BLOG & NEW POSTINGS January 22, 2016Bill White TOWARD A RECOVERY ECONOMY

Is it time for economic development as a central strategy of the new recovery advocacy movement?

Liberation movements to alter the cultural status and global health of historically marginalized groups must inevitably forge pathways of inclusion into the mainstream economy or build alternative systems of economic participation. These twin strategies achieve many goals. They reduce the marginalized groups’ vulnerability for economic exploitation by the dominant culture. They break the marginalized community’s dependence upon the financial largesse of the dominant culture. They weaken illicit underground economies that undermine personal and community health. They expand opportunities for licit economic development, forging new community institutions and leaders that enhance the resilience of individuals, families, and neighborhoods. They provide opportunities for meaningful work and community service. And they elevate community cohesion and an ethic of mutual aid, e.g., “We each rise when all rise.” When successful, these strategies elevate the esteem and status of marginalized groups and counter the personal and collective stigma that limits one’s sense of possibilities. In the United States, economic development has been an essential component of social movements that have worked to alter the status of communities of color, migrant workers, women, persons with disabilities, and the LGBT community.
This raises a series of provocative questions.
Is it time for people in recovery to rise above divisions of age, gender, gender identity, race and ethnicity, sexual orientation, political and religious affiliations, past drug preferences, and diverse pathways of recovery to experience their larger oneness? Is it time for people in recovery of all stripes to recognize their membership in an ecumenical culture of recovery—recognize themselves as a people—with a shared history and future that transcends their identification or lack of identification with a particular recovery mutual aid group?
Is it time the organized recovery advocacy community more aggressively challenged the addictions service industry to politically and financially support recovery-focused public and professional education and the expansion of local non-clinical recovery support services? Addiction-related treatment, research, educational, and peer certification/licensing bodies are drawing financial capital and other resources from the recovery community; are they returning financial capital and other forms of support to the recovery community to enhance its economic and cultural development?
Is it time recovery advocacy organizations exposed and legally and legislatively challenged discriminatory practices that affect the hiring, retention, and advancement of people in recovery within the nation’s workforce?
Is it time we moved beyond “We recover!” declarations to assert that we also vote, work, pay taxes, volunteer, AND patronize local businesses with financial resources that no longer feed licit and illicit drug industries?
Is it time we recognized the immense size of this community and the potential to carry recovery through our collective buying power? Is it time recovery-generated dollars were spent whenever and wherever possible to support recovery community institutions, recovery-friendly businesses, and people in recovery?
Is it time local recovery community organizations (RCOs) created an Honor Roll of recovery-friendly workplaces and encouraged members of the recovery community to patronize these businesses?
Is it time we created an alternative economy—alternative to the mainstream and illicit economies—to support the employment of people in recovery who face multiple obstacles to economic self-sufficiency, e.g., age, minority status, limited education, past incarceration, limited or stained licit employment history, or chronic health challenges?
Is it time local RCOs served as incubators for small business development organized by and employing people in recovery?
Is it time philanthropists in recovery and others affected by addiction created rotating loan funds to help people in recovery start their own businesses?
Is it time for people in recovery from diverse occupations to mentor people in recovery who seek entry into or advancement within those occupations?
Is it time to create scholarship funds to support people in recovery seeking technical, college, or post-graduate education?
Yes! It is time!

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Updates from William L. White | Blog Blog & New Postings In the 01/09/2016 edition:

