Recovery Advocacy Movement
ABOUT THE NEW ADVOCACY RECOVERY MOVEMENT BY WILLIAM L. WHITE
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. 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).
At the Heart of the Movement: Recovery Community Organizations
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.
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.
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, f) increased recovery focus within peer-reviewed scientific journals, 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.
The Bigger Picture: The 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.
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.