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.

More Recent Posts

LGBT and Recovery Advocacy Movements (Tom Hill and Bill White)

January 10, 2019
Original Blog Date:  September 4, 2015 There is much that the recovery advocacy movement can learn from the LGBT rights movement of recent decades.  The latter movement is one of the most successful social movements in history as judged by the speed at which it has elicited broad changes in cultural attitudes and policies of import to the LGBT community.  We have just completed a draft of a paper on lessons drawn from the LGBT rights movement that we feel have great relevance to the recovery advocacy in the U.S. and internationally.  We invite you to read and provide us with your comments and suggestions on this paper.  The paper can be accessed by clicking HERE. If the recovery advocacy movement continues to culturally and politically mobilize people in recovery and their families and allies and to draw upon the experience of other social movements, we are likely to see the following in the coming years: A more conscious effort on the part of recovery advocates to extract lessons from the civil rights, women’s liberation, disability rights, LGBT rights, and other successful social reform movements. The expansion of symbolic firsts in recovery beyond the arenas of music, entertainment, and sports to such arenas as government, business, science, medicine, and religion. The mass mobilization of families affected by addiction/recovery, including families who have lost a family member to addiction (e.g., public story elicitation). The increased portrayal of recovery as a family achievement that produces profound effects on family relationships and family health. Continued growth in local and national recovery celebration and recovery advocacy events. Legislative milestones that mark a shift from punitive to public health responses to alcohol and other drug problems, including the dismantling of legal barriers to full community participation of people in recovery, e.g., in such arenas as housing, employment, education, health care, voting, and other areas of civic participation. The continued growth of local recovery support institutions (beyond addiction treatment and recovery mutual aid fellowships) and growth of recovery advocacy organizations addressing specialty issues related to housing, education, employment, leisure, and social networking. The growth of recovery social clubs (beyond 12-step clubhouses) and the emergence of “recovery neighborhoods” within large urban communities. Growing regional networks of recovery community centers as social, service, and organizing hubs. The proliferation of micro-businesses created by and for recovering people that will afford marginalized people in recovery opportunities to acquire new skills and participate in the licit economy. More fully developed portrayals of people in recovery within the popular media (film, television, theatre, and literature), including the portrayal of the diversity of people living in long-term recovery and the varieties and styles of long-term recovery. Growing interest in the history of the recovery advocacy movement via new historical treatises, memoirs, and documentary films. Growing sophistication in advocacy/activism, issue articulation, and mobilization strategies. Tensions within the recovery advocacy movement on the boundaries of movement inclusion (e.g., range of inclusion of people recovering from other compulsive behaviors) and definitions of recovery. The abandonment of professionally stigmatizing language within healthcare and specialty sector addiction treatment (e.g., abuse/abuser, alcoholic/addict, and clean/dirty) as a result of successful recovery advocacy efforts. The establishment of recovery as a legitimate research and clinical specialty within the alcohol and other drug problems arena. Development of sophisticated strategies to fund recovery advocacy efforts, including expanded donor base (large and small gifts) from recovery community members, corporations, and foundations. Advanced awareness of factors that impact recovery organizing and outreach, such as gender, sexuality, culture, race, class, and histories of trauma and incarceration. Continued capacity-building and infrastructure development in recovery community organizations, institutions, cultures, and the networks that connect them. We look forward to hearing your thoughts and suggestions on this latest paper. A final version of this paper will be posted that incorporates this feedback. Appreciatively, Tom and Bill William L. White Emeritus Senior Research Consultant Chestnut Health Systems Punta Gorda, Florida William (“Bill”) White Emeritus Senior Research Consultant at Chestnut Health System Recovery Historian Read all of Bill White’s Blog Posts on his website here

7 Steps to Start the New Year off on a Positive Note

January 7, 2019

Happy New Year! 2019 is here, and with it comes a whole new world of possibilities. What will you accomplish in 2019? How will you grow? Who will come into your life? The next 365 days lie before us, a completely blank page ready to be written on.

However, these next few days are critical to how you start the new year. Because January marks new beginnings, it can also influence the rest of 2019, which means the beginning of the year can affect the end of the year. And of course, you want 2019 to be a great year! If you want to start the new year off on a positive note, check out these seven steps to keep in mind as we dive into 2019.

1. Reflect on 2018.
The first step in starting your new year off right is reflecting on what went right (or wrong) in the previous year. Take some time to reflect on 2018 and evaluate everything you liked, loved or hated. What did you do well? What could you have done differently? Take notes so you can thoroughly examine the previous year.

2. Set achievable goals.
Once you have 2018 in mind, it’s time to move forward into 2019. Imagine the very end of 2019. What do you want your life to look like? Get a vision for the future, and then work your way backwards to set goals for the year. But, make sure these goals are actually achievable, not just impossible dreams that will leave you feeling unaccomplished.