“The best way to predict the future is to create it.” –Peter Drucker

In 2003, Dr. Tom McGovern, the distinguished Editor of Alcoholism Treatment Quarterly, and I published an article offering some predictions on the future of alcoholism treatment in the United States. In spite of our long tenure as students of addiction treatment history, we did so with the full realization that those who have risked making such predictions in the past often made fools of themselves. A dozen years later, it seems a good time to revisit those 22 predictions.
Infrastructure and Cultural Context
Prediction 1: The federal/state/local partnership created by the Comprehensive Alcoholism Prevention and Treatment Act of 1970 (known as the Hughes Act) will be challenged by the growing restigmatization, demedicalization and recriminalization of severe alcohol and other drug problems.
Prediction 2: The federal investment in an alcohol problems research infrastructure will reap significant rewards in the coming decades.
Organization
Prediction 3: The integration of the treatment of alcohol and other drug problems–arguably one of the major professional achievements or (according to some) the worst mistake of the past 25 years–will progress in the next decades with a full integration of the treatment of nicotine addiction alongside the treatment of other drug addictions.
Prediction 4: The categorical segregation of the treatment of alcohol problems will be severely challenged in the next two decades as alcohol treatment programs are absorbed into larger umbrellas of “behavioral health” and “human services.”
Problem Definition
Prediction 5: Multi- pathway models of understanding and intervening in alcohol problems will replace more traditional, single-pathway models.
Prediction 6: The next two decades will witness attempts to integrate the emerging public health and medical/clinical models of understanding and responding to alcohol problems.
Changing Characteristics of Treatment Consumers
Prediction 7: Differences between community and clinical populations will widen with the multiple problem client/family (greater problem severity and psychiatric co-morbidity and fewer recovery assets) becoming the norm within publicly funded treatment programs.
Prediction 8: Escalating life expectancies and the demographic aging of the “war babies” will spark growing concern about the problem of late-onset alcohol problems.
The Professionalization of Treatment Providers
Prediction 9: The recognition of addiction medicine as a recognized specialty will continue, but will be offset by greater involvement of primary physicians, physician assistants, and nurse practitioners in the treatment of alcohol problems.
Prediction 10: The continued professionalization of the role of the addiction counselor (e.g., the licensure movement) will be balanced by new roles (recovery coaches, recovery support specialists) that will bring greater numbers of recovering people back into the field.
Prediction 11: Professional roles in the field, dominated by men when the first issue of ATQ was published, will be increasingly filled by women.
Treatment Technology
Prediction 12: The organizing mantra of the next decade will be the call to bridge the gap between clinical research and clinical practice in the resolution of alcohol problems.
Prediction 13: The next decade will witness the widespread application of disease (recovery) management technologies from primary medicine to the treatment of severe and persistent alcohol problems.
Prediction 14: Research findings will compare and contrast explicitly religious and spiritual frameworks of recovery from explicitly secular frameworks.
Prediction 15: There will be a movement to push the breakthroughs in knowledge about special populations of clients from the enclave of the demonstration project to the mainstream of the field.
Professional Ethics
Prediction 16: There will be a significant movement in the next decade to get the treatment field ethically re-centered.
Prediction 17: New roles that focus on harm reduction, pre-treatment/engagement, and sustained recovery support will call for a re-evaluation of traditional definitions of appropriateness related to ethical conduct, particularly those governing relationship boundaries.
Recovery and Community
Prediction 18: The treatment field will face in the next decade what it has never faced in its history: a strong consumer/constituency movement.
Prediction 19: The locus of treatment will expand beyond the institutional/office environment to the natural environment of each client.
Prediction 20: There will be increased demands for the field to shift its research focus from one of pathology to one of resilience and recovery.
Prediction 21: The growing “varieties of recovery experience” will continue to manifest themselves within the growing diversification of mutual aid structures.
Achilles Heel: The Aging of the Field
Prediction 22: The rapidly approaching loss of long-tenured clinical and administrative leaders will constitute one of the most significant challenges to the future integrity and existence of the field.
I will leave it to the reader to judge the accuracy of these predictions now that years have passed since they were formulated. What would your predictions be for the future of addiction treatment and recovery during the next 20 years?
Post Date January 8, 2016 by Bill White
Categories Articles
Tags Addiction treatment | alcoholism treatment | predictions

BLOG & NEW POSTINGS January 1, 2016 – Bill White – NEW RECOVERY ADVOCACY MOVEMENT BASICS


