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



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:
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


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