RecoveryBlog
recoveryblog: a blog for recovery advocates!
Our recovery advocacy blog is produced by individuals in recovery! Here you will find commentary and personal discussions on different aspects of addiction recovery and advocacy.
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JOIN US
OCT 3 – 6, 2021 This Recovery Leadership Summit will be held virtually over the course of three days and is filled with exceptional presentations, critical discussions and optional early morning and evening activities.
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On July 20, The Senate Caucus on International Narcotics Control held a hearing on the state of treatment and recovery in the United States, entitled “The Federal Response to the Drug Overdose Epidemic.” Witnesses included federal officials Regina LaBelle (Acting Director of the Office of National Drug Control Policy) and Tom Coderre (Acting Director of the Substance Abuse Mental Health Services Administration.) The role of recovery support services was a central theme of the testimony.
Tom Coderre shared his personal story of recovery and urged lawmakers to see the positive results it has yielded. “True success with substance use disorder also involves enduring efforts, many of which are through recovery supports,” he stated.
Coderre cited that Recovery Support efforts have been part of SAMHSA’s portfolio since the late 1990s. SAMHSA first launched the Recovery Community Support Program, later the Recovery Community Services Program (RCSP) in 1998. This grant helped launch and supported the development and strengthening of recovery community organizations (RCOs). Their focus has been emphasizing the critical importance of as a bi-directional bridge between communities and formal systems, including SUD treatment, and the criminal justice and child welfare systems. Coderre praised RCOs for being peer-led and managed.
Also receiving attention in the hearing were two newer grant initiatives, the RCSP 5-year grant program and the Treatment, Recovery and Workforce Support Grants (Workforce Support). The 5-year RCSP grants build peer recovery support services capacity through recovery community centers, and the Workforce Support grants enhance employment opportunities for individuals in recovery from SUDs by addressing gaps in services and providing opportunities for veterans, homeless individuals, and those reentering the community after incarceration. Coderre mentioned that also of note, SAMHSA developed the targeted capacity expansion-peer to peer (TCE-PTP) grant portfolio forging the path for the extensive ongoing training of peers towards certification and expanding the workforce. This portfolio has provided state recognition for peer support service providers in the workplace and, in some states where allowable, Medicaid reimbursement for their services.
Since 2017, SAMHSA allocated over 60 million dollars to recovery support initiatives, but Coderre urged the Senate to do more to build out the continuum. Following the lead of President Biden’s FY 2022 Budget, he reiterated his call for a 10 percent set aside for recovery support services in the Substance Abuse Prevention and Treatment Block Grant which would provide states with funding to further invest in building out recovery support services.
Acting Director LaBelle reiterated the priorities of the Biden Administration, including a need to expand access to recovery support services, as well as the advancement of recovery-ready workplaces. She recognized that recovery support services are offered in various institutional and community-based settings and include peer support services and engagement, recovery housing, recovery community centers, and recovery programs in high schools and colleges, and increased capacity and infrastructure of these programs will create strong resource networks to equip communities to support recovery for everyone. The required infrastructure includes a safe, reliable, and affordable means of transportation to access recovery support services. She pledged that ONDCP will work with Federal partners, State, local, and Tribal governments, and recovery housing stakeholders to begin developing sustainability protocols for recovery housing, including certification, payment models, evidence-based practices, and technical assistance.
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A Historical Summit
by: Bill White
In 2001, more than 130 recovery advocates from more than 30 states gathered in Saint Paul, Minnesota at the invitation of the Johnson Institute’s Alliance Project and with support of the Center for Substance Abuse Treatment’s (CSAT) Recovery Community Support Program (RCSP). That gathering marked the formal launch of a new recovery advocacy movement in the United States. The vision of culturally and politically mobilizing people in recovery and their families and allies was not a new vison, but those of us in St. Paul during those momentous days had an unmistakable feeling that we were participating in something that could reshape the future of addiction recovery. Now, with 20 years of hindsight, we can acknowledge what was so significant about this event.
The 2001 Recovery Summit marked a clarion call to shift the center of the alcohol and other drug problems arena to a focus on the lived solution for individuals, families, and communities. The shift from pathology/clinical paradigms to a “recovery paradigm” exerted pressure for urgent changes in policy, research, treatment, recovery support practice, and service system evaluation. The emergence or elevation of such concepts as recovery management, recovery-oriented systems of care, recovery coaching, recovery support services, recovery capital, recovery cascade (contagion), culture of recovery, community recovery, etc. would be missing from our current landscape without this paradigm shift, as would many recovery-focused research studies.
The 2001 Recovery Summit marked the passing of the recovery advocacy leadership torch from an earlier generation of advocacy organizations, most notably the National Committee for Education on Alcoholism (1944, later the National Council on Alcoholism and Drug Dependence) and the Society of Americans for Recovery (1991). The founding of Faces and Voices of Recovery as an outcome of the Summit set the stage for subsequent efforts, including Young People in Recovery, Facing Addiction, Shatterproof, the Recovery Advocacy Project, Latino Recovery Advocacy, Black Faces Black Voices, the African American Federation of Recovery Organizations, and other national recovery advocacy efforts. Faces and Voices provided the connecting tissue for RCO leaders to gather, communicate, share resources, and speak with a collective voice. The 2001 Recovery Summit set the foundation for the landmark accomplishments of Faces and Voices of Recovery and other recovery advocacy organizations.
The 2001 Recovery Summit marked the coming of age of a new organizational entity—the grassroots recovery community organization (RCO). The emerging RCO was not a recovery mutual aid fellowship, an alcohol/drug problems council, or a prevention or treatment organization, but rather an organization focused exclusively on recovery community mobilization, recovery advocacy, and recovery-focused community development. Subsequently linked through the Association of Recovery Community Organizations, RCOs have been instrumental in supporting further recovery community institution building, e.g., recovery community centers; recovery residences; occupational/workplace recovery programs; recovery high schools and collegiate recovery programs; recovery ministries; recovery-focused health, sports, and adventure programs; and recovery-focused projects in music, theatre, art, and community service.
