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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The Advocacy & Outreach ProgramAssistant provides support for the Public Affairs department within the organization. The Program Assistant works on advocacy and public policy projects collaboratively with team members on activities such as awareness campaigns, legislative issues, public speaking events, constituent training, national and international outreach.The primary purpose is to provide administrative support to ensure project goals are met efficiently and in a timely manner.Duties & Responsibilities
- Answer phone and emails and respond to requests for information and resources
- Create calendar events in Outlook
- Maintain project files in Sharepoint
- Enter data into Salesforce
- Host virtual meetings through the Zoom platform
- Schedule conference calls and meetings
- Prepare meeting materials and record meeting notes
- Assist with collecting project data and preparing reports
- Update website as needed
- Create surveys and collect results
- Coordinate travel and event logistics
- Other administrative duties
- Strong commitment and enthusiasm for recovery advocacy and the people and groups we serve around the country
- Must be a self-starter with the ability to work independently and as a team.
- Administrative experience required
- Strong aptitude for technology required
- Proficient in Microsoft Office Suite, including SharePoint
- Experience with Salesforce, WordPress, Survey Monkey, Doodle a plus
- Superior internet research skills
- Excellent interpersonal, organizational, and written/oral communication skills
- Copy editing skills a plus
- Bachelor’s degree preferred; Associate (AA) or equivalent administrative experience required
- $40,000 – $45,000 – Commensurate with experience.
Faces & Voices of Recovery employs remote workers, but projects may require staff to travel. All necessary personal arrangements for travel; childcare, house care, etc. should be done on staff personal time. Errands, like shipping and mailing, that pertain to projects can be done during work hours. All staff are required to maintain a suitable home office environment and be working and available to reached during office hours –9-5 ET unless discussed otherwise with supervisor.Physical requirements Must be able to remain in a stationary position 90% of the time. Constantly operates a computer and other office productivity machinery, such as a calculator, copy machine, and computer printer. The person in this position frequently communicates with customers who have inquiries. Must be able to exchange accurate information in these situations.Some occasions may call for moving equipment weighing up to 50 pounds to and from venue locations for various event’s needs. Direct Reports
“Unlocking the Potential of Recovery Community Organizations and Peer Recovery Support Services is an important call to action on the future of addiction recovery in the United States”, says William L. White, Recovery Historian, and author of Slaying the Dragon: The History of Addiction Treatment and Recovery in America. “If its recommendations are heeded, this seminal report could well be a milestone in the future of recovery community organizations and peer recovery support services.”
The white paper, soon to be released publicly by Faces & Voices of Recovery, demonstrates how the current financing models for peer recovery support services present significant barriers to maximizing the role of the peer workforce in addressing the addiction crisis in the United States. The peer-to-peer relationship impacts health at multiple levels of the socioecological model (i.e., at individual, family, community, and societal levels) and has potential not currently actualized. The inclusion of peer workers has become a best practice and a number of interventions utilizing them demonstrate compelling outcomes. In this report, the authors lay out the key issues underlying the need for action to bring about broad systems change.
“While we recognize the complexity of policy and financing issues, the peer workforce and recovery community organizations that employ them need a paradigm shift now to sustain their invaluable work in communities across America. This report is a must-read for everyone interested in the future of recovery community organizations and peer recovery support services”, says Patty McCarthy, CEO of Faces & Voices of Recovery.
Authors of the white paper are Kenneth D. Smith, PhD, Assistant Professor of Public Health at the University of Tennessee Knoxville, Robin Peyson, MHSA, Owner & Lead Consultant of RLP Consulting, and Sierra Castedo de Martell, MPH, Doctoral Candidate, UTHealth School of Public Health, Austin Regional Campus.
Join Faces & Voices of Recovery at 3-4:30 pm ET on December 1, 2022, for a webinar with the authors, as well as other nationally recognized leaders in the recovery movement. To learn more or register https://facesandvoicesofrecovery.org/event/a-seat-at-the-table-leadership-to-unlock-the-potential-of-recovery-community/
Unlocking the Potential of Recovery Community Organizations and Peer Recovery Support Services will be made available on the Faces & Voices of Recovery website at https://facesandvoicesofrecovery.org/ prior to the event.
