovery should be the goals of every community. Recovery community organizations like CCAR are showing us how this can be done.

Post Date January 12, 2018 by Bill White

December 29, 2017 -Bill White- A YEAR-END NOTE OF GRATITUDE


We have covered a lot of territory within the more than 50 communications we have shared in 2017. From concerns about troubling directions in national drug policy to the prevalence, pathways, styles, and stages of personal/family recovery; we have taken time each week to explore critical issues related to addiction recovery.

When this weekly recovery blog debuted in 2013, my hope was that it would provide a forum through which I could continue to communicate with addiction professionals, recovery advocates, and people in recovery. I had just been forced by advancing age and health limitations to end decades of traveling and speaking about addiction treatment and recovery. This recovery blog was one more morphing of my role within this special ministry begun nearly half a century ago. I hoped the blog would provide a platform of continued connection to people across the country and the world. The communications that have flowed from this effort have far exceeded my expectations. Thanks to each of you for taking the time to read my words and reflect on their meaning to your life and service activities. Your presence and expressions of appreciation have warmed an old man’s heart.

I would be remiss if I did not also offer a special thank you to those who emailed or posted notes of appreciation and photos of tagged pages and yellow highlighted passages from my recently-released book, Recovery Rising. This book was quite personal and unlike anything I had attempted before, and I was unsure whether the story/reflection format would find an appreciative audience. The release of a book (or a blog) is like an election; in spite of your hopes and the best predictions of others, you never know the outcome until the votes are in. Thank you to all of you who “voted” for Recovery Rising by reading and talking about it with friends and colleagues.

Most importantly, I want to share my gratitude for those of you who continue to work every day on the front lines of addiction treatment, recovery advocacy, and recovery support. You are my heroes, and it is your compassion and commitment I have tried to honor through my writings. Many years ago, I called on a new generation of activists with the words, “Let’s go make some history.” You/we have indeed done that. The world of recovery today is beyond anything I could have imagined when I began this journey. There is much work yet to be done, but, at this closing of the year, let us pause to reflect with gratitude on all that has been achieved and the lives touched and transformed through that process.

Post Date December 29, 2017 by Bill White

December 22, 2017 -Bill White- CONTINUITY OF RECOVERY SUPPORT VS. REPLICATION OF ABANDONMENT (BILL WHITE AND JASON SCHWARTZ)


Many people enter addiction treatment in the United States with abuse, abandonment, and loss as central thematic threads within their lives. Such experiences distort one’s self-perceptions (e.g., “I am not worthy of love and respect”), diminish one’s capacity to trust (e.g., “Everyone I love will either abuse or abandon me”) and impede one’s ability to initiate and sustain healthy relationships. The clinical antidote to such wounds has long been posited as a “corrective emotional experience” in which the person, through a helping relationship marked by safety and trust, is able to redefine themselves and their view of the world. In reality, the helping relationship can either achieve such redefinition or reconfirm this self-limiting view of self and the world. So what does all this mean for the provision of addiction treatment and recovery support services? Here are five beginning reflections on this question.

Effectively treating people with histories of abandonment and loss requires a time-involved process of testing and engagement. Arbitrarily brief treatment and abrupt relationship terminations (driven by considerations of cost over quality of clinical care) inadvertently confirm self-limiting views of self and the world by replicating the experience of abandonment and loss within the context of professional care at a time the embryo of trust is often just forming. Acute care models of addiction treatment can unwittingly replicate earlier trauma, with each episode of treatment decreasing one’s future capacity to enter into a transformative helping relationship. Continued replications of abandonment within these acute interventions often breed self-defeating styles of relating to those in professional and peer helping roles. In contrast, models of sustained recovery management offer some hope for continuity of support by affording time to work through this testing and relationship building process.

Effectively treating people with histories of abandonment and loss may require continuity of relationship support spanning multiple levels of care and episodes of care. This proposition challenges what have been standard practices in many addiction treatment programs, e.g., refusing to readmit people who resumed alcohol and other drug (AOD) use following one or more earlier treatments, assigning a new primary counselor each time a patient is readmitted, or discharging individuals for behaviors that test the helping relationship.