Definition The New Recovery Advocacy Movement (NRAM) is a social movement led by people in addiction recovery and their allies aimed at altering public and professional attitudes toward addiction recovery, promulgating recovery-focused policies and programs, and supporting efforts to break intergenerational cycles of addiction and related problems.
Historical Context The NRAM rose in the late 1990s in reaction to the increased demedicalization, restigmatization, and criminalization of alcohol and other drug (AOD) problems and the resulting cultural pessimism about the prospects of long-term addiction recovery. New grassroots recovery community organizations (RCOs) across the U.S. were aided by seed grants from the Center for Substance Abuse Treatment’s (CSAT) Recovery Community Support Program (RCSP). The RCSP meetings served as an incubator for the gathering of local RCOs and recognition of the need for a national recovery advocacy movement. The Alliance Project of the Johnson Institute hosted an October 2001 Recovery Summit that marked the creation of Faces and Voices of Recovery and the formalization of a national infrastructure for the NRAM. The subsequent cultural and political mobilization of people in recovery and people personally affected by addiction was enhanced by a the growth and diversification of recovery mutual aid groups, a new generation of recovery advocacy literature (Let’s Go Make Some History: Chronicles of the Addiction Recovery Advocacy Movement; Alcohol Problems in Native America: The Untold Story of Resistance and Recovery; Many Faces One Voice), a landmark documentary film (The Anonymous People), and a national recovery rally in Washington D.C. (Unite to Face Addiction).
Why “New”? References to a “new” recovery advocacy movement pay homage to earlier advocacy movements, particularly the past work of the National Council on Alcoholism and Drug Dependence (NCADD) and the Society of Americans for Recovery (SOAR), and signal the rise of new ideas and strategies that distinguished the NRAM from earlier movements aimed at addressing alcohol and other drug problems in the United States.
NRAM Organization The heart of the NRAM is the more than 100 grassroots RCOs operating in local U.S. communities. The national infrastructure, from its beginnings, has been a collaborative one. Key partners in this collaboration have included Faces and Voices of Recovery, National Council on Alcoholism and Drug Dependence, Young People in Recovery, Unite to Face Addiction, and Legal Action Center. People in medication-assisted recovery have been represented by The National Alliance for Medication Assisted Recovery, Advocates for Recovery through Medicine (ARM), the National Alliance of Advocates for Buprenorphine Treatment (NAABT), and Stop Stigma Now. Local RCOs are now represented by the Association of Recovery Community Organizations. New recovery support institutions—a key product of this movement—are represented and supported by such organizations as the National Alliance of Recovery Residences, the Association of Recovery Schools, and the Association of Recovery in Higher Education.
NRAM Funding Organizations within the national recovery advocacy movement are funded by a mix of governmental and foundation grants and the private philanthropy of people in recovery and their allies. Local recovery community organizations are funded by a mix of federal, state, and private grants and contracts (mostly for the delivery of recovery-related professional and public education and peer-based recovery support services) as well as through the private philanthropy of local citizens. The work of the NRAM is also supported by a new generation of private advocacy organizations and foundations organized by persons blessed by recovery or who have lost family members to addiction.
Movement Goals The founding goals of the new recovery advocacy movement were to:
1) portray alcoholism and addictions as problems for which there are viable and varied recovery solutions,
2) provide “living proof” of the diversity of those recovery solutions,
3) counter any actions that dehumanize, objectify, and demonize those with or recovering from AOD problems,
4) enhance the variety, availability, and quality of local/regional treatment and recovery support services, and
5) remove environmental barriers to recovery by promoting laws and social policies that reduce AOD problems and support long-term individual and family recovery.
Kinetic Ideas The core and evolving messages of the NRAM include the following:
Addiction recovery is a living reality for individuals, families, and communities.
There are many (religious, spiritual, secular) pathways to recovery, and ALL are cause for celebration.
Recovery flourishes in supportive communities.
Recovery is a voluntary process.
Recovering and recovered people are part of the solution: recovery gives back what addiction has taken from individuals, families, and communities.
Recovery is contagious and can be spread in local communities by increasing the density of recovery carriers and expanding recovery landscapes (physical, psychological, social, and cultural spaces) supportive of addiction recovery.
Movement Strategies The major strategies of the NRAM include:
Building strong, grassroots recovery community organizations (RCOs) and linking these RCOs into a national movement to develop recovery leaders, offer opportunities for the recovery community—people in recovery, family members, friends, and allies—to express their collective voice on issues of common concern, respond to community-identified recovery support needs, and provide a forum for recovery-focused community service.