Faces & Voices of Recovery is seeking a Director of Public Affairs.
This is a full-time home-based position with a competitive annual starting salary- based on experience. Faces & Voices of Recovery offers generous leave and health benefits.
We believe that diversity in experiences, perspectives, knowledge, and ideas fuels creativity, broadens knowledge, and helps drive success. That’s why we’re proud to be an equal opportunity employer and strive to treat all employees with honesty, dignity, and sensitivity. We welcome all qualified applicants regardless of recovery status, criminal justice history, race, color, national origin, ethnicity, religion, sex, pregnancy, sexual orientation, gender, gender expression or identity, age, disability, veteran status, marital status or any other legally protected class.
A cover letter describing your interest in THIS job and why you’re a good fit is required.
Send resume and cover letter to email@example.com.
The Director of Public Affairs works closely with the senior management team to develop, advance, and oversee the public affairs activities of Faces & Voices of Recovery, including the organization’s communications, marketing, public relations, government relations, policy, and advocacy strategies.
Special focus of this position includes leveraging the existing initiatives and expertise of the organization to develop a cohesive message and platform for all relevant stakeholders, including members of the recovery advocacy community, government leaders, and the general public. It includes understanding, identifying, and maximizing opportunities to advance public policy issues relevant to the organization and developing and implementing communications strategies. This position requires the ability to swiftly maximize opportunities and mitigate risks, while building positive relationships with stakeholders, the media, and the public. The Director will leverage the expertise of board members, public policy committee and other partners to implement communications and public relations plans to help operationalize the mission and vision of Faces & Voices of Recovery.
The Director of Public Affairs leads the Public Affairs team and works collaboratively across departments to achieve the following:
- Develop and implement cohesive national messaging around addiction recovery
- Develop and implement a process for measuring national impact
- Identify and leverage opportunities to generate national, regional and local news
- Develop and implement public relations and communications strategies
- Oversee implementation of a cross-functional government relations, public policy and advocacy strategy
- Oversee implementation of a cross-functional marketing strategy for products and services
- Build, manage, and strengthen relationships with government officials, stakeholders in the recovery advocacy community including Recovery Community Organizations (RCOs), and industry partners at the local, state, and federal levels
- Generate written content, including press releases, op-eds, articles, keynote speeches, talking points, and other promotional materials for public consumption and internal use
- Oversee the creation of high-quality briefing materials for political audiences to support public policy strategy and advocacy priorities
- Ensure the organization’s commitment to justice, diversity, equity, and inclusion (J-DEI) is reflected throughout all communications, publications, materials, and messaging
- Improve and oversee communications platforms and delivery vehicles, including social media platforms
- Develop and oversee execution of work plans and project plans to achieve the organization’s public relations, communications, and policy goals and vision
- Develop a wide range of new opportunities to maximize the impact of the organization.
- At least 5 years of progressive experience in public affairs related to social justice, healthcare, and/or behavioral healthcare
- Experience with running grassroots campaigns to engage members and other stakeholders in policy discussions is a plus
- A strong track record of positioning an organization to achieve tangible outcomes in a competitive communications environment
- Ability to quickly develop subject matter expertise on a range of issues and translate complex issues and ideas for public consumption
- Ability to coach, mentor, and support leaders and emerging leaders at all levels of the organizations as public spokespeople, and to function as the organization’s spokesperson when needed and appropriate
- Expertise in developing messaging strategies
- Ability to communicate with the public about why we back certain policies and why advocates should make their voices heard to influence government decisions
- Experience in remote work and virtual platforms a plus
- Values recognizing accomplishments and abilities of other staff
- Passionate about Faces & Voices mission and able to promote and communicate the mission and values to external and internal stakeholders
- A Bachelor’s Degree in public relations, communications, political science, healthcare administration, or another related field, is required for this position
- Master’s Degree a plus. Relevant experience may be considered as a possible substitution
- Demonstrates an understanding of diversity, equity and inclusion (DEI) and a willingness to grow with the team in our DEI journey
- Thorough understanding of how the internet and social media have transformed grassroots advocacy
- Understanding of addiction and recovery principles, recovery support services and Recovery Community Organizations
- Skilled in effective supervision and training of staff
- Skilled in speaking and writing effectively
- Skilled in providing public presentations and trainings
- Proficient in Microsoft Office Suite
- Ability to establish and maintain effective working relationships with staff and representatives from other agencies, organizations, and the general public
- Ability to use technology to maintain records
- Ability to juggle multiple priorities in fast-paced environment
- Ability to be agile and respond to changing needs and priorities quickly
- Ability to facilitate teamwork and individualized professional growth among direct reports
- $80,000 – $90,000 – Commensurate with experience.
