Recovery and recovery-based care AUGUST 8, 2014 BY DAVID CLARK

“Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has.”
Margaret Mead, US cultural anthropologist

Here’s a little section I wrote for a book I am working on.
‘1. The Problems
Substance use problems represent a major concern in society today. These problems do not just arise from use of illegal drugs, but also from alcohol, solvents and addictive prescription drugs. They are intimately tied up with, and can be caused by, social, emotional and/or mental health problems. A person’s substance use problems impacts negatively on the wellbeing of family members and other loved ones.
Far too few people are recovering from the problems caused by drugs and alcohol, in large part because of shortcomings in the systems of care that society has developed. Many people circulate in and out of treatment, and much of the treatment system has become disempowering and lacking in hope.
The prejudice and stigma that exists in society towards individuals and families affected by substance use problems is also a strong barrier to recovery.
The situation need not – and should not – be like this. Many people do recover from substance use problems, some overcoming the most difficult of life circumstances and many (probably the majority) without accessing professional treatment.
The lived experience of recovering and recovered people, along with findings from scientific research, has given us considerable insights into the recovery process and into how to improve the way that society helps people overcome substance use problems. (Sadly, too little of this information is circulated, either to people in need of help and or to those people providing help).
Moreover, in parts of the USA and other parts of the world, there has been a transformation in systems of care, shifting away from systems based on pathology and symptom management – the medically-based approach used by most of treatment today – to ones that promote hope and recovery.
As a result, more people are overcoming addiction. Recovering people have been playing a key role in helping other people recover from addiction and some are becoming leaders in their community.
Despite these positive changes, many communities cling to the notion that treatment is the panacea for addiction. Their treatment services continue with limited success, which is often attributed falsely to addiction being a condition that is almost impossible to overcome (the so-called ‘chronic relapsing condition).
Moreover, people attending treatment services are often blamed when they relapse – this system is possibly unique in discharging patients for showing a symptom of their disorder – rather than the system accept it may not be doing its job properly.
Efforts to change the care system for people affected by substance use problems are ignored or met with strong resistance, in part due to vested interests and a perceived need to maintain the status quo.
2. Working towards solutions
Efforts to improve the way that society helps people overcome substance use problems must begin with a fundamental understanding of what is needed to help a person recover from addiction.
Such an understanding is best gained by considering the journeys that people take into and out of addiction. Who best to teach us about recovery than the people who have travelled the journey?
Most people who develop a serious substance use problem are self-medicating in response to psychological pain caused by a lack of long-term social integration, family problems, early abuse and other traumas, homelessness, emotional difficulties, drug withdrawal, or just trying to find meaning and relationships in a society where feelings of community and commonality are disappearing.
These problems may exist before a person starts using substances, whilst others start, or intensify, as substance use gets out of control. Recovering from the consequences of addiction is often much harder than overcoming the addiction itself. These consequences help lock a person into addiction.
Recovering people learn to live without resorting to substance use to cope with problems in their life. They build or rebuild meaningful and valued lives, where they can realize their aspirations, be treated with respect and dignity, and contribute to society.
In transforming themselves in this way, recovering people are much less likely to relapse. They have often overcome severe self-esteem problems, self-hatred (to a level where they considered or attempted suicide), isolation, anxiety, social phobia and depression.
Given this, it is not surprising that the recovery process takes time and involves a lot of hard work. It also involves great courage and resilience.
Despite this, many people do recover from addiction and related problems. There is an incredible resilience of the human spirit, which is often forgotten in society’s rush to give out or use medicines to manage symptoms of a psychological problem.
Addiction is not ‘fixed’ by a medication or any other treatment (like cancer), nor by a doctor or treatment practitioner. Recovery comes from the person with the problem. They do the work in overcoming their substance use and related problems, getting well and getting their lives (back) on track.
Professionals and other people can catalyze a person’s self-healing processes, acting as a coach or guide and helping a person gain the internal and external resources they need to help them overcome addiction.
Two fundamental factors underlie recovery, which are summed up by the maxim: “I alone can do it, but I can’t do it alone”. To help people recover from addiction, we need to empower them to help themselves and we need to connect them to other people who can facilitate their recovery journey.
People with substance use problems can be empowered by providing them with hope, understanding, and a sense of belonging.
Recovering people play a key role in each of these elements. Firstly, they provide hope by showing that recovery is possible via a multitude of different pathways.
Secondly, they help other people understand the nature of their problem and how it can be overcome.
Thirdly, recovering people support each other, allowing people in the early stages of recovery to gain a sense of belonging, and feelings of acceptance and self-worth which are key to recovery.
Recovery is rarely achieved alone. Society must enable a person with a substance use problem to connect with a variety of resources in their community that they believe will facilitate their recovery. People in early recovery learn from recovering people who are further along in their journey. The latter benefit from helping others – “giving back” is known to be a key therapeutic process.
Connecting recovering people into recovery communities allows the growth of healing social networks and a culture of recovery. The latter is essential to counter the culture of addiction that is pervasive in society.
Peer support networks, such as AA, NA and SMART Recovery, have shown considerable success in helping people for many years. Connections enable recovery to become contagious.’

New Jersey Gov. Christie surprises some with broad call for offender treatment

Details to come on priority item from State of the State address.
February 1, 2012 by Gary A. Enos, Editor
New Jersey Gov. Christie surprises some with broad call for offender treatment
While gay marriage constitutes the latest topic capturing national attention among followers of the never-dull administration of New Jersey Gov. Chris Christie, the addiction treatment community in the governor’s home state is abuzz over his recent call for mandatory treatment for nonviolent offenders with substance use problems.Although even the staunchest supporters of treatment were somewhat surprised that addiction treatment was elevated to a signature issue in last month’s State of the State address by Christie, they also point out that his attention to this subject in general shouldn’t catch anyone off guard.
Christie has witnessed the societal impact of substance use problems from numerous perspectives, including as a prosecutor and as a former board member of a New Jersey addiction treatment organization (Daytop Village). In addition, media reports pointed out that the governor’s wife has engaged in volunteer work at a number of treatment facilities in the state.Stating that “everyone deserves a second chance,” Christie proposed in last month’s State of the State speech a policy shift that would divert nonviolent offenders to mandatory treatment. Many media outlets lauded the proposal, with the Philadelphia Inquirer writing in an editorial that the governor “smartly recognizes that addiction is still winning the 40-year-old war on drugs, so he is changing up New Jersey’s strategy.”
Few details are known about how the Christie administration will seek to achieve this goal, both financially and programmatically. More information could be forthcoming in the governor’s budget proposal, due to be released later this month.Debra L. Wentz, CEO of the New Jersey Association of Mental Health and Addiction Agencies, Inc., said some as-yet unsubstantiated reports have indicated that an interdepartmental task force that was formed by the administration last year to centralize anti-drug efforts could drive much of the change the governor wants to see.Wentz adds that others have reported that a plan to divert offenders to treatment could be initiated as a pilot program in a couple of New Jersey counties. At this point, she says, her organization’s advocacy focus regarding the administration’s proposal will center on ensuring that treatment services be evidence-based and delivered by credentialed providers.

In a Jan. 29 commentary she wrote for the Star-Ledger newspaper, Wentz stated that “Christie is taking advantage of the confluence of public sentiment, fiscal imperative, compassion and good policy that has the potential to change lives and definitively solve the state’s fiscal crisis.” She added that at present, fewer than 7% of state residents with substance use disorders are able to access needed treatment services.