The 2001 Recovery Summit marked a milestone in multicultural and multiple pathway recovery advocacy. The 2001 Summit was diverse in its representation of women, communities of color, and the LGBTQ community as well as its representation of diverse pathways of addiction recovery. The Summit was historically noteworthy in bringing affected family members into the advocacy movement on an equal footing with those with lived experience of addiction recovery. The Summit marked a milestone: people representing diverse pathways and styles of recovery seeing themselves collectively as “a people” with shared needs and aspirations. That “peoplehood” inspired subsequent calls for authentic and diverse recovery representation at all levels of decision-making within the AOD problems arena.
The 2001 Recovery Summit marked an early vision—the seed—of the integration of primary prevention, harm reduction, early intervention, treatment, and peer recovery support—a process that continues to this day through efforts to delineate roles and responsibilities as well as efforts of coordination and collaboration across this service and support continuum. Prior to the 2001 Recovery Summit, recovery never appeared on the alcohol and other drug service continuum. The emergence of peer recovery support services as a distinct service entity following the Summit constitutes a significant historical milestone.
What the 2001 Recovery Summit did more than anything was weld the personal commitments of individuals and programs into a national recovery advocacy movement. We had a name; a consensus on vision, goals, and tactics; and, most importantly, we had mutually supportive relationships across the country that bound us together in common cause. I look forward to our gathering this October to revision the future of recovery advocacy in the United States.
An Invitation to Return to Saint Paul
by: Philip Rutherford
Even before my arrival at Faces & Voices, I learned about the rich history and significance of the St. Paul summit that happened on October 5, 2001. While working at a Minnesota RCO, I attended an event put on by The Association of Recovery Community Organizations (ARCO) that was modeled after the original summit. At the time, it was called the ARCO Executive Directors Leadership Academy, and it transformed both my personal understanding of the recovery movement, and ultimately the trajectory of my organization. ARCO’s roots are connected to the powerful movement that arose from the St. Paul summit and that continue to propel the work of countless organizations today.
On October 3, 2021, at the River Centre in St. Paul, Minnesota, we will convene another summit to commemorate the passing of the 20th anniversary of that event. We will examine where we are today and look toward the future. The event will have plenary speakers like Bill White, Dr. Nora Volkow, William Moyers Jr. and Dr. Delphin-Rittmon, and will include six different tracks of learning concentrations around Advocacy, Peer Recovery Support Services, Capacity Building, Diversity, Equity, and Inclusion, Family and Youth, and Leadership Development.
Many things have changed about the recovery movement since 2001. At Faces & Voices, we see this event as an opportunity to celebrate the tireless efforts of those who have come before us, honor those in the trenches right now, and help clear a path for anyone who wants to join the journey. Similarly, some things haven’t changed, and we see this event as an opportunity to have frank and open discussions about where change is required.
If 2020 has taught me anything, it is to expect the unexpected, and as such, I’d be remiss if I didn’t mention COVID-19 and the possibility of rates of infection affecting our plans. The COVID-19 Delta and Lambda variants are influencing how the celebration will take place. We are closely monitoring guidelines and restrictions and will make decisions as the situation unfolds.
Unless restrictions prohibit us from gathering, we plan on hosting the conference in-person. We understand some people may be hesitant to attend, due to safety concerns.
If necessary, we will deliver a webinar-based, hybrid option to accommodate more people, so that we can still be together as a community for this important milestone. We will update you as we can. In addition, the River Centre has taken a number of precautions to ensure your safety.
Thank you for your patience and understanding during this time.
To make it a bit clearer, here are three possible scenarios as examples:
Scenario A– All is well. No mandates or city-wide orders in place regarding COVID
*Summit takes place as scheduled. Proof of Vaccine/Negative test results/mask required (with audit during event). We will stream only keynote events.
Scenario B– Positivity rates increase, moderate concern surrounding transmission. No mandates or city-wide orders in place regarding COVID.
*Summit takes place as scheduled. Proof of Vaccine/Negative test results/mask required (with audit during event). Social distancing rules will be enforced, hybrid conference occurs with streaming of each session.
Scenario C-All is not well, mandates or city-wide orders are in place regarding COVID
Summit takes place entirely in virtual space.
Gate: September 1 decision date
Nationwide positivity of >12% Scenario C
Nationwide positivity of 5-12% Scenario B
Nationwide positivity of <5% Scenario A
Regardless of the eventual format, we extend a warm invitation for you to participate. You can register by clicking HERE. Let’s go make some more history.
UPDATE: On September 1, 2021 Faces & Voices of Recovery made the difficult decision to move the event to a completely virtual setting.
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When I remember the thousands who died, many whose stories were never recorded in history, I bow my head. And when my wailing is done, I get up and carry on, not in my name, but in theirs….When you know your history, you know your value. You know the price that has been paid for you to be here. You recognize what those who came before you built and sacrificed for you to inhabit the space in which you dwell. –Cicely Tyson (with Michelle Burford), Just as I am
We have not even to risk the adventure alone; for the heroes of all time have gone before us; the labyrinth is thoroughly known; we have only to follow the thread of the hero-path. And where we had thought to find an abomination, we shall find a god; where we had thought to slay another, we shall slay ourselves; where we had thought to travel outward, we shall come to the center of our existence; where we had thought to be alone, we shall be with all the world. –Joseph Campbell, The Hero with a Thousand Faces
Those seeking and in recovery owe a great debt of gratitude to earlier generations of people whose life discoveries opened and charted pathways to addiction recovery and built the recovery support organizations available to us today. Much of my (BW) past work focuses on excavating and celebrating the lost stories of these recovery pioneers.