3. Use positive language.
Did you know you can actually speak positivity into your life? How you use words can influence the atmosphere around you and the attitude inside you. Be sure to use positive language throughout your everyday life, but particularly when goal-setting. For instance, instead of “lose weight” a goal could be “exercise three times per week.”

4. Avoid toxic relationships.
Let’s be honest: some people can have a negative influence on our lives. And often—for whatever reason—we let them stay. This year, take proactive steps to avoid toxic relationships which tear you down or make you feel unhealthy. Hopefully the other person will take positive steps in their life to change the behavior, as well.

5. Incorporate positive habits.
Oftentimes, little steps which seem simple can actually have a hugely positive impact on our lives. For instance, take time every morning to relax and read a good book with a cup of coffee. Or, journal about a positive experience you had the previous day. By incorporating small, favorable habits throughout the day, you will feel much more positive overall.

6. Ask for help.
One action that is not positive: trying to handle everything on your own. This independent, “let me handle it” mindset often leads to frustration or defeat. Instead, start the new year off on a positive note by intentionally asking for help when you need it. Not only will it take stress off, but you will have a much better chance of accomplishing your goals.

7. Give back to others.
Ultimately, one of the best ways to incorporate positivity throughout the new year is by giving back to others. Numerous studies and research have shown that volunteering and donating actually have extremely positive effects on the giver, not just the receiver. So if you want to have a positive year in 2019, consider how you can give to those in need in your community.

With the new year comes a whole new world of possibilities for things to do, say or accomplish. If you want to start the new year off on a positive note, consider these seven steps to incorporating positivity into your life. Give them a try and see how your life grows in 2019.


January 5, 2019

Steps to accomplish task:

1.    Contact affiliate via email
2.    Include this introduction:  “Dear ___________, I am a volunteer working with Faces & Voices of Recovery.  I’m working on a project to highlight the amazing work of our affiliates across the nation.  Patty McCarthy, Executive Director, asked me to contact you to write a brief spotlight about the incredible work your organization is doing.  If you are willing to be spotlighted on the Faces & Voices of Recovery website and on social media, will you please respond to the following questions?
a.    How has your organization addressed the opioid/addiction epidemic? (specific program or advocacy activity)
b.    How are people impacted by addiction part of the solution through your organization?
c.     What is advocacy priority in your state or local community?
3.    Please ask them to limit their response to 500 words.
4.    Select a deadline that allows enough time for you to review and edit the response and to upload the spotlight to the website.
5.    New spotlights will be released the first day of each month.

Recovery is Contagious Redux

January 3, 2019

Original Blog Date:  January 25, 2014

Those of you who have been reading my weekly blogs these past six months will recognize two simple and enduring themes: Recovery is contagious and recovery is spread by recovery carriers.  Those notions first came to me on April 14, 2010 when I stood to speak at Northeast Treatment Centers’ (NET) dinner honoring NET’s 40th anniversary and the achievements of NET members.   Here are some of the words that came to me as I stood before a room packed with people filled with hopes of what their newly found recoveries would bring.

“This night is a celebration of the contagiousness of recovery and the fulfilled promises recovery has brought into our lives.  Some of you did not leave the streets to find recovery; recovery came to the streets and found you.  And it did so through volunteers of the NET Consumer Council walking those streets.  They put a face and voice on recovery.  They told you that recovery was possible, and they offered their stories as living proof of that proposition.  They told you they would walk the road to recovery with you. Some of you hit low points in the early days of that journey, and it was your brothers and sisters in this room that lifted you back up–who called when you missed group, who, in some cases, went and got you.”

“The contagion of addiction is transmitted through a process of infection–the movement of addiction disease from one vulnerable person to another.  The contagion of recovery is spread quite differently–not through infection, but affection.  Those who spread such affection are recovery carriers.  Recovery carriers affirm that long-term recovery is possible and that the promises of recovery are far more than the removal of drugs from an otherwise unchanged life.  They tell us that we have the potential to get well and to then get better than well.  They challenge us to stop being everyone’s problem and to become part of the solution.  They relate to us from a position of profound empathy, emotional authenticity, respect and moral equality–lacking even a whisper of contempt.  Most importantly, they offer us love.  Yeah, some of us got loved into recovery, and I don’t mean in the way some of you with smiles on your faces may be thinking.”

“We all have the potential to be recovery carriers.  Becoming a recovery carrier requires several things.  It requires that we protect our recoveries at all cost–Recovery by any means necessary under any circumstances.  It requires that we help our families recover.  It requires the courage to reach out to those whose lives are still being ravaged.  It requires that we give back to NET and other organizations that helped us along the way.  And it requires that in our new life, we try to heal the wounds we inflicted on our community in our past life.”