Faces & Voices of Recovery employs remote workers who must maintain a home office conducive to optimal work performance and free of distractions. Some projects may require staff to travel. All necessary personal arrangements for travel such as childcare, house care, pet care, etc. should be done on personal time. Local errands, like shipping and mailing, that pertain to work projects should be done during work hours. All staff are required to work and be available during office hours – 9:00 am -5:00 pm ET unless otherwise approved by supervisor.
Employee must be able to remain in a stationary position 90% of the time. Constantly operates a computer and other office productivity equipment. Some occasions may call for moving equipment weighing up to 50 pounds.
Marketing and Communications Manager; Advocacy and Outreach Manager
Faces & Voices of Recovery is seeking a dynamic person to assist in providing technical support for our training courses starting immediately.
This is an independent contractor role, up to 20 hours per week, as needed. Technical Hosts must be available to work between 9:00 am – 6:00 pm EST (Eastern Standard Time).
Tasks and Responsibilities
Technical Hosts will assist the Faces & Voices of Recovery’s National Recovery Institute by providing technical support for virtual training via the Zoom platform.
Position Duties and Responsibilities
- Open, host, and close virtual training
- Support facilitators by monitoring the chat, managing breakout rooms, uploading documents or links in the chat, and presenting slideshows as needed
- Support participants with any technical difficulties, such as locating Zoom features, renaming, utilizing cameras and microphones, etc.
- Answering questions related to the National Recovery Institute and their services
- Troubleshoot any technical issues on Zoom for participants and facilitators
- Provide excellent customer service via email, phone, Slack, and Zoom
- Advanced knowledge of Zoom platform and computer programs
- Excellent organizational, verbal, written, public speaking, and interpersonal skills
- Ability to work under pressure and think quickly on your feet
- Ability to work independently, as well as part of a team
- Experience/interest in engaging and motivating a large group
- Familiarity with and interest in substance use disorders, addiction recovery, and healthcare issues a plus
- Excellent computer skills: proficient in Zoom, Microsoft PowerPoint, Word, and Outlook
- Excellent attention to detail
- Excellent written and oral communication skills
- Ability to show creative and flexible thinking
- Strong time management skills
- Strong ability to follow procedures
- Minimum of 6 months hosting Zoom meetings and/or virtual conferences
- Remote work as a student, volunteer, contractor, or employee for at least 1 year
- Introductory or higher understanding of adult learning
- People with lived experience who have been involved with grassroots campaigns in behavioral health, harm reduction, justice reform, multi-pathways of recovery, or LGBTQIA+ communities, are encouraged to apply
To apply, send a letter of interest and current resume/CV to firstname.lastname@example.org
Equal Opportunity Employer
We believe that diversity in experiences, perspectives, knowledge, and ideas fuels creativity, broadens knowledge, and helps drive success. That’s why we’re proud to be an equal opportunity employer and strive to treat all employees with honesty, dignity, and sensitivity. We welcome all qualified applicants regardless of recovery status, criminal justice history, race, color, national origin, ethnicity, religion, sex, pregnancy, sexual orientation, gender, gender expression or identity, age, disability, veteran status, marital status, or any other legally protected class.
“In the early days of the pandemic during lockdown, I lost three people in one month. With that happening and being in the recovery field, sometimes you wonder if you’ve done enough for someone.” – Pete Walker.
2020 was an unprecedented year. Feelings of uncertainty and dread crept over the general public as COVID-19 broke headlines, further spreading and festering into a full-blown pandemic. The whole world seemed to be turned upside down as everything shut down around us. People lost their jobs, their homes, and their loved ones. Yet while this ongoing pandemic continues to dominate headlines, in the United States there has been another, tangential crisis gripping the country and its communities long before COVID – the addiction and overdose epidemic.