The stories of many of our recovery ancestors remain publicly shrouded behind a veil of stigma. For generations, others who sought our control or cure spoke on our behalf while our own faces and voices remained hidden and silent. Actually, those who spoke for us spoke their stories—their perceptions of us and their work on our behalf, but authentic, first-person narratives of addiction and recovery remained obscured and sometimes misrepresented by such accounts.
Today, we are rediscovering lost recovery stories and declaring that we can now speak for ourselves. Every stigmatized and oppressed people must liberate their history and take control of their own stories. As the African proverb suggests, “Until the lion learns how to write, every story will glorify the hunter.”
We as a people can assure that the stories of our recovery ancestors are preserved and called forth at critical times to illuminate our present circumstances. Here are few potential possibilities.
*Designating and training archivists and archival skills within recovery-focused organizations
*Creating formal recovery archives for historical preservation and research
*Digitizing historical materials and creating virtual libraries filled with resources on the history of addiction recovery
*Creating and disseminating histories of recovery, recovery mutual aid and advocacy organizations, and key recovery figures via articles, books, films, plays, and photo exhibits.
*Creating and disseminating the history of recovery among special populations, e.g., women, youth, people of color, LGBTQ, etc.
*Preserving iconic historical sites
*Creating forums for communication between people interested in the history of recovery, e.g. AA History Lovers, NA History Lovers
*Creating oral history projects through which the stories of local recovery elders are recorded and preserved
*Hosting symposia on the history of addiction recovery and related organizations, and
*Ancestor consultations: Consulting with local recovery elders and regularly asking ourselves how recovery ancestors responded to challenges and opportunities similar to those we are currently facing.
Our recovery ancestors have provided a body of historical lessons. They have endowed an intellectual and emotional inheritance on how to best navigate the complexities, challenges, and opportunities within the experience of addiction recovery. They have also forged values and traditions that can best guide our collective life within recovery-missioned organizations. We honor our ancestors by letting their lessons inform our current circumstances. We show up to assert our own needs and aspirations, but we also show up to honor the ancestors that make our survival possible.
You cannot know yourself without knowing the history of your people. We bear the scarred wounds of past recovery generations—the emotional memory of objectification, demonization, maltreatment, and mass incarceration, but we also possess within us the inherited capacity to survive and thrive if we draw upon it.
We must all become students of our history as a people. Once we become students of history, the wisdom of our recovery ancestors lives inside us. We can then elicit the voiced guidance of our ancestors when we most need it. We are but one link in this chain of history. What we as a people achieve today are the fulfilled dreams of our ancestors. What we do today in preparing those who will follow us will shape the future of recovery for generations to come.
We must show up and do our part to prevent a break in this historical chain of personal healing and social progress. We do that for ourselves and in payment for our ancestors’ sacrifices. Our ancestors do not die until we last speak their names. In honor of what they have bequeathed to us and as aide to our own survival and health, we must continue to speak their names.
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Posts from William White
Featured Panelists: Christina Love, Dharma Mirza, and Meghan Hetfield
Christina Love, Advocacy Initiative Specialist, Alaska Network on Domestic Violence & Sexual Assault (ANDVSA)
Dharma Mirza Equity & Justice Fellow at ARHE & Oregon Measure 110 Oversight & Accountability Council Member
Dharma Mirza (she/her) is an artist, activist, policy advocate, and scholar living in Corvallis, OR. Dharma is a Public Health and Gender Studies student at Oregon State University. Dharma focuses her work and research on harm reduction, sexual health, addiction, public health equity, and the intersections of behavioral health and marginalized health populations. Dharma informs her work through intersectional, feminist, and decolonial frameworks and draws on her own experiences in navigating health/harm reduction services as an HIV-positive, queer, biracial transgender woman, Khwaja Sira (Pakistani Third Gender), and former survival sex worker and IV drug user.
Meghan Hetfield, Certified Addiction Recovery Coach and Certified Recovery Peer Advocate
As a Nationally Certified Peer Recovery Support Specialist and a NY State Certified Recovery Peer Advocate and Trainer, Meghan has found purpose in supporting people in their individual pathways of health and wellness. She is a dedicated advocate for Harm Reduction and ending the racist War on Drugs. She believes that radical compassion is needed to heal each other and meet our fellow humxns “where they’re at” without shame or judgement. Meghan is currently working from home in New York’s Catskill Mountains for WEconnect Health Management as a PRSS where she enjoys swimming holes, mushroom club hikes and cooking all her plant & fungi foraging finds.
Description: Recovery belongs to us all. Leading up to the second summit in St. Paul, MN this October 3-6, 2021 – 20 years after the original summit – what do we expect of our future? Three vibrant leaders discuss their perspectives and hopes for the next two decades of the Recovery Community. Through this moderated discussion, we will investigate the need to end gatekeeping and welcome everyone to recovery by lowering barriers to recovery support, creating inclusive spaces and programs, and broadening our understanding of what recovery means for people with different experiences. As we grow in empathy and understanding, we save lives by adding protective factors and building resiliency. Ever reminding us that Recovery is for Everyone: Every Person, Every Family, Every Community.
Moderated by: Keegan Wicks, National Advocacy and Outreach Manager, Faces & Voices of Recovery
This webinar series is sponsored by Alkermes.
Peer recovery support service (PRSS) programs require an ethical framework for service delivery. In most cases, simply “importing” a professional code of ethics is not effective. There is a difference between the professional-client relationship and the relationship of the peer leader and the peer being served that warrants an ethical framework specifically tailored to PRSS.