“Addiction is visible everywhere in this culture, but the transformative power of recovery is hidden behind closed doors.  It is time we all became recovery carriers.  It is time we helped our community, our nation, and our world recover.  To achieve this, we must become recovery.  We must be the face and voice of recovery.  We must be the living future of recovery.”

“So to all who are here tonight–individuals and families in recovery and allies of recovery, I leave you with this message.  Recovery is contagious.  Get close to it.  Stay close to it.  Catch it.  Keep catching it.   Pass it on.”

I’m still not sure where those words came from; I had never used such phrases before, but I believe them even more today than when they were first spoken years ago on a spring evening in Philadelphia.

Medication Patients May Find Chilly Reception in NA’s Rooms

January 3, 2019

Addiction Professional, December 27, 2018

Attending Narcotics Anonymous (NA) meetings had reinforced Alan Wartenberg, MD’s recovery for years, until the early 1990s when he started overseeing medical services at New England programs that offered methadone treatment. The reaction the internist says he then received from some members of the NA fellowship ran the gamut from uncomfortable to downright menacing.

“I was ‘outed’ at meetings, by members who were saying people were killing people with these drugs,” recalls Wartenberg, who has served as a consulting physician for facilities such as Meadows Edge Recovery Center in Rhode Island. “At one point I was even threatened, by a 19-year-old,” he says with a tone of bewilderment.

At a time when a deadly opioid crisis rages and treatment professionals respond with an ever-warming embrace of the evidence-based agonist medications methadone and buprenorphine, attitudes in the most prominent mutual-support group for individuals with opioid addiction are much slower to change.

Professionals and advocates interviewed by Addiction Professional describe a scenario in which individuals attending NA meetings might not even know from meeting to meeting how their use of these medications will be looked at in their home group—even in those groups that hold a comparatively welcoming attitude toward individuals on medication-assisted treatment (MAT).

They add that treatment programs that recommend or even mandate 12-Step meeting attendance as part of a recovery plan often have no idea how receptive local meetings are to members on MAT. Some individuals are likely to encounter NA members who will aggressively urge them to stop taking agonist medication, suggesting it is not compatible with true recovery (a notion that contradicts how groups such as the physician-based American Society of Addiction Medicine define recovery).

“This creates a hierarchy, a notion of ‘I’m better than you,’” says Brandee Izquierdo, director of advocacy and outreach at the national organization Faces & Voices of Recovery. “I don’t think NA has sat down long enough to flesh this out.”

For its part, NA acknowledges that the topic has caught the attention of those at the highest level of governance in the worldwide organization.

“NA World Services has heard through member delegates of geographic areas in the Fellowship and from professionals that we have vocal members who do not welcome those on medication to treat addiction,” says Jane Nickels, a member of NA’s public relations team. In response, she says, the organization’s World Board has encouraged a fellowship-wide discussion of MAT as it relates to NA, with plans in the works to issue new literature on the topic after NA convenes for its 2020 conference.

The question remains as to whether this response is sufficient or rapid enough, when some NA group members may be persuaded to believe they would be better off quitting the medications that science considers their best defense against returning to dangerous use of heroin or prescription painkillers.

Adhering to tradition

As with Alcoholics Anonymous (AA), NA explicitly states as part of its organizational philosophy that it does not express opinions on issues it considers outside its focus on 12-Step recovery. That includes medical issues such as MAT.

NA spokespersons, however, also referred Addiction Professional to a published pamphlet written for health professionals who prescribe medication for addictions. The language in “Narcotics Anonymous and Persons Receiving Medication Treatment” clearly depicts a separation between members who receive MAT for opioid addiction and those who don’t.

The pamphlet defines the term ”clean” as typically referring to “being free of all drugs, or abstinent. However, an addict who is not clean is free to attend meetings; we hope through attendance at meetings addicts will gain a sense of belonging and identification with other recovering addicts.”

Another section of the pamphlet states, “Our hope is that those who receive medication to treat addiction will come to meetings and listen to people who are recovering. … NA offers a community and a lifestyle that support staying clean, and NA may be compatible for addicts on medically assisted protocols if they have a desire to become clean one day.”

Wartenberg says this plays out largely in a scenario in which individuals on MAT are encouraged to attend meetings but not actively participate. “They need to keep quiet and listen,” he says.

He adds that in an unscientific canvassing of NA groups in the Boston and Providence, R.I., areas, he found that around three-quarters of them followed to the letter an NA position that holds that any individual still taking an opiate is still considered to be using.

Wartenberg sees this mindset as damaging to individuals, at a time when they could benefit greatly from a fully supportive community of peers in recovery who would reward them for their progress in stopping their heroin or prescription opioid use.

“These are folks who haven’t gotten a lot of standing ovations in their life,” he says.