The addiction and overdose epidemic has impacted communities across the country for years now. According to the CDC, there have been close to 841,000 people die from a drug overdose over the span of 20 years from 1999 to 2019. Despite research, advocacy efforts, and attempts to partially mobilize the recovery community, no one was quite prepared for the storm that 2020 would bring across the nation.
The convergence of the COVID-19 pandemic and overdose epidemic led to a spike in overdose deaths, with overdoses hitting an all-time high in 2020. Recently, the CDC released new data showing that for the first time ever, during the ongoing pandemic, overdose deaths had exceeded 100,000 during a twelve-month period . According to the Recovery Research Institute, substance overdose deaths increased the most during the first five months of the pandemic . This can be attributed to most states going into lockdown, leaving many stuck in their homes. The isolation and disconnect experienced during this time often intensified existing mental health and substance use disorders.
Abraham “Pete” Walker of Michigan and Florida, owner of Walker Consulting and Recovery Coaching, reflects upon the challenges he experienced during those early months of the pandemic and lockdown.
“I like to say that with my emotions, I am pretty level keeled. I try to be spiritual and do good. But during lockdown I went into a very dark place”, says Pete.
During this time, as Pete worked for his own LLC and some other recovery nonprofits, he lost three individuals to overdose in just one month. The emotional burden that compounded loss places upon a professional working in recovery support services is tremendous. By being a person in recovery as well, Pete directly understands the challenges that the isolation of the pandemic brought on to so many.
“All of this is like a tornado happening. Maybe some that weren’t necessarily going to get caught up in it are getting swept up. Perhaps some of it comes from isolation and boredom, or from the scares and anxiety of the pandemic. We don’t know what happens to some people or what they might be going through – and COVID really intensified emotions and swept more people up into this tornado.”
This metaphor Pete uses to capture the grim reality of what happened in 2020 hits close to home for many communities across the United States, as this ‘tornado’ touched down and wreaked havoc in nearly every corner of the country. At Healing Transitions in Raleigh, North Carolina, Courtni Wheeler leads the Rapid Responder Team. She began this role at the very start of the COVID pandemic, when most overdoses that Courtni and her team responded to were related to heroin or fentanyl use. However, as lockdowns started, the overdose calls they were responding to shifted to cocaine, pressed pills, methamphetamines, and even marijuana.
Overdoses from marijuana were something Courtni described as ‘simply unheard of’. In fact, the majority of calls her team responded to in those early months of the pandemic were overdoses resulting from substances one wouldn’t typically overdose from. In working alongside Emergency Medical Service (EMS) personnel, Courtni became aware of how overloaded they were with calls, with many of them being related to mental health.
“With the world shutting down and people losing their jobs, mental health crises were going up and so was substance use,” Courtni says. “We all know working in this field that mental health and substance use go hand-in-hand.”
In responding to calls during the pandemic and lockdown, Courtni witnessed just how much COVID was impacting her community and those with substance use disorder.
“For a lot of people. . . the only thing they have as a coping skill – to release those emotions and that stress and anxiety – is to use something to make them feel better,” says Courtni. “People who normally don’t suffer from mental health problems, or those that just have generalized anxiety, are now trying to cope with depression and are turning to substance use to do that.”
Tornadoes don’t impact all communities equally. More marginalized communities don’t have as strong of structures to sustain themselves. When a tornado hits, they are more brutally damaged, even in less severe conditions. They have fewer resources to respond to the disaster crisis and scant reserves to fall back on when their communities lose infrastructure. The convergence of the COVID-19 Pandemic and the addiction and overdose epidemic— what is known as a ‘syndemic’ —has not impacted all communities equally. We need to address the long-standing deficits and historic gaps that have been exposed by the crises that have unfolded across all our communities.
The syndemic has also taken its toll on the first responders that millions rely on each day. In many communities across the country, EMS first responders were already answering large volumes of calls related to overdoses. The COVID-19 pandemic just created even more of a burden. Anxieties over getting and spreading COVID to their families, coupled with the stress and increasing number of calls became almost unbearable for most. Many first responders interviewed for this article expressed experiencing compassion fatigue and had an internal conflict of wanting to help, but not feeling that compassion towards individuals who were overdosing. This internal struggle and burnout were something that they each had to cope with and work through, as they navigated through their emotions and the toll of being on the front lines of both crises.