Understanding oneself is incomplete when divorced from the history of one’s people. Those with lived experience of addiction and recovery share such a larger history. Over the course of centuries and across the globe, we have been:
Abandoned Arrested Berated Caned Castigated Coerced Confronted Condemned Conned Defamed Defrocked Divorced Deported Denied Probation Denied Pardon Denied Parenthood Executed Electrocuted Electroshocked Evicted Expelled Exploited Exiled Feared Fired Forsaken Hated Humiliated Incarcerated Incapacitated Kidnapped Kicked Out Quarantined Restrained Ridiculed Sedated Seduced Shunned Shamed Surveilled Tough Loved Criticized Colonized Commercialized Criminalized Delegitimized Demonized Depersonalized Deprioritized Disenfranchised Eulogized Euthanized Glamorized Homogenized Hypnotized Institutionalized Lobotomized Marginalized Memorialized Miscategorized Mischaracterized Monetized Mythologized Objectified Ostracized Patronized Politicized Proselytized Publicized Sensationalized Stigmatized Scandalized Sensualized Sterilized Terrorized Theologized Traumatized Tranquilized Trivialized
More recently, through the efforts of recovery advocates and professional and public allies, we are being:
Applauded Awakened Celebrated Defined Educated Elevated Encouraged Helped Healed Enfranchised Hired Informed Inspired Motivated Profiled Reconstructed Recruited Redeemed Rekindled Renewed Restored Represented Reunited Supported Surveyed Transformed Uplifted Utilized Valued Vindicated Actualized Baptized Decriminalized Destigmatized Diversified Enfranchised Hypothesized Idealized Legitimized Medicalized Mobilized Organized Prioritized Professionalized Radicalized Randomized Recognized Reconceptualized Revitalized Secularized Sympathized Theorized
Through our shared journeys, recovery is gifting us with:
Accountability Acceptability Adaptability Authenticity Clarity Collegiality Community Dignity Employability Fidelity Flexibility Honesty Humility Integrity Longevity Maturity Opportunity Possibility Predictability Productivity Prosperity Respectability Responsibility Sanity Serenity Sobriety Spirituality Stability Survivability Tranquility Visibility Wellbriety
Is it any wonder given the complexity of these experiences that we struggle in recovery to answer, “Who am I?” We cannot fully understand the “me story” without the “we story.” Our personal stories nest within the hands of this larger multigenerational and multinational story. Our present circumstances, our shared needs, our individual aspirations, and our future destinies are inextricably linked to this complex, collective past. We can draw upon that past for resolve and inspiration at the same time we rise above it. Personally and collectively, we have fallen, yet like Lazarus, we rise anew. Personally and collectively, we are moving from pain to purpose.
To ensure fidelity to the recovery community organization model, Faces & Voices of Recovery, RCOs across the nation, and stakeholders have identified the following as national best practices for recovery community organizations.
I recently discovered a UK-based project that I found so exciting that I solicited the below blog to share with my readers. To me, the Well-Fed Social Supermarket signals a next stage in the evolution of recovery support services: programs that serve those seeking and in recovery while simultaneously benefiting the larger community. For generations, “service work” in the recovery community has reflected the support we provide each other, our mutual aid organizations, and individuals and families seeking recovery. Perhaps the day has arrived when that service ethic will be extended in new and dramatic ways to larger communities and cultures.
–Bill White
Recovery Innovations: The Well-Fed Social Supermarket
Dave Higham, Ged Pickersgill and David Best
Background
Recovery is a process that is characterised through the acronym CHIME – standing for Connectedness (the importance of social engagement); Hope; Identity (the growth of positive personal and social identities); Meaning (engaging in activities that give value to each day) and Empowerment (often experienced as positive self-esteem and self-efficacy).
For recovery community organisations, supporting people to achieve sustainable recovery is often about finding ways to promote CHIME that are personalised to individual aspirations and goals, and the stage of a person’s recovery. This means creating access to positive social and community resources that can nurture recovery capital.
In the UK, there have been a glut of recovery cafes, some of which have succeeded and others failed, but an increasing quest for diverse programmes and social enterprises that can both bolster recovery experiences while also contributing to the growth and wellbeing of the local community. This article provides a brief overview of the Well and then will focus on its innovative contribution to recovery pathways and community wellbeing.
The Well
The Well is a not-for-profit, community interest company (CIC) formed by ex-offender Dave Higham in 2012. Dave left prison for the last time in 2007 having spent over 25 years in addiction and in that time spent more time in prison than he did in the community. Since leaving prison in 2007 he has dedicated his life to supporting others with drug and alcohol addiction through both voluntary and paid employment. Dave set up The Well with his own money and with no blueprint to follow. Instead, he used his experience, vision and determination to create what has now become a leading provider of recovery services in the region.
Dave set up The Well when he recognised a gap in the provision of services during off-hours and weekends for those people who wanted to achieve or maintain abstinence. The first hub was launched in Lancaster in 2012, and a further four sites quickly followed in Lancashire and Cumbria (in the North-West of England).The majority of staff at The Well have lived experience of substance misuse and offending histories.
The Well has always been shaped, designed and delivered by the people it serves and supplemented by the assumption that both the person and their family need to recover and are thus welcomed. The Well is also open to people with prescription drug histories, mental health issues and trauma, and nearly all the people served have experienced CPTSD (Complex Post Traumatic Stress Disorder). The Well is based on the assumption that ‘Where we serve our community, we become active citizens in the community’.
The Social Supermarket
A Social Supermarket has been designed as a positive way of supporting those on low incomes, tackling poor diet and overcoming health inequalities, through the provision of surplus stock sold at heavily subsidised prices.
Since store’s opening in November 2019, Wellfed Social Supermarket has had a footfall of over 5,000 people and has also resulted in 279 referrals into The Well Communities through various mechanisms of support. The social supermarket has also facilitated (including but not limited to ) delivery of over 1500 hot meals to marginalised families, issued over 150 food bank vouchers, issued 17 free flu vaccination vouchers, delivered 37 emergency food parcels, delivered 242 sets of ingredients and recipes, and assisted families with welfare signposting in respect of white goods.
Well Fed social supermarket secures high-quality short dated food from retail and manufacture supply chains that would otherwise be sent as waste to landfill but is fit for human consumption. We sell this food to customers at reduced prices, typically an average of one-third of normal retail prices. Marketing is carefully targeted at residents on the lowest incomes and thus at greatest risk of experiencing food poverty and related health issues.