He says AA once held a similar stance toward medication treatments for alcohol dependence, such as disulfiram (Antabuse), but he has witnessed a softening of that position over the years. Meanwhile, he sees NA as “doubling down” on the notion that MAT falls short of true recovery. One clear reason for the difference in philosophy, he believes: There are no “substitute” drug treatments for alcohol in the alcoholism treatment arsenal—nothing analagous to methadone or buprenorphine.

As a result of NA’s perspective, “If we have patients who really want to take part [in a 12-Step fellowship], we tell them, ‘Go to an AA meeting,’” Wartenberg says. He has said to patients, “When they say the word ‘alcohol’ in the meeting, you think ‘all drugs.’”

Nickels, the NA spokesperson, says the organization also takes no official position on members’ use of the opioid antagonist Vivitrol, or on their use of psychotropic medication. She says all of these matters are seen as falling under Tradition Ten of NA’s guiding principles, which states, “Narcotics Anonymous has no opinion on outside issues; hence, the NA name ought not to be brought into public controversy.”

Should members disclose?

Another approach backed by Wartenberg, who admits that his own initial medical training was strongly anti-methadone, involves not revealing one’s medication status when participating in an NA group. This in fact does not conflict with NA’s own stance, as NA World Services “has no opinion on self-disclosing for those who receive MAT,” the NA spokesperson said in comments e-mailed to Addiction Professional.

But the founding president of SMART Recovery, the best-known alternative support group organization to 12-Step based groups, believes that encouraging people not to reveal such information (in a setting where they otherwise are expected to be honest) can be psychologically damaging.

“I was at an MAT talk at an ASAM conference, where a speaker advised that professionals tell patients not to admit taking medication, and I found that scandalous for clinical and ethical reasons,” says Joe Gerstein.

Gerstein, a physician, adds that in the 3,000-plus SMART Recovery meetings he has facilitated, “I have never heard a discouraging word about appropriately prescribed medications.”

For some individuals, then, alternatives to 12-Step support might be preferable to a situation in which a person might be welcomed to an NA meeting one week, only to feel isolated next time because a new group leader with a contrary opinion has taken over.

Encouraging a dialogue

Faces & Voices of Recovery’s Izquierdo, who says she has been open about her work in the NA fellowship and has been criticized by some members for language she uses outside the group, would like to see a meeting of the minds on the MAT issue.

“We need to do some kind of workshop that discusses how to merge the ideas of accepting harm reduction and MAT while staying authentic to the fellowship,” Izquierdo says. “It’s hard to advocate when members of the recovery community are battling each other.”

In the meantime, Wartenberg believes it is important for professionals in facilities such as opioid treatment programs (OTPs) to warn their MAT patients of what they might encounter in NA. At the extremes, they may be told that buprenorphine and methadone represent a profit-driven ploy to enslave patients—a legal drug trade of sorts.

“There are OTPs that mandate that patients go to NA,” Wartenberg says. “They don’t have a clue.”

Yet Mark Parrino, president of the American Association for the Treatment of Opioid Dependence (AATOD), which represents OTPs, says the programs with which he is familiar don’t mandate 12-Step attendance for that very reason, over concerns about members’ perspective on medications.

“I’ve heard in open meetings comments that if you are on medication, you have not achieved recovery,” Parrino says.

This mindset creates something of a self-fulfilling prophecy, Wartenberg says, when regulars at NA meetings see an MAT patient stop attending meetings after just one or two visits. This reinforces their view that the person on MAT is not doing well, and would see better results with total abstinence, he says.

For Wartenberg, the path he chose was to disengage from NA in his own recovery. He became involved in trying to organize “Methadone Anonymous” groups as an alternative to NA in some programs where he worked. However, “We never got to a real critical mass,” he says, with membership rising initially but then falling off.

Izquierdo has taken a different approach, choosing to stay in a fellowship that she still would like to see make more progress toward embracing the science.

“In the beginning I thought, ‘Maybe I’ll explore another pathway,’” she recalls. “But if I leave NA, it would be like leaving an old neighborhood. If your neighborhood goes bad, are you part of the problem because you’re leaving it?”

Make Giving a Part of Your New Year’s Resolutions

December 31, 2018

Ah, New Year’s Eve. Every year, this day brings with it a sense of excitement, anticipation and hope as we look forward to the upcoming year. Suddenly, everything that happened in 2018—the things we did or didn’t do, did or didn’t say—doesn’t seem to matter as much. Instead, we can look ahead and clearly see 2019 laid out before us, untarnished and ready for our next adventures in life.

Of course, with New Year’s Eve come New Year’s resolutions. These resolutions symbolize the things we care about most in life, and reflect the areas of life we want to improve. Whether it be weight loss, reading more or simply trying something new, resolutions often mark what matters most to us. Which means, if you want to make a difference in 2019, make giving a part of your New Year’s resolutions. Here are some ideas for how you can create resolutions that give back.