Advocating for meaningful representation and voice for people in recovery and their families at local, state, and federal policy levels on issues that affect their lives.
Assessing and responding to national and local needs related to the adequacy and quality of local treatment and recovery support services.
Educating the public, policymakers, and service providers about the prevalence, pathways, and styles of long-term addiction recovery.
Developing human and fiscal resources by expanding philanthropic and public support for addiction treatment, recovery support services, and recovery advocacy and by cultivating volunteerism within local communities of recovery.
Creating recovery community centers that make recovery visible on Main Street and provide a setting for the delivery of non-clinical, peer-based recovery support services, supports, and activities.
Celebrating recovery from addiction through public recovery celebration events (e.g., marches, rallies, concerts) that offer living proof of the transformative power of recovery.
Supporting research that illuminates the pathways, processes, stages, and styles of long-term personal/family recovery.
Accomplishments The major achievements of the NRAM as of 2015 include:
Mass Mobilization: A national recovery advocacy constituency has been mobilized through creation of more than 100 local RCOs, recovery-focused social media outlets, recovery messaging training, multiple recovery summits, and the ritualization of local and national recovery celebration events with ever-increasing numbers of participants. Particularly distinctive has been the leadership roles that women, people of color, members of the LGBT and other historically marginalized communities, and members of diverse recovery communities have played in assuring the cultural inclusiveness of the NRAM. Scientific surveys have been conducted on public attitudes toward addiction recovery and on the demographics, experiences, and opinions of U.S. citizens in recovery.
Policy Victories: Policy advocacy efforts have contributed to a) passage of Mental Health Parity and Addiction Equity Act and the Affordable Care Act, b) mobilization of bipartisan support for Comprehensive Addiction and Recovery Act of 2015 (CARA), c) removal of key discriminatory laws and regulations affecting people in addiction recovery, d) elevation of recovery as a new organizing paradigm at ONDCP and SAMHSA/CSAT and within state planning/funding authorities, and e) the first inclusion of recovery within the National Drug Strategy.
Professional Influence: Major developments include a) increased recovery representation within AOD-related policymaking and governance bodies; b) professional consensus conferences on the definition of recovery and on extending the benefits of addiction treatment via recovery support services, c) progress in purging stigmatizing language (e.g., abuse, clean/dirty, alcoholic/addict) from the addiction field’s language of professional discourse, d) sustained pressure to extend acute care models of addiction treatment to models of sustained recovery management (RM) nested within larger recovery-oriented systems of care (ROSC), e) legitimization of recovery as an important arena for scientific investigation, to include an increase in scientists specializing in recovery research (e.g., Best, Davidson, Dennis, Galanter, Godley (M), Godley (S), Humphreys, Jason, Kaskutas, Kelly, Laudet, McKay, Mericle, Pagano, Polcin, Scott, and Tonigan), f) increased recovery focus within peer-reviewed scientific journals (e.g., special issues of Journal of Substance Abuse Treatment, Alcoholism Treatment Quarterly, Journal of Groups in Addiction and Recovery), g) expansion of funding streams to integrate pre-treatment, in-treatment, and post-treatment recovery support services (e.g., outreach, recovery coaching, ongoing recovery check-ups) within clinical models of addiction treatment, and h) progress in the tri-directional integration of harm reduction services, clinically-directed addiction treatment, and recovery support services.
Expansion of Recovery Support Institutions: Expansion of a) RCOs, b) recovery community centers, c) recovery residences, recovery high schools and collegiate recovery programs, d) recovery industries, e) recovery ministries, and f) recovery cafes and other social venues.
Expansion of Culture of Recovery: Promulgation of recovery-focused language, symbols, rituals, art, film, theatre, music, and social media.
NRAM as International Movement The international spread of the recovery advocacy movement is evident in the rise of recovery advocacy movements and organizations in Canada, the UK, South America (e.g., Brazil), Africa (e.g., South Africa), Asia (e.g., Japan), and Australia.
Movement Challenges The long-term cultural and professional influence of the NRAM is unclear. The NRAM will face many of the challenges faced by other social and health care transformation movements, including cultural backlash, professionalization and commercialization of indigenous support, and highly publicized episodes of emotional/sexual/financial/ideological exploitation of service recipients prior to development of ethical standards of practice and effective structures for selecting, training, and supervising those providing peer-based recovery support services. That said, the NRAM has the potential to dramatically alter public and professional perceptions of addiction recovery and forge fundamental changes in the design of addiction treatment and the nature and magnitude of recovery support services available to American citizens.
Post Date January 1, 2016 by Bill White
Categories Articles
Tags recovery advocacy | recovery community organizations | recovery moveme