The social supermarket model innovates further by working with local agencies to provide a range of on-site support services. These are tailored to members’ needs and help them overcome multiple barriers to getting out of poverty. On-site support, signposting and assertive linkage may include money advice, debt counselling, and courses on healthy eating and cooking on a budget, as well as employability and vocational skills training. The Well-Fed Social Supermarket is a non-profit organisation with all monies re-invested back into the local community.
The Well Communities Social Supermarket is a model which enables residents in Barrow in Furness to access the retail aspect of the social supermarket and our Fairshare Model Food clubs and to be included in The Well Communities Building Better Opportunities (BBO) Project which helps members benefit from the employment and business opportunities that are arising in Barrow in Furness both now and through the longer term delivery of the BBO programme.
This is linked to the Well-fed Food Clubs which provide a sustainable alternative to free food distribution and foodbanks. Through a £3 per week payment, members receive approximately £10 to £15 worth of food each week while reducing food waste by working closely with fareshare North West by collecting the food from the regional Hub in Preston. The Well has built up a very strong membership of marginalised families; most of the postcode areas we serve are listed in the indicies of multiple deprivation. Over 30 tonnes of surplus food has been distributed to date.
The whole model is based on looking upstream and looking behind the actual need for discounted food. Each family has difficulties which mean they need to obtain goods due to some form of financial hardship; the intention is to determine such reasons and help in some way to alleviate these problems. These are then linked to in-house support mechanisms which Include assertive linkage to local statutory and third sector organisations.
Building Recovery and Community Capital
The Well identifies people’s recovery capital, identifies their passions, and works with them to create enterprises. They have had several successful enterprise ideas, the first being The Well itself, but they have also had some failures or learning that were not so successful. To get to the successful Social Supermarket idea we went through a process of ideas and attempts, the first being a catering trailer business, where the Well bought and renovated a trailer and employed a member of our community as he had experience as a chef, got a pitch for the trailer, but the marketing strategy of announcing that we were recovering addicts and alcoholics was the wrong thing to do as in the first year the project was working at a loss. The lesson was that the most important factor about a food trailer is the pitch, and let this business go but kept the company name Well-Fed and started up foodbanks.
The other successful business, “Well maintained” used the employment capital and experience within the Well membership, including carpenters, electricians, plasterers and so on, and renovated our Dolton Road Hub which is now the location for The Social Supermarket.
Conclusion
There were false first steps on the road to creating the Social Supermarket, but the commitment to the principles of peer empowerment, community engagement and CHIME have resulted in a number of successes that contribute to the growth, wellbeing and inclusiveness of the recovery community as an active and vibrant part of the local, lived community. Not all of these enterprises will succeed, but the skill base, dedication and creativity of the recovery community will ensure a net gain and a positive contribution to individual recovery journeys, family inclusion and community connections and growth.
In an earlier blog posted in 2017, I offered some preliminary observations on mechanisms of change in recovery and the variation in such mechanisms across pathways of recovery, stages of recovery, clinical populations, and cultural contexts. A recent collaboration with Dr. Marc Galanter in designing a study to investigate such mechanisms of change among members of Narcotics Anonymous has stimulated further thinking about the precise catalytic elements that contribute to addiction recovery.
Mechanisms of change involve precise behaviors that when performed over time elicit radical changes in personal character and identity, personal lifestyle, and interpersonal relationships. They involve decisions, actions, and rituals that strengthen motivation for recovery, serve as building blocks of a recovery-centered lifestyle, and elevate the quality of personal and family life in long-term recovery.
Recovery-focused behavioral mechanisms (repeated actions) lead to intermediate processes that enhance recovery stability and the progressive movement towards global health and social functioning. Such intermediate effects include increased hope for recovery, increased self-confidence in achieving recovery, improved decision-making and coping skills, increased family and social support, and spiritual awakening (sudden epiphanies and turning points; clarification of values and life goals; increased life meaning and purpose).
In my earlier blog, I noted the following: “Addiction recovery involves processes of destruction, retrieval, and creation. Destruction entails breaking entrenched patterns of acting, thinking, feeling, and relating. Retrieval involves the reacquisition of lost assets. Creation requires new recovery-nourishing daily rituals, character traits, relationships, and reformulating life meaning and purpose. These recovery processes can be thought of in terms of subtraction, addition, and multiplication.”
Understanding the mechanisms of change in addiction recovery requires 1) identifying a menu of potential actions, 2) investigating which precise actions or combinations/sequences of mechanisms have the greatest potency and 3) determining how the use of these mechanisms varies across the stages of recovery initiation, recovery maintenance, and enhanced the quality and meaningfulness of one’s life in long-term recovery. A menu of potential change mechanisms could include such actions as the following:
- Altering the frequency, intensity, or circumstances of drug use
- Stopping all drug use
- Seeking specialized addiction treatment
- Seeking other counseling
- Seeking treatment for other health conditions
- Using prescribed medication to facilitate withdrawal and to reduce craving and drug-seeking
- Using medication as prescribed to treat conditions that contribute to drug use, e.g., anxiety, depression, pain, etc.
- Participating in face-to-face recovery support meetings
- Choosing a home group / meeting for regular attendance
- Participating in online recovery support meetings
- Attending other recovery-focused events
- Sharing my recovery story
- Celebrating anniversaries of being drug free
- Participating in the service structure of a recovery mutual aid fellowship
- Reducing or ceasing contact with drug-involved friends and family members
- Severing unhealthy, addiction-supportive relationships
- Reconnecting with weakened or lost family and social relationships
- Socializing with other people in recovery and people supportive of recovery
- Reading recovery-focused literature
- Reading other change-inspiring literature
- Choosing and meeting regularly with a recovery sponsor / mentor / coach
- Serving as a recovery sponsor / mentor / coach for others
- “Working” recovery program Steps/principles
- Working to improve coping and communication skills
- Centering activities, e.g., praying, meditating, reflecting, journaling
- Participating in recovery community center activities
- Participation in religious services and practices
- Participating in recovery advocacy and peer recovery support activities
- Pursuing further education or training
- Resuming old pastimes or cultivating new interests, hobbies, and pastimes
- Helping others / acts of volunteer community service
- Improving physical health (e.g., increased exercise, improved nutrition, regular sleeping schedule, smoking cessation)
- Changing living environment
- Relocating to safer and more recovery-supportive environment
- Changing occupation or employment setting
Important research related to such mechanisms of change is progressing. Below are my predictions on what we will ultimately discover from these studies.