Get your family on board.
One simple way to make giving a part of your New Year’s resolutions is to get your family on board. Altruism is an incredibly important value to instill in young children. As you make plans for 2019, consider how you and your family can serve the community together.

Share on social media. 
With today’s technology, social media often plays a critical role in the success of various fundraising and awareness efforts. This year, see how you can support organizations around the world simply by sharing, tweeting, pinning or posting.

Give blood.
No matter who you are, we all have something we can give: blood. If you’re eligible, make a commitment to donate blood consistently in 2019. Whether you give to a community blood bank or a national chain, you can feel confident in your efforts to support—and save—another’s life.

Mentor a child.
Speaking of support, you can many times find children in need of support in the community. One way you can support a child in 2019 is by volunteering to be a mentor. Give a child the gift of someone who loves, encourages and supports them this year to have an impact on their life.

Pay it forward.
For a simple way to have a huge effect this upcoming year, pay it forward. Commit to taking small acts of kindness whenever you possibly can. For example, pay for a person’s coffee, leave a caring note or donate used goods. However you pay it forward, keep the message of positivity moving in 2019.

Volunteer consistently.
If you want something to really commit to doing next year, then consider volunteering consistently. Local and national nonprofit organizations are constantly looking for new people to get involved with their cause. Join in as a regular volunteer they can rely on.

Commit to donating.
Finally, make a difference in 2019 by finding a cause you care about and committing to donating regularly. While one-time donations are definitely celebrated, regular donations can have a huge impact all-year round. Find a monthly amount you feel comfortable with and commit to giving.

With 2019 upon us, the New Year’s resolutions will soon start rolling in. If you want to have an even-greater impact this upcoming year, make giving a part of your resolutions. Try out some of these ideas, or come up with your own to give back and make a valuable contribution to the life of a fellow human being in 2019.

The Recovery Monographs (Volumes One and Two)

December 28, 2018

Original Blog Date:  March 25, 2016

By the late 1990s, tremendous strides had been achieved in elevating the accessibility and quality of addiction treatment in the U.S., yet leaders in the field were beginning to suggest the need for a radical redesign of addiction treatment—a shift from acute and palliative care models of intervention to models of assertive and sustained recovery management (RM) nested within larger recovery-oriented systems of care (ROSC).  In 1998, I began work with Michael Boyle on the Illinois-based Behavioral Health Recovery Management (BHRM) project—a project specifically charged with exploring the potential of adapting chronic care models drawn from primary medicine to enhance the quality of addiction treatment. The papers on RM emanating from the Illinois project garnered considerable attention and led to early consultations with the State of Connecticut and the City of Philadelphia–early pioneers in RM-focused systems transformation processes.  The early BHRM work also led to an invitation from the Center for Substance Abuse Treatment’s (CSAT) Great Lakes Addiction Technology Transfer Center (ATTC) to author and co-author a series of monographs on RM & ROSC. I could not be more delighted that the most central of these monographs have now been assembled into a two-volume set of books (available in hardcopy and as e-books) through support from the Center for Substance Abuse Treatment’s ATTC Coordinating Network. Also of note is that all royalties from these books will be paid directly to support the work of Faces and Voices of Recovery.

The first monograph, Recovery Management, was published in 2006 and contained four essays.  Recovery: The Next Frontier, originally published in Counselor in 2004, described the emergence of recovery as a new organizing paradigm for addiction treatment and non-clinical recovery support services. The Varieties of Recovery Experience, co-authored with Dr. Ernest Kurtz and published in abridged form in the International Journal of Self Help and Self Care, summarized what could be gleaned from history and science about the pathways, stages, and styles of long-term addiction recovery. Recovery Management: What if we Really Believed Addiction was a Chronic Disorder? was a preliminary attempt to outline the changes in service practices implicit within RM models of care.  And Recovery Management and People of Color, co-authored with Mark Sanders and originally published in Alcoholism Treatment Quarterly, was a first attempt to explore application of the RM/ROSC model to historically disempowered communities.

Wide dissemination of the first Great Lakes ATTC monograph on recovery management generated considerable interest from the field and led to two follow-up monographs in 2006 and 2007. Recovery: Linking Addiction Treatment and Communities of Recovery, co-authored with Dr. Ernest Kurtz, offered concrete suggestions for addiction counselors and recovery coaches on how to best link those they served with recovery mutual aid societies and other indigenous recovery support institutions.  The third monograph, Perspectives on Systems Transformation: How Visionary Leaders are Shifting Addiction Treatment Toward a Recovery-Oriented System of Care, focused on the RM/ROSC implementation process through a collection of interviews offering national (Dr. H. Westley Clark), State (Dr. Thomas Kirk), municipal (Dr. Arthur Evans, Jr.), program (Michael Boyle), recovery community (Phil Valentine), and ATTC (Lonnetta Albright) perspectives on the implementation of RM/ROSC principles.