The substance use care system was already deep into what would be considered a severe workforce crisis, simmering for over at least the last two decades. In 2019, the Annapolis Coalition released a report commissioned by SAMHSA on our pre-COVID workforce crisis. It was estimated then that there was a need for 1,103,338 peer support workers and 1,436,228 behavioral health counselors, as part of the 4,486,865 behavioral health workers conservatively anticipated at the time of this report to meet the current need . However, it is even worse now. Recovery support systems have suffered from inconsistent funding and low compensation, and the result has been devastating. A recent occurrence has been individuals all over the country walking out of their jobs in what has been dubbed ‘The Great Resignation of 2021’. We are witnessing some recovery programs with 100% turnover of peer staff. The loss of recovery infrastructure at a time of greatest need is unsustainable. To rebuild, we must create a trauma and recovery-informed substance use disorder service system that is inviting for people to work in, focused on long-term healing and inclusive of the recovery community in all its diversity.
A fundamental facet of how communities successfully respond after a disaster includes meaningful inclusion of all the members of that community in the rebuilding process. The first responder and recovery workforce have been working in this dynamic of assisting communities even as their own support systems have been ravaged. We must address the needs of first responders and peer workers in ways that foster healing at the individual and community level with stable funding at both the federal and state levels. A good start to this would be supporting the ten-percent recovery support set-aside in our federal Substance Abuse Prevention and Treatment Block Grant (SABG).
The Substance Abuse Prevention and Treatment Block Grant (SABG) enables states and jurisdictions to provide prevention, treatment, and recovery support services. This federal funding allows programs to plan, implement, and evaluate activities related to substance use. Grantees are required to spend at least 20% of SABG dollars on primary prevention strategies. Currently, a similar carve-out for recovery support services is in discussion for the federal FY2022 budget. Fondly referred to as the Recovery Set-Aside, this new dedicated funding would require Grantees to spend at least 10% of SABG dollars on recovery services and strategies to strengthening recovery community organizations, collegiate recovery programs, recovery residences, and other peer recovery programs for substance use. Supporting and advocating for the Set-Aside is just one important step towards ensuring states can use these much-needed resources to support grassroots recovery community efforts in a sustainable and inclusive manner. Communities across the country depend on it, including yours.
Faces & Voices of Recovery, a national advocacy organization and staple in the recovery community since 2001, is proud to further the work and dedication of International Recovery Day (IRD). Assuming responsibility of International Recovery Day – formerly International Recovery Day, Inc. – and all its assets, Faces & Voices will now lead and manage the continuation of this incredible event and its movement into the future.
In 2019, John Winslow founded International Recovery Day, Inc. as an organization and event dedicated to promoting all recovery pathways from substance use disorders and educating the public on the value of recovery. Celebrated the 30th of September (Recovery Month), International Recovery Day is an opportunity to celebrate recovery with countries from across the globe! Although International Recovery Day, Inc. will no longer operate, the annual celebration remains. Entering its third year, Faces & Voices will continue this international celebration by working with organizations, entities, and enthusiastic supporters of recovery to illuminate monuments and structures in purple across the world on September 30th.
Founder, and former owner of International Recovery Day, John Winslow, shares his excitement for this transition, “From its earliest inception, I have pondered how best to ensure the continuity and growth of International Recovery Day… I felt an increasing recognition of the need to find and establish a solid home base for this new and tender venture that held the potential to impact millions. I feel confident this transition will ensure continuity of our annual global event and expand addiction recovery awareness and involvement to a much larger scale. It just feels right.” IRD blends seamlessly into Faces & Voices core service – advocacy. Continuing the tradition of International Recovery Day embraces Faces & Voices mission to change the way addiction and recovery are understood and embraced through advocacy, education, and leadership.
Faces & Voices is ecstatic for this opportunity to heighten international awareness for recovery. “International Recovery Day has demonstrated that the global recovery movement has incredible power and provides a vital connection for millions around the world. We’re sincerely grateful for John Winslow’s leadership and vision for IRD. We’re honored to coordinate the annual observance and raise awareness for all recovery pathways from all addictions. We aim to engage individuals in every country around the world as a way to honor those in recovery and provide hope for those still struggling with addiction”, says Patty McCarthy, Chief Executive Officer, Faces & Voices of Recovery.