Mechanisms of change in addiction recovery include a core of essential mechanisms (without which recovery for most people is not possible) and a larger set of secondary and complementary mechanisms.
Such common factors are widely shared among people with diverse recovery stories, with some differences shaped by age of recovery initiation, gender, ethnicity, sexual orientation, primary drug choice, degree of problem severity, levels of recovery capital, and degree of religious orientation.
Mechanisms of change differ across stages of recovery, with some having greater salience in recovery initiation and others coming into greater play in the transition to recovery maintenance or enhancing quality of life in recovery. We will likely find variations in such effects across cultural contexts, where personal recovery must be integrated into a larger rubric of cultural values and rituals. Differences may also exist in these mechanisms across secular, spiritual, and religious pathways of recovery.
Particular combinations and sequences of actions will be identified that are particularly catalytic in recovery initiation or facilitating the transition from one stage of recovery to another.
The mechanisms of change (actions) in addiction recovery are woven together within two very different processes: story construction and storytelling. Those experiencing addiction, affected family members and friends, and those seeking to offer help all have a need for sense-making. There are numerous theories about the sources and solutions to addiction that become woven into personal and professional narratives that may or may not have anything to do with the actual processes through which such change occurs. The ultimate truth and the best news is that such change is possible and increasingly common. Behavioral prescriptions for recovery initiation, maintenance, and enhancement will become increasingly clear in future research on mechanisms of change. That is cause for considerable optimism and anticipation.
For decades, the United States has meticulously measured the prevalence of alcohol and other drug (AOD) use and related problems. The question of how many U.S. adults have resolved such problems has received far less attention until recently. In 2012, I reviewed published studies of clinical and community populations in the U.S. that reported rates of recovery from such problems, and two recent landmark studies provide the best data yet on recovery prevalence in the U.S.
Answering the basic question, “How many people are in addiction recovery in the United States?” is complicated because of differences in definitions of the problem and the solution. Reported outcomes differ depending on the language used in the surveys. Survey responses vary when questions include references to addiction, substance use disorder, or problem with alcohol or other drugs. They similarly differ depending on the resolution language: abstinence, sobriety, recovery, remission, controlled (moderate) use, or once had but no longer have an AOD problem. Recovery prevalence estimates expand and contract based on expansive or restrictive problem and solution definitions. In spite of such challenges, a series of important studies reveal a surprisingly high prevalence of lifetime AOD problem resolution that challenge the notion that “recovery is the exception to the rule.”
My 2012 review of recent studies concluded that 5.3% to 15.3% of the U.S. adult population are in remission from significant alcohol or other drug problems—a conservative estimate of 25 million people (not including those in remission from nicotine dependence alone). The reviewed surveys included the Epidemiologic Catchment Area Study, National Comorbidity Survey, National Health Interview, National Longitudinal Alcohol Epidemiologic Survey, and the National Epidemiologic Survey on Alcohol and Related Conditions. In community studies published since 2000, 54% of people who met lifetime criteria for a substance use disorder no longer met such criteria at the time of follow-up. Problem resolution strategies spanned complete AOD abstinence and deceleration of AOD use.
In 2017, Kelly and colleagues published the results from the National Recovery Study—a U.S. survey of the course of AOD problems in the adult population. Survey findings revealed that 9.1% (22.35 million) U.S. adults responded in the affirmative to the question, “Did you used to have a problem with drugs or alcohol, but no longer do?” Of those who had resolved an AOD problem, 46% self-identified as being “in recovery.”
In 2020, Jones and colleagues published an analysis of recovery data from the 2018 National Survey on Drug Use and Health. Of the 27.5 million U.S. adults reporting ever having an AOD problem (11% of the adult population), 75% (more than 20.5 million) reported no longer experiencing such problems. Both the Kelly and Jones surveys found both supported and unsupported pathways of recovery, including a substantial portion of people who had achieved recovery without participation in formal treatment or recovery mutual aid groups.
In 2020, Stefanovics and colleagues published a survey of more than 1,200 veterans who had experienced an alcohol use disorder during their lifetimes as part of the National Health and Resilience in Veterans Study. More than three-quarters of U.S. veterans surveyed who reported a lifetime alcohol use disorder (AUD) no longer met diagnostic criteria for AUD at the time of the survey.
In 2001, recovery advocates from across the United States participated in a summit in St. Paul, Minnesota that formally launched a new addiction recovery advocacy movement in the U.S. The kinetic ideas at the core of this movement included: 1) Addiction recovery is a reality in the lives of millions of individuals and families, and 2) There are many pathways to recovery and ALL are cause for celebration. Those core propositions, grounded in the experiential knowledge of people in recovery across the U.S., now have substantial scientific support. Recovery is not just a possible outcome for AOD problems; it is the probable and likely outcome when people have access to formal and informal recovery support resources.
References
Jones, C. M., Noonan, R. K., Compton, W. M. (2020). Prevalence and correlates of ever having a substance use problem and substance use recovery status among adults in the United States, 2018 [Epub ahead of print]. Drug and Alcohol Dependence, 214, 108169. doi: 10.1016/j.drugalcdep.2020.108169
Kelly, J. F., Bergman, B., Hoeppner, B., Vilsaint, C., & White, W. L. (2017) Prevalence, pathways, and predictors of recovery from drug and alcohol problems in the United States Population: Implications for practice, research, and policy. Drug and Alcohol Dependence, 181, 162-169.