These first three monographs can be ordered by clicking Recovery Monographs, Volume I.

One central question loomed as RM/ROSC language and approaches spread through the field: What is the evidence-base for this proposed redesign of addiction treatment?  The fourth monograph, Recovery Management and Recovery-Oriented Systems of Care: Scientific Rationale and Promising Practices, was released in 2008 to answer that question.  It describes promising practices in such critical treatment performance areas as attraction, access, screening/assessment, engagement/retention, team composition, service relationship, service dose/scope/quality, locus of service delivery, linkage to recovery communities, and post-treatment monitoring and support.

If there was a single area within RM/ROSC proposals that captivated the field’s attention and often emerged as the most visible element of RM/ROSC transformation efforts, it was the reintegration of people in recovery into the addiction treatment arena in both volunteer and paid roles at all levels of the system. Such integration generated mountains of emails and calls about how to achieve such integration and the evidence-based approaches to such efforts.  In response, the fifth monograph, Peer-based Addiction Recovery Support: History, Theory, Practice, and Scientific Evaluation, was published in 2009.   This monograph achieved two goals.  It addressed what was known at that time about peer-based recovery support services from the standpoint of history and science, and it described in considerable detail how peer-based recovery support services were being implemented within addiction treatment and recovery community organizations across the United States.

In 2010, a major question arose about the implications of RM/ROSC for medication-assisted treatment. This question prompted collaboration with Lisa Mojer-Torres (the “Rosa Parks of Medication-Assisted Treatment”) in co-authoring the sixth monograph, Recovery-oriented Methadone Maintenance (ROMM).  The ROMM monograph was widely disseminated and led to numerous follow-up presentations and papers.  Two other monographs and a book (Addiction Recovery Management coedited with Dr. John Kelly) followed this first series, but I will always think of these first six monographs as my foundational writings on RM/ROSC.

Monographs four through six can be ordered by clicking Recovery Monographs, Volume II.

The RM/ROSC monograph series was done in tandem with numerous other efforts to enhance long-term recovery outcomes in the U.S. Of particular note is the now iconic paper on addiction as a chronic disorder led by Tom McLellan that was published in the Journal of the American Medical Association in 2000. There were also CSAT monographs and monographs from other ATTCs during these same years that played an important role in promoting RM/ROSC system transformation efforts   And the increased focus on long-term recovery would not have been possible without the research studies of Michael Dennis, Mark Godley, Susan Godley, James McKay, Christy Scott, and others focused on extending the effects of addiction treatment through assertive approaches to post-treatment continuing care.

There are many people to thank for their support of this monograph series, but none more important than Dr. Westley Clark, Lonnetta Albright, Dr. Michael Flaherty, and Dr. Arthur Evans, Jr. whose leadership and support were beyond what words can adequately express. RM/ROSC offered a new vision and new service technologies that promised to transform addiction treatment from an almost singular focus on recovery initiation to a system capable of supporting enhanced stability and quality of personal and family life in long-term addiction recovery. It will be up to future generations to judge how close we as a field came to fulfilling that vision.

6 Ways to Brighten Someone Else’s Christmas

December 24, 2018

Merry Christmas Eve! If you celebrate Christmas, then chances are you’re spending today wrapped in a warm blanket, curled up by the fire and sipping hot chocolate with loved ones. You may have spent the last weekend ice skating, baking cookies or opening up a present or two. But, what have you done for someone else this Christmas?

While the holiday season is a joyful time for many, it can also be a difficult time for others. If you live an altruistic lifestyle, you can give back and make someone’s holiday a bit more joyful. Here are six ways you can brighten someone else’s Christmas.

1. Call your loved ones.
One simple way to brighten another’s Christmas is by calling. Some of your loved ones might live far away, have different plans or not be able to see you during the holiday season. Particularly for older family with limited mobility, this can be difficult. However, you can brighten their day by simply giving them a call and checking in. A few quick words of encouragement and affirmation can make a world of difference this Christmas.

2. Make Christmas dinner.
Food is always the perfect way into someone’s heart, especially through Christmas dinner. You can spread the love and brighten someone’s day this Christmas by making a little bit extra of dinner to share. For people who may not be able to cook for themselves or can’t afford to buy the ingredients, this can truly be the greatest gift of all.

3. Invite someone over.
It’s often been said that the holidays are the loneliest time of the year. Unfortunately, lots of people find themselves alone during Christmas for a variety of reasons. Instead, bring extra joy this year by inviting someone into your home. Share food, time and conversation with them to show how much they are loved and valued this holiday season.

4. Donate a gift.
Many individuals, families and children cannot afford gifts during the Christmas season. If you find yourself with a little bit of extra income, time or gifts this week, consider donating extra presents to a family in need. Whether you give gently-used goods, or buy a brand new toy off the shelf, you can definitely brighten someone else’s day—particularly a child’s.