International Recovery Day demonstrates the immense impact addiction recovery has on the world around us. From Niagara Falls in New York to Google Headquarters in California, and landmarks across the world lit purple on a single day to acknowledge recovery shows the tremendous affect that substance use disorder and recovery has on communities.
International Recovery Day’s website – internationrecoveryday.org also provides space for people across the world to launch virtual fireworks on September 30th, to symbolize the hope and help that is offered through different recovery pathways and allow people to celebrate their own recovery – in a way that’s unique to them – and yet still a small part of a greater whole.
Advancing IRD’s accelerated progress requires a revitalized sense of community from person-to-person gatherings or screen-to-screen hangouts, “around the world, the recovery movement is gaining traction and depth. We are thrilled to continue International Recovery Day and support equitable access to recovery for any human being who wants it. At Faces & Voices, we envision a global recovery movement that knows no bounds, borders, or barriers”, says Phil Rutherford, Chief Operating Officer, Faces & Voices of Recovery.
Whether anyone or any group participate launching virtual fireworks or illuminating landmarks and buildings purple, International Recovery Day reminds us that “Recovery is for Everyone” and engaging and celebrating recovery extends well beyond a single person.
Thank you for supporting us in our efforts and advocacy for a brighter future for all.
Emily Porcelli, Marketing and Communications
Faces & Voices of Recovery
Posts from William White
Oppression involves objectification and rendering the targeted person or group as the ‘other.” That distinctive “otherness” is then conveyed in caricatured images that feed stigma, social exclusion, and, in its most extreme form, genocide. The first task of the social reformer is to illuminate the humanity of those objectified and break down barriers between “they” and “we.” The machinery of oppression and strategies of liberation rely on these opposing scaffolds of belief and perception.
By projecting recovery stories into the public arena, recovery advocates undermine the demonized addiction archetype. These stories are often first viewed by the public through a lens of exceptionalism—seeing these ennobled individuals as the rare exception to the rule, “Once an addict, always an addict.” As recovery advocates, we can inadvertently contribute to this perception by only thrusting our most attractive, most articulate, highest achieving members into the public eye and characterizing our own redemption as an uncommon miracle.
The goal of any social movement seeking to elevate a historically marginalized group is not to thrust a few remarkable individuals onto the larger cultural pedestal, but to instead elevate the group as a whole. What is needed within the recovery advocacy movement is not a handful of highly visible charismatic leaders, but thousands of people in recovery stepping together into the light to affirm the reality and transformative power of recovery. We do not need or desire all people in recovery to publicize their recovery status. Anti-stigma movements instead rely on a vanguard of people whose life circumstances and available supports allow taking such risks. The question is the extent to which that vanguard accurately portrays the diversity of people in recovery.
The recovery advocacy movement will have matured when we can ALL stand publicly to represent the diversity of our past brokenness and the extent of our present healing. Addiction is a spectrum disorder representing a broad continuum of severity and complexity; addiction recovery similarly represents broad levels of healing and social functioning. Every increment of that healing is cause for celebration, even among individuals who would not be the most obvious choice for the face and voice of recovery.
Enter multiple recovery mutual aid rooms and you will see the lowest and highest “bottoms” and everything in between, the most and least educated, all manner of professions, the most and least financially blessed, decades of age differences, a rainbow of colors, languages and accents of all varieties, and diverse gender and sexual identities. It is that very diversity united in common cause and mutual support that distinguishes communities of recovery across the globe. As worldwide recovery advocacy movements come of age, it is that diversity that must be reflected in the faces and voices of recovery we project across the globe.
If you don’t fit the iconic recovery poster image, you are still the face and voice of recovery, and your time in the sunshine is coming. Prepare yourself for that day.
The wide range of injuries inflicted on the human body by excessive and prolonged alcohol or other drug (AOD) use have been extensively documented for more than two centuries, but until recently little was known about the relative health of people recovering from addiction. The potential burden of continued health problems in recovery has been obscured by general findings of improved health and quality of life in recovery from follow-up studies of clinical samples. Little information has been available on the health status of people in recovery within larger community samples.