Stefanovics, E. A., Gavriel-Fried, B., Potenza, M. N., & Pietrzak, R. H. (2020). Current drinking patterns in US veterans with a lifetime history of alcohol use disorder: Results from the National Health and Resilience in Veterans Study. The American Journal of Drug and Alcohol Abuse, September. DOI: 10.1080/00952990.2020.1803893
White, W. L. (2012). Recovery/remission from substance use disorders: An analysis of reported outcomes in 415 scientific studies, 1868-2011. Chicago: Great Lakes Addiction Technology Transfer Center; Philadelphia Department of Behavioral Health and Developmental disAbilites; Northeast Addiction Technology Transfer Center.
White, W. L. (2007). The new recovery advocacy movement in America. Addiction, 102(5), 696-703.
This final blog in our five-part series concludes our exploration of the portrayal of addiction recovery within 35 American comic books and 9 graphic novels.
The Role of Recovery Mutual Aid Groups
The supportive role of recovery mutual aid groups was limited exclusively to Twelve-Step groups (Alcoholics Anonymous) within American comic books and graphic novels that contained addiction storylines.
Characters seeking recovery through AA include Tony Stark, Carol Danvers, Katina (“Katchoo”) Choovanski, and five characters in the graphic novel Sobriety. Tony Stark and Carol Danvers even go to the same AA meetings in multiple issues. In Iron Man: Resolutions #313, Tony spends New Year’s Eve at an AA meeting reflecting on his early exposure to alcohol as a pre-teen and current struggles with alcoholism. The role of an AA sponsor is portrayed through the character of Dr. Black, who serves as Ruben’s (Buzzkill) sponsor:
“The rest [beyond admitting you have a problem] is going to be tough, but I’ll be here to guide you. I’ve been through this before. It’s not impossible, Man.”
All five characters in the graphic novel Sobriety were involved in a Twelve-Step program. Larry noted his early perceptions of rehab and AA: “Look at rehabs: They’re invested on getting reimbursement from health insurance companies—the very same companies that require a medical treatment. It seems to me that the Twelve Steps are about something else; it’s like a cult!”
Several characters report getting sober through the help of other AA members. The character Matt (Sobriety) describes how the Twelve-Step program works:
“The problem is easy: we have a disease of the body that causes us to lose control when we drink or drug, and an obsession of the mind that causes us to drink and drug. That’s the powerlessness that step one describes…The solution to that irreconcilable dilemma is that the other steps give us a way to restore purpose and meaning to our lives.”
Resistance to Twelve-Step programs was portrayed via the character of Matthew Parker in Larceny in My Blood. At one of his parole hearings, Parker declares: “Well, I’ll tell you what I won’t do. I won’t go to NA meetings, or AA meetings, or any of that other crap.” (He was then paroled based on his honesty). In speaking of a later parole hearing, he recalls: ”I told them what I really thought of their rehabilitation policies and 12-Step programs in particular. I just think it’s all bullshit.”
There were no references to secular, spiritual, or religious recovery mutual aid alternatives to Twelve-Step programs in the comic books and graphic novels we reviewed. Given the national and international growth and diversification of alternative groups such as Women for Sobriety, SMART Recovery, LifeRing Secular Recovery, Celebrate Recovery, and numerous others, it is somewhat surprising that they have yet to appear within comic book and graphic novel addiction storylines.
Portrayal of Addiction Treatment
The representation of addiction treatment in American comic books is limited. Natural recovery is far more common than professional treatment, and comic book storylines offer few details related to the actual nature of treatment beyond medical withdrawal. In spite of the portrayal of opioid addiction in numerous storylines, there is little portrayal of the pharmacotherapy of opioid addiction. Recovery most often involved heroic rescue or was portrayed as an isolated episode that when shaken off allows other storylines to proceed without continued references to a recovery process. Below are the few treatment references we located.
In the Batman series, there are references to Doctor Leslie Thompkins and Tiffany Fox operating addiction treatment programs without reference to what such treatment involved. The DC Fandom Wiki explains, “Doctor Thompkins ran the free Thomas Wayne Memorial Clinic for criminals and drug addicts in Gotham City. While the majority of her patients were repeat offenders, she continued to do her job with great perseverance and determination.” Dr. Thompson later ceased her helping role and became a vigilante.
There are numerous examples over multiple decades of Tony Stark seeking treatment for alcoholism, however they rarely show details of what that treatment entailed. In Iron Man: Deliverance #182, Tony is admitted to a hospital for detoxification and later shown attending AA meetings.
In Vengeance of Bane, the psychiatrist Dr. Flanders, who Bane saw while in prison, is portrayed as empathic and skilled
The character Leslie in Hey Kiddo references going to a clinic after her release from prison and getting involved with another patient there: “He’s getting treatment, just like me….Miguel and I are on this road to recovery together.” She relapses and later dies of a heroin overdose.
Alex (Sobriety) entered a government-sponsored rehab for four weeks following an overdose. He warmly describes his counselor, who introduces him to the Twelve Steps: “David was a guy who listened—really listened—to me. He was in recovery himself. And he let me see the truth of my life: that it had spun out of control and was insane.”
The most detailed of addiction treatment appears in The Abominable Mr. Seabrook.
William Seabrook’s physician admitted him to Doctors Hospital, dried him out with the aid of “prescription booze”, and then discharged him as cured. The images of this episode show Seabrook looking through bars. Following his discharge from Doctors Hospital, he immediately returned to heavy drinking and was subsequently committed to the Bloomingdale Insane Asylum. Seabrook was a challenging patient, often objecting to various rules of the institution. Treatment at Bloomingdale consisted of “cold turkey” withdrawal from alcohol, hydrotherapy (baths and wetpacks), and psychotherapy to address his “addictive personality” and his sexual perversions. Seabrook was discharged after seven months and later detailed his experience there in his book Asylum. At the end of Asylum, he proclaimed himself cured, that he could now drink without excesses of the past and that he had conquered his writer’s block. “I’m now able to take a drink or two without desiring another and I seem to be cured of drunkenness.”