5. Volunteer in the morning.
We get it: Christmas is a time to spend with your loved ones, which makes volunteering a tough request. But, why not consider volunteering Christmas morning? After you open presents with family, create a new tradition by volunteering at your local shelter or nonprofit organization. A simple hour or two of your time can have a huge impact on someone’s day. Afterwards, you will still have plenty of Christmas left to spend together eating, talking and celebrating.

6. Have a conversation.
Ultimately, one of the most valuable gifts you can give this Christmas season is your time. Have a deep, intimate conversation with a loved one, neighbor or even a complete stranger, to share in the spirit of the season. While some people might feel alone or hurt during the holidays, you can share joy by listening to their stories and speaking affirmation into their lives.

Christmas is a wonderful time to spend together with family, friends and loved ones. However, it’s also an opportunity to give back. If you want to brighten someone else’s Christmas this year, keep these tips in mind to spread the holiday cheer.

Good Tidings Do Shine

December 21, 2018

I listen to the radio. The seasonal carols have begun. I Hark!—and sing along. I repeat and repeat the sounding joy. Of course, many stories and carols focus on the news of old, proclaiming, “unto us a child is born.” I recall the words of that grown up child who, it is written, said, “if you don’t believe in me, believe in what I teach.” Of course, the radio also brings snooze news, commercials galore, and talk shows.  Beyond the nativity is the negativity.

Not all good tidings:  I have read many Christmas stories. I just discovered one I missed. It’s a nativity story called the “Grumpy Sheep.” Among the shepherd’s flock is a grumpy sheep who is not only cross but lazy as well, and has the wrong idea of what the big deal is about not joining other sheep to see this new arrival. The grumpy sheep does discover that it is a big deal when she finally goes to the manger. We now celebrate that “big deal” of long ago as Christmas. Grinch is grumpy. Scrooge is grumpy. Now, in spite of many reasons for joy and contentment, there are millions of grumpy sheep following grumps. They are caroling, do you fear what we fear, say the grumps to the fearful sheep. Baa baa, humbug.  Offsetting this was the celebration of the life of George H.W. Bush, who gave us words to remember.  “Hate corrodes the container it’s carried in.” Living in a kinder, gentler nation is a valid notion that will serve us well in any season

Good tidings. The drug crisis presents opportunity. The positive state of the economy allows increased resources to find solutions and overcome the present and any future crisis.  The recovery movement is strong and growing. Holiday season is very much about children. Unto families, children are born. It has been written that it takes a village to raise a child. For our children and all of us, all the nation’s villages must face and overcome the crisis of the evil that is drug misuse and addiction. In the Betty Ford Children’s Program, illustrated books for children portray, in cartoon style, addiction as a villainous character that destroys families.  In the program, boys and girls, seven to twelve years old, learn about alcoholism and drug abuse and how to separate the person they love from the disorder that consumes them. Even at very low or no cost, there is resistance to assistance driven by stigma, shame, and guilt held by parents and family members. Needed is the lived experience of family peer support.

Not so good tidings: In the face of the devastating news about opiates, we forget that there are other drugs like alcohol, nicotine, and marijuana. These remain threats to families. Alcohol remains the #1 killer. It is cheap, legal, and accessible. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) notes that holiday celebrations feature alcohol and consequences. They provide a Navigator to show the way to safety and sobriety. Vaping is the new delivery system for nicotine and marijuana. It is a growing threat to our young people. Surveys showing growing use by the very young are alarming. The real threat will be impaired brain development and addiction. There is little joy when Individuals and families are living in quiet desperation due to alcohol and other drug mis-use and addiction.

Good tidings. There is hope for families. Over the past few years, “systems of care” have been developed. There are frameworks that involve collaboration across government and private agencies, providers, families, and youth. Community reinforcement and family training (CRAFT) in communities around the country, has been shown to have success in getting substance abusers, perhaps with medical assistance to be motivated to get into treatment.  CRAFT is a set of therapeutic techniques taken from community reinforcement approach (CRA) and applied to the substance abusing population. Rather than target the person with addiction directly, CRAFT works with the concerned significant others (CSOs) so that they can assist the identified patients (IPs). Congress has taken action in the passage of the SUPPORT for Patients and Communities Act.  It includes policies and resources that support individuals and families in recovery from addiction across the lifespan. The act provides for building communities of recovery. Faces and Voices or Recovery founded the Association of Recovery Community Organizations—ARCO.  It has an important role to play.

