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Just A Little More Change Required

By: Kevin McLaughlin, Executive Director, Recovery Allies

Part of my job is to organize the “recovery” community. How can we organize the community if we don’t know who they truly are. Those who suffer consequences due to a substance addiction do not all look alike, nor are the paths they take to become free of that addiction all the same. The more I learn about recovery and the people in it, the more I learn that the paths out of addiction are varied.

I think many of us make an assumption that in general the recovery community is made up of people that have messed up their lives really badly. They have legal issues, medical issues and money issues. There is a certain image that comes to mind when we hear the word alcoholic or drug addict.

Unfortunately, this negative image is not only true coming from the general population (those who don’t have negative consequences due to use) but some of those in active recovery as well. If those of us in recovery have a misguided notion of what we look like, how can we expect those that don’t look like that to change? And how can we reach those that don’t fit that description?

In an effort to help as many people as possible, we need to change the distorted image we have of those with addiction. This message is for those in recovery, for those that simply chose not to drink or use drugs, for those struggling in active addiction, and for those who treat people for addiction.

Let’s look at the clinical categories for people with addiction. The categories are separated into three groups: mild, moderate and severe. I think that the general population and the treatment industry think of ALL people with addiction as being in the last category of severe. This is due to the fact that by the time this person surfaces for help, they are in the later stages of addiction. Before we go on about the two categories of mild to moderate we need to talk about the three different ways people identify themselves who are no longer using.

Recovery Identity 

It is important to know that for 5 to 10% of the drinking population (regardless of their socio-economic status), addiction is a normal side effect of continued use of a drug.

Remembering that, lets look at three kinds of recovery identity or association to recovery.

First is called recovery neutral. This person says simply “I don’t drink”. They never connected to the recovery community and never had a need to. They had problems of some sort and just stopped. Typically these people don’t have any trouble saying they “had a few problems” which is why they quit. If asked how long they have been in recovery they may say, “what do you mean?” Labeling it and counting the days is not a part of quitting for them.

Next is the recovery negative identity. For this person it is a bad or shameful thing to be associated with the recovery community. This person doesn’t tell anyone they have a history. They fear judgment and stigmatization. For many it’s for good reason. The employer may change their attitude about an otherwise stellar employee, which may result in a missed promotion or a change in position. But for most, experiences like those aren’t necessary for the feelings of shame to exist.

The last group is the recovery positive group. The person in this group is proud of the achievement of such a monumental change in themselves. They have no problem sharing their story especially in the hopes of helping someone else.

Now that we understand how people may think of themselves in relation to no longer using substances, we can look at the mild and moderate groups. The mild to moderate group identifies typically with the recovery neutral group and very often is made up of kids. The group is also made up of young professionals, stay at home moms and dads and lastly retired people. I propose that we develop a different language to get this group’s attention. If they only have a few consequences it is more likely they will fall into the “recovery neutral” group. If we suggest a lifetime of abstinence we usually lose them. If we say that recovery is a journey and will require a ton of work for a long time we could lose them. If we say they have to change everything especially friends we lose them. So why not change our approach?! We could start by listening to the individual and actually believe them when they say “I don’t think I’m an alcoholic”. They may not be. But then again they might.

I also find that by sharing my path (ie my early reluctance to be labeled or join the recovery community,) the ground is laid for further discussion. My experience has been that the more I learn about them and adapt my language to fit their situation, the more engaged in change these people become.

Another fascinating thing I’m finding is that many people are “coming forward” and sharing that this is exactly their experience with addiction. Some have failed treatment yet ultimately reached a place of overall well being without “joining” a recovery program. One reason they typically don’t talk about this within recovery communities is that their experience is often challenged, discredited, or discounted. When coaching a person, seeking wellness and recovery, I absolutely love the response a person, usually young, gives when they hear these words: “you may not be an alcoholic”, or “you don’t need to attend a support group to get well,” or “you don’t have to identify with the recovery community or call yourself anything other than human.” It is as if a heavy weight is lifted off their shoulders.

For those unfamiliar with the history of treatment, labeling is a necessary thing used to establish a system of being able to pay for treatment. To treat someone we need a diagnosis and the ability to measure the effectiveness. Labels serve a purpose for that goal; let’s use them just for that. I think we should be allowed to define ourselves.

We at Recovery Allies have had to open ourselves up to some new and different ideas and facts and then take the next steps and make a sincere effort at changing such things as our language and assumptions of what the recovery community looks like. The result so far is people who don’t fit the image of an alcoholic or drug addict are coming to us and talking. They are doing so because they have a desire to help those that may identify with their story. After saying all this, the funny thing is, it seems like people that don’t identify or relate to those in the recovery community look an awful lot like someone who does….

 

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The New Face of Recovery and The Age of Multiple Pathways

By Tom McHale – Recovery Supports Coordinator, Northern Michigan Substance Abuse Services, Recovery Center, Gaylord MI

In recent years research has painted a very different picture of what recovery looks like, not in terms of its visual appearance, but in how people gain access to and define their recovery. The old picture of a single recovery pathway has evolved into a broad range of diverse pathways and an expanding definition of what recovery means. Examples of diverse  pathways include medication assisted recovery, harm reduction, secular recovery, faith based recovery, twelve step  programs, spontaneous remission and the list goes on.  Whether a person sees this new face of recovery as positive or negative doesn’t change the fact that 23 million Americans have recognized their alcohol/drug use as a problem and took corrective action. This is a reason to celebrate. It is also a time to express gratitude for the efforts of individuals and groups that forged the initial recovery path. The message emanating from the face of recovery is clear, however there  is  no single pathway.

I had hoped treatment facilities in the private and public sectors would begin offering clients support options based on this new picture of recovery and the diverse pathways now available, but I continue to see a great deal of reluctance to get on board with multiple pathways and I have even read affirmations from treatment facilities expressing loyalty to the one pathway. I fully understand that there are people working in the treatment industry, who are in recovery, and maintain  their recovery by using a 12 step pathway. This is great for that individual. I am concerned however with insistence on  guiding everyone down the same recovery path. It is disheartening that clients unwilling to embrace a prescribed  pathway are identified as recovery resistant or worse dismissed until they get so sick they will accept a program of recovery they didn’t accept during better times. I believe as the field of addiction treatment moves toward the implementation of evidence based practices, the pathways introduced to an individual will represent the diversity now available. Choosing a pathway is a personal decision based on the person’s beliefs, values, culture, and other extenuating  circumstances. The role of the therapist is to help the individual find his or her own personal pathway. The treatment industry has an ethical obligation to support multiple pathways until the research tells us different.

Personally, I believe that we’ve been totally unfair to the initial pathway by creating an unrealistic expectation that this  pathway alone could  help EVERYONE. As a result, this pathway became a dumping ground for individuals that society  did not want or could not serve, and the practice of forcing people to attend, compromised the supportive atmosphere for those who want to attend.

The solution to addiction and maintaining recovery is not likely to come in one nice neat package. By supporting  and  facilitating multiple pathways  we stand a much better chance of growing the number of people who stabilize in an addiction free lifestyle. Just think of how many more lives we can reach by being open to multiple pathways that all work toward a common goal: to afford everyone the opportunity to recover from his or her addiction. I  suspect that treatment facilities that learn this lesson will be the first to come out on top