Seabrook’s drinking again raged out of control.
Matthew Parker provides the most detailed account of treatment resistance in his graphic memoir, Larceny in my Blood. Parker describes being ordered into a halfway house by a judge: “I was allowed to go to work and report back to the rehab each night, which made it easy to maintain my habit.” When arrested for failing a drug test, he “played the contrite junkie.” At a later 28-day rehab, he sarcastically describes his superficial compliance: “Oh, yes, I’ve seen the light. Hit rock bottom. I’m powerless over my addiction. I have to give it away to keep it.” Then released to Maverick House, he described feeling like he was “being conned.”
On Addiction Recurrence
Addiction recurrence following a period of recovery is described in several comic book and graphic novel storylines. Carol Danvers experienced a recurrence of drinking at a time she is struggling with writer’s block. Another time, she follows the Avengers into a bar on a mission commenting that she will need to stay vigilant to avoid another recurrence. Tony Stark experienced multiple relapses across his many storylines. Below is scene from Ironman: Demon in the Bottle that offers a typical depiction of the tensions that often precede a recurrence:
“For days, the stalemate rages—until at long last, emotional blocks begin to crack, then crumble—and Tony Stark spills his pent-up pain like milk from a spilt pail. He sighs, he shudders…and he shakes.” The purge helps and he returns to work. He apologizes to Jarvis saying he has “a handle on it now,” and Jarvis responds, “You have an illness. I quite understand.” While he’s at the Avenger’s mansion, Tony knows there’s a bottle in his room but says, “I don’t need the booze…I can handle this on my own without any counterfeit courage at all.” Later back at the mansion, Tony starts to pour a drink and Beth stops him. His face is sweating, eyes are down, he’s frowning, his hands are shaking. It’s described as the “hardest battle of his life.” Beth reminds him of his life’s dream, and shaking he recaps the bottle.
The self-talk that feeds addiction recurrence is vividly displayed in The Abominable Mr. Seabrook. Following treatment and a period of sobriety, Seabrook tires of the sober life and proclaims: “I’m tired of being a cripple. From now on, I’m going to prove that I can take a drink or leave it alone, like any other man.” After losing control over his drinking again, he would pledge sobriety anew but soon became bored and commence his drinking binges. His repeated refrain when talking to himself in the mirror: What do drunkards do? They drink themselves to death.” At a later stage of his story, Seabrook’s lover and third wife-to-be plunged his hands in boiling water to scald the skin so that he would be unable to pick up a drink. Seabrook continues drinking from a liquor bottle using a straw. He was committed to the Hudson State Hospital in mid-1945. A few months later and after his release, Seabrook committed suicide with sleeping pills and whiskey on September 20, 1945.
Brandon Novak (The Brandon Novak Chronicles) re-experienced heroin addiction after publishing his book, Dreamseller, in which he recounted losing his career as a professional skater due to his heroin addiction. In his graphic memoir, he describes coming back from his “insatiable appetite for heroin.”
Addiction, Recovery, and the Family
An area of scant attention in the addictions storylines of American comic books and graphic novels is the effect of addiction upon the family or the involvement of affected families in family support groups or addiction treatment. The few conclusions that can be drawn related to family include the following.
Addiction inflicts repeated episodes of humiliation, helplessness, worry, guilt, anger, and loss on the family (The Abominable Mr. Seabrook; Drinking at the Movies, Hey Kiddo).
Addiction can become so imbedded within the marital relationship that recovery may pose more of a threat to the relationship than continued addiction. Willie Seabrook’s second wife reveals, “I confess, Willie had handled the teetotaling better than I did.”
Sustained family support can play a crucial role in addiction recovery. Jarrett’s grandfather (Hey Kiddo) purchases a house for Leslie when she finishes the release program to support her new sobriety. Matthew Parker in Larceny in my Blood recounts such support:
“But as pissed as she [his mother] was, I always had a place to live. She was too kind and I used her…. At 41 years old and on my fifth trip to prison, she [mother] saw no reason for hope…But my mom never gave up on me—I think because our shared struggles showed how bad it could get….We were still family, not despite but because of all that we had lost.”
Sustained recovery brings indescribable relief to the family. Again, Matthew Parker reflects:
“She [mother] was not convinced of my commitment to kick heroin until a year after my release, during my second semester at SCC….I think that was the first time in 40 years that my mom could relax.”
Closing Reflection
The portrayal of the role of recovery mutual aid organizations in the process of addiction recovery is limited within the storylines of American comic books and graphic novels to Twelve-Step fellowships. In spite of their recent growth in the U.S. and internationally, the existence of secular, spiritual, and religious mutual aid alternatives have yet to be portrayed. Addiction treatment is briefly referenced within the addiction storylines of American comic books and graphic novels without substantial details related to the nature of such treatment or its degree of effectiveness. Addiction recurrence following an initial recovery attempt is common within the addiction storylines, with trajectories ranging from death to a final re-stabilization of recovery. American comic books and graphic novels have yet to fully portray the effects of addiction on the family and the processes, stages, and long-term effects of family recovery from addiction.
We anticipate a future in which collaborations between addiction professionals, recovery advocates, and the writers and illustrators will produce a new generation of addiction storylines within American comic books and graphic novels that more accurately portray the prevalence, pathways, stages, and styles of long-term addiction recovery.
About the Authors: Alisha White, PhD, is an associate professor of English Education at Western Illinois University. Her research focuses on representations of disability and mental health in young adult literature and teaching with arts-based practices. William White, M.A., is Emeritus Senior Research Consultant at Chestnut Health Systems. His research focuses on the history, prevalence, pathways, stages, and styles of long-term addiction recovery.