Also of concern is how people with histories of abandonment and loss can be effectively treated within a system whose workforce is constantly turning over. Such workforce transience is not conducive to quality of clinical care and makes continuity of support impossible for those with the most severe, complex, and chronic substance use disorders. If sustained relational engagement is an essential ingredient in successful addiction treatment, then we as a system of care are failing to meet that challenge. At present, of nearly 1.5 million people annually admitted to addiction treatment in the U.S., only 43% successfully complete treatment. (More than 380,000 leave against staff advice and more than 106,000 are administratively discharged—most for confirming their diagnosis via continued or resumed AOD use.)

Transitions in relationship support of people with histories of abandonment and loss risk rapid clinical deterioration, resumption of excessive drug use, and increased risk of death. Multiple studies (see here for review) confirm that the period of highest risk for post-treatment resumption of drug use is immediately following discharge from a level of care, with most addiction recurrence beginning in the days and weeks following loss of the clinical support relationship. Such abrupt transitions are inherent as an endpoint in the dominant brief models of acute care, but they are also common within these models. The person entering addiction treatment is too often rapidly transitioned from person to person without a single point of relational continuity. Screeners and intake workers give way to a primary counselor and a host of allied roles that can change mid-treatment and with every movement from one level of care to the next. Every passing of the service torch is, in actuality, one more replication of abandonment and loss. Current efforts to integrate recovery coaches within acute models of addiction treatment are, in part, an effort to assure some degree of continuity in what is otherwise experienced as a relay race—conveying the feeling that one is being processed on a fast-moving assembly line.

A just published study by Bogdanowicz and colleagues underscores the high stakes involved in such relationship transitions. Their study examined the risk of death for patients in medication-assisted treatment during their transfer from one program setting to another. Bagdanowicz and colleagues found that patients in medication-assisted treatment transferred to another treatment provider experience increased overdose mortality risks, particularly within the days immediately following the transfer. Earlier studies of all forms of treatment found increased rates of drug use and death following treatment dropout and immediately following planned discharge from treatment, but no earlier study has so definitely focused on the risks of transition within the process of continued treatment. All relationship transitions within the early stages of addiction recovery constitute zones of risk for recovery destabilization. Such transitions must be minimized and assertively managed via increased monitoring and support.

People with histories of abandonment and loss may find it easier entering into relationship with a community of shared experience than the more emotionally risky relationship with a single professional helper. But such communities require great care in their creation and maintenance, particularly when nested within formal service organizations that can drift towards cold hospitality. As Christine Pohl suggests: There is a kind of hospitality that keeps people needy strangers while fostering the illusion of relationships and connection. It both disempowers and domesticates guests while it reinforces the hosts’ power, control, and sense of generosity. It is profoundly destructive to the people it welcomes. In the field of psychiatry, this has come to be christened “sanctuary harm.” When we seemingly do all the right things with a spirit that emphasizes our virtue and the pathology and neediness of those we serve, we inflate ourselves as we deflate those who seek our help. In making them feel small and incapable, we feed hopelessness in the name of hope.

In contrast, The Book of Life describes how. . . the warmly polite person is always deeply aware that the stranger is (irrespective of their status or outward dignity) a highly needy, fragile, confused, appetitive and susceptible creature. And they know this about the stranger, because they never forget this about themselves. Such warmth and empathic identification are built upon our own prior experiences of pain, fear, anguish, hopelessness, confusion, vulnerability, and loss. The former is a noisy hospitality that focuses on the value of the host; the latter quietly focuses on the hidden assets masked by the immediate vulnerability and needs of the guest.

Riane Eisler, in The Chalice and the Blade, has characterized the former style of helping as a dominator relationship model and the latter a partnership relationship model. Achieving the latter requires that traditionally-trained professionals step out of their more detached comfort zone to embrace the value of mutuality and rethink professional boundaries of self-disclosure and personal vulnerability. It also requires a deep understanding of the role of community in recovery.

Effectively treating and supporting people with histories of abandonment and loss requires the creation of what Sandra Bloom has christened healing sanctuaries or what Don Coyhis has depicted as a healing forest. Ernie Kurtz and Katherine Ketcham have described such healing environments and the experience of finally “being-at-home.”