Timely Tidings: Bill White’s blog titled “Family Recovery 101” has been republished recently on the Faces and Voices of Recovery Blog site. He writes:  “Knowledge about the effects of addiction on families and the family recovery process has grown exponentially as a result of scientific studies and cumulative clinical experience. He outlines 12 important conclusions from this knowledge.” His blog concludes with some important words: “It is time—no, past time—that the basic unit of service within recovery support service settings shifted from the individual to families and kinship networks. Making that shift will require substantive changes across the addiction treatment and recovery support service continuum.”

Very Good Tidings: May all seek and find the joy of hope, help, and holiday spirit and together let’s repeat and repeat the sounding joy,

“Mama’s in Recovery” – Caroline’s Story

December 19, 2018

Meet Caroline, our December “Mama’s in Recovery” feature story.  Caroline took the time to sit down with Faces & Voices of Recovery to share a bit of her recovery journey.

Caroline’s story is one we hear far too often.  At the ripe age of 14, Caroline began drinking and smoking marijuana, quickly taking to pain medication.  By the age of 17 she was in full blown addiction.  Her parents did what they could, sending her to long-term treatment facilities, but Caroline “had no desire to be in recovery…her parents tried to control it and she only stayed because she had to”.  Her first treatment experience was in Florida and when she came back to her home state, she picked up that first drink and soon found herself right back in the grips of addiction.  After her second go at treatment, Caroline moved home for good, connecting to a three-quarter recovery house, and her journey began.

It was in the recovery house that Caroline was asked to join a few others in recovery for a fellowship convention.  Of course, for Caroline, the convention was exciting and as a bonus, she was exceptionally excited about the guys, “it was like a man fest”.  That’s where she met, her now husband, Dan.  They were babies in recovery with about six months under their belt, but there was something about Dan that drew Caroline, “I was young and naïve, and he was well established with a career”.  For Caroline, this was her first “real” relationship, “I acted out and he would leave…we would go back and forth but he didn’t give up on me”.  That support spoke to Caroline as she transformed through her recovery process, “I slowly became more polished.  If the old me were to meet the new me…the old me wouldn’t think I was capable of being the new me”.

Caroline and Dan both continued their journeys and after 5 years of marriage, little Sydney made her mark on the world.  For Caroline, there was a lot going on in her life when she got pregnant, “it wasn’t an ideal time” but they welcomed the bundle of joy with open arms.  Juggling responsibilities, Caroline knew that change was on the horizon and wanted to make a change that could help other women just like her.  That change came when Caroline opened a recovery house.  Between selling her cleaning business and opening up a recovery house, Caroline stays active in the recovery community.  She doesn’t have much time on her hands and while the recovery house keeps her connected to women who are fresh in recovery, she still enjoys connecting to the mamas in recovery.  For Caroline, the group of moms share their struggles and joys, “I look to them as friends.  They know things about me that I wouldn’t share with everyone and we can be vulnerable.  We talk about sex or lack thereof”.  Caroline mentioned that, “mom shaming is a big thing in the world.  There’s a lot of judgment passed on us and we judge ourselves.  Anything I feel guilty about, I bring it to them.  They are my confidants and understand every aspect of my life”.  For the mamas, recovery comes up but its not all about recovery, recovery is interwoven into life, “I take my recovery skills and apply them to real life.  “I have awareness and live life, striving to be the best version of myself that I can be”.  Caroline expressed that her recovery lifestyle impacts Sydney, “I’m raising her to know that she is enough”.

Caroline has the support of the mamas in recovery but also has the support of her family.  Both her mom and dad are in recovery and her mother, Jill, even works as a Certified Family Recovery Coach!  With the mamas, Caroline has grown in her recovery and the connections offer new discovery and companionship.  Faces & Voices of Recovery is proud to be one of those connections.  Thanks to Caroline and Dan for sharing their love and showing so many that recovery is a family affair!  Happy Holidays to you and congratulations on your precious gift, Sydney!

Posts from William White

Program Oversight Tip Sheet

October 1, 2021

Peer recovery support service (PRSS) programs should have an established, formal recovery community advisory council or community board, in addition to a Board of Directors.

Board of Directors Tip Sheet

October 1, 2021

Building a Strong Governing Board

A peer recovery support services (PRSS) program benefits from having a strong board that is dedicated to the mission of the organization, representative of the local recovery community, and effectively prepared for their governing role.

Marty Walsh US Secretary of labor video

September 30, 2021

What Does the Future Hold for the Recovery Community?

September 9, 2021

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.

COVID-19 Vaccine FAQs

August 25, 2021

COVID-19 Vaccine FAQs_FVR

Ethics Tip Sheet

April 6, 2021

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.

We Have Been (Addiction Lament & Recovery Celebration)

February 25, 2021

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.


National Standards of Best Practices for RCOs

February 24, 2021

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.

Recovery Innovations: The Well-Fed Social Supermarket

February 18, 2021

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


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.


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.

2020 Faces & Voices of Recovery Annual Report

February 13, 2021