Some places are more conducive to this experience than others. But wherever and whenever we do attain the sense of “being-at-home,” we experience a falling away of tension, a degree of balance between the pushing and pulling forces of our lives. In such a place, we can cease fighting—most important, we can cease fighting with ourselves….Home, then, is the place that is like our pelt, our skin, our hide, in that it is that which covers us less in a concealing than in a protective way….It is the place where I can be naked, which is to say vulnerable—undefended against being wounded because of confidence that I will not be wounded. Or that if I am wounded, that I will also be healed. (Kurtz & Ketcham, 1992, p. 237).

Treating and supporting addiction recovery among people with histories of abuse, abandonment and loss requires, time, safety, systems stability, continuity of support, and community—a place to “be-at-home.” Assuring these ingredients will require moving from a focus on brief clinical micro-interventions to forging healing communities within and beyond the walls of addiction treatment and recovery mutual aid societies.

Post Date December 22, 2017 by Bill White

December 15, 2017 -By Bill White- FAMILY RECOVERY 101


Knowledge about the effects of addiction on families and the family recovery process has grown exponentially as a result of scientific studies and cumulative clinical experience. Among the most important conclusions to date that can be drawn from this body of knowledge are the following.

1. Alcohol and other drug (AOD) problems spring from diverse influences; unfold in widely varying patterns of severity, complexity, and duration; and are resolved through multiple pathways and styles of personal and family recovery.

2. The effects of addiction (a generic term used for the most severe patterns of AOD problems) on the family are influenced by the role of the addicted person within the family, the timing of addiction within the family life cycle, the degree of co-occurring challenges faced by the family, the cultural context within which the family is nested, and the resilience resources and recovery capital available to the family.

3. Addiction can be transmitted intragenerationally and intergenerationally via multiple, interacting mechanisms. These mechanisms include the following: a) genetic and neurobiological influences (e.g., those with family histories of addiction are at increased biological risk of developing a substance use disorder), b) assortative mating (i.e., the propensity of individuals to select intimate partners with shared family and developmental experiences) intensifies both biological risk and substance use as a preferred coping mechanism), c) parental/sibling/spouse modeling (i.e., substance use as a learned behavior and one potentially initiated and coached through the influence of other family members), d) adverse childhood experiences with multiple traumagenic factors (e.g., early trauma, multiple episodes and duration of trauma, more boundary-invasive forms of trauma, multiple perpetrators, perpetrators drawn from family or trusted social network, failure of belief and protection when trauma is disclosed), d) historical trauma (e.g., such as that experienced by Native American tribes), e) early onset of AOD use (early onset increases risk of addiction, greater problem severity, more rapid problem progression, and a longer course of problem resolution), and f) environmental factors (e.g., drug-saturated neighborhoods, social promotion of excessive AOD use). In short, the addiction of one family member increases the risks of addiction in other family members; addiction in past and present generations increases the risks for addiction and related problems in future family generations.

4. Family roles, rules, rituals, and relationships; the frequency and quality of family interactions with kinship and social networks; and the global health and functioning of family members are all severely disrupted by addiction. These effects can be far-reaching, with effects on children carrying into their adult development, including their future intimate and family relationships. (See interviews with Claudia Black, Stephanie Brown, Sharon Wegscheider Cruse, and Jerry Moe)

5. The adaptations families make to survive the immediate threats of addiction enhance short-term safety and emotional survival of family members and lower threat of family dissolution, but also constitute roadblocks to long-term personal and family recovery.

6. With proper coaching and support, families can play a catalytic role in recovery initiation and maintenance of the addicted family member and the family as a whole. (See interview with Robert Meyers)

7. The recovery of affected family members can begin prior to the initiation of recovery by the addicted family member. The improved health of affected family members increases pressure for change in the addicted family member. Strategic actions can be taken by families that increase opportunities for recovery initiation.

8. Family-focused addiction treatment and recovery support services generate recovery outcomes superior to treatment focused solely on the addicted person.

9. Recovery can destabilize family relationships if families are not provided ongoing support through the recovery process. According to the research of Dr. Stephanie Brown, addiction-affected families in recovery need “scaffolding” of support to manage the transitions from active addiction to stable recovery. Lacking such support, families that absorbed and survived every addiction-related insult may be fractured (i.e., family dissolution) during the recovery process.

10. With support, families can achieve a level of health and functioning superior to that which existed before the family was impacted by addiction. Addicted individuals and their families have the potential to get “better than well.”

11. With support (including the options of peer and professional support services), families can heal and break intra- and intergenerational cycles of addiction and related problems. (Recovery of one family member increases the probability of successful recovery of other family members. See Here.) Families that lose a family member to addiction also need a recovery process—a process that can be enhanced through peer support and professional guidance.

12. Individuals and families in recovery can play a larger role in healing communities wounded by addiction via their support of others affected by addiction, their recovery advocacy activities, and larger service to their communities.
It is time—no, past time—that the basic unit of service within recovery support service settings shifted from the individual to families and kinship networks. Making that shift will require substantive changes across the addiction treatment and recovery support service continuum.
Coming Soon: Couple Recovery

Post Date December 15, 2017 by Bill White

December 8, 2017 -By Bill White- THE KARMA OF RECOVERY


The concept of karma holds that one’s fate in this life or future lives is not a random roll of the dice, but a direct product of one’s thoughts and actions. Rooted in many of the great religions and a central motif within Hinduism, Buddhism, and Jainism, karma is mistakenly confused in popular culture with the idea of good or bad luck. In contrast, karma suggests the presence of a universal principle of justice–that the decisions one makes or the actions one takes or fails to take have inevitable consequences. This principle can be found in many popular aphorisms:
You reap what you sow.
Violence begets violence.
They that sow the wind shall reap the whirlwind.
What goes around comes around.
Chickens come home to roost.
You get what you give.
Those who live by the sword die by the sword.
The principle of karma poses an interesting dilemma for people initiating recovery from addiction: How does one atone for the injuries one’s addiction-shaped actions and inactions inflicted upon others and the community at large? How does one balance the karmic scales to escape the whirlwind?
Most enter recovery with a karmic burden. Harm to others is a near-inevitable and -universal dimension of addiction—a progressive process of relational disconnection and self-absorption. Addiction, by definition, involves a prioritization of the drug relationship above all other aspirations, needs, commitments, and responsibilities. It is thus little wonder that the person at the doorway of recovery is haunted by ghosts of past harmful acts of commission or omission. The oppressive weight of guilt (I have done bad things) and shame (I am a bad person) can lead to self-sabotage for those who feel unworthy of the gifts of recovery. Such baggage must be shed to achieve sustained recovery and a reasonably fulfilled life.
It is common for people on the threshold of recovery to face resentment or rage from shredded promises; confront disappointment, distrust, and disdain in the eyes of others; and fear a backlog of consequences that could come at any time—all while experiencing cellular screams for anesthesia or stimulation. The question then becomes, “How does one step out of such quicksand into sustainable recovery, restore personal sanity, and repair relational trust?” Early Native American recovery circles, the Washingtonians, Fraternal Temperance Societies, Ribbon Reform Clubs, institutional support groups (e.g., Godwin Association, Keeley Leagues), Alcoholics Anonymous and other 12-Step programs, and the growing menu of secular and explicitly religious recovery mutual aid groups have all addressed this question.
Where some groups focused solely on achieving sobriety, on the assumption that with continued sobriety these broader concerns would take care of themselves, most recovery mutual aid groups, particularly those embracing religious and spiritual frameworks of recovery, emphasize the need for character reconstruction and restorative actions within the recovery process. Looking across such frameworks over a span of two centuries, one finds a consistent menu of suggested remedial steps aimed at balancing the karmic scales:
1) unflinching identification of harmful thoughts, feelings, actions, and inactions (self-inventory, humility);
2) private or public ownership of such harm (contrition, confession, self-forgiveness);
3) making amends to those harmed (restorative justice); and
4) unpaid acts of service to others and the community (generic restitution, gratitude, compassion, generosity, story reconstruction, and storytelling).
Accompanying such recommended actions have been admonitions that such actions be taken slowly, deliberately, repeatedly, and with the support of a community of shared experiences and aspirations. The message across generations is: The lived testimonies of millions of people in recovery suggest that positive changes in character and the quality of one’s relationships are both possible and common within the recovery process. The karmic baggage of active addiction can be progressively shed in recovery and replaced by a different kind of karma—one bearing the promises and gifts of long-term recovery. When the latter is achieved, people who were once part of the problem emerge as a vibrant part of the solution by balancing the karmic scales and becoming wounded healers and recovery carriers. Recovery pathways are also pathways of reconciliation.
Post Date December 8, 2017 by Bill White