In 2010, the Philadelphia Department of Behavioral Health and Intellectual disAbility Services contracted with the Public Health Management Corporation (PHMC) to incorporate recovery-focused items into PHMC’s Southeastern Pennsylvania Household Health Survey of Philadelphia and four surrounding counties. Nearly ten percent (9.45%) of the adult population surveyed reported once having but no longer having an AOD problem. Those in recovery, compared to citizens not in recovery, were twice as likely to describe their health as poor and report higher rates of asthma, diabetes, high blood pressure, obesity and past-year emergency room visits. They were also more likely to report lifetime smoking (82% vs. 44%), current smoking (50% vs. 17%), exposure to smoke in their residence, no daily exercise, and eating fast food three or more times per week. In terms of resources to address health concerns, people in recovery compared to the general population reported greater family/social isolation, lower income, less insurance coverage, and less likelihood of past year health screenings, primary health care, and dental care.
While the Philadelphia survey findings were alarming, it remained unclear whether the survey findings were representative of all people in recovery in the United States. A just-published study by Eddie and colleagues reports strikingly similar findings in a nationally representative sample of the adult U.S. population. Relative to the general population, those self-reporting having resolved an AOD problem report higher rates of hepatitis C, HIV/AIDS, chronic obstructive pulmonary disease, heart disease, and diabetes. Quality of life among people in recovery was lower when one or more of these diseases were present.
The findings from the Philadelphia and U.S. surveys reveal the burdens of disease that can continue into the addiction recovery process–burdens that if unattended can plague personal health and quality of personal and family life for years to come. Such findings have profound implications for the state of professional care for AOD problems in the United States. At a systems level, we have a model of care that functions as an emergency room to provide acute biopsychosocial stabilization but is not designed to provide long-term health management for people in addiction recovery. The management of other chronic health disorders (e.g., diabetes, hypertension, asthma, etc.) is now viewed as requiring the management of global health (e.g., management of co-occurring medical conditions, diet, exercise, psychosocial stressors) over a prolonged if not lifelong period of time. It is past time that the treatment of the most severe and complex AOD problems was similarly conceived. Such approaches would move beyond brief episodes of symptom amelioration (recovery initiation and diagnostic remission) to the promotion of global health and quality of personal, family, and community life in long-term recovery.
At its most practical level, the survey findings suggest that every person entering recovery should have an ongoing relationship with a primary care physician who is knowledgeable about addiction recovery and who can serve as an ongoing consultant on the achievement of health and wellness. It also suggests the need for increased bi-directional integration of addiction treatment and primary health care and the potential role of the primary care physician in performing ongoing recovery checkups. Hopefully, the day when such integration constitutes mainstream practice will arrive soon.
Eddie, D., Greene, C., White, W. L. & Kelly, J. F. (in press). Medical burden of disease among individuals in recovery from alcohol and drug problems in the United States: Findings from the National Recovery Study. Journal of Addiction Medicine.
White, W. L., Weingartner, R. M., Levine, M., Evans, A. C., & Lamb, R. (2013). Recovery prevalence and health profile of people in recovery: Results of a Southeastern Pennsylvania survey on the resolution of alcohol and other drug problems. Journal of Psychoactive Drugs, 45(4), 287-296.
I can now add shaking to the mix. Earth— be still. My family and I have returned to California after more than 20 years in Colorado. We returned to familiar surroundings in Southern California. It also is where I began my journey on the road to long-term recovery. It continued successfully through almost 20 years in Colorado. I appreciate friends and associates, along with early and continuing support for the founding of Advocates for Recovery— Colorado and Faces &
Voices of Recovery, nationally and internationally. All have kept me active and involved through the years. We have moved and are settling in. California has long been designated as “the golden state” related to the early rush for gold. It is apparent that during the time of my absence that the alchemists have been at work. The golden California poppy fields have been overshadowed by the invasion of the product of other poppy fields. It reminds me of what happened to the characters in the poppy field episode in the movie, The Wizard of OZ. The wizards behind the political curtains in this land of OZ continue to deal with the diversity and depth of humans being and humans doing. There is varied diversity and depth in brains, hearts, and courage among all those humans. In the face of the reality of the agonies and ecstasies that life provides, the Wizard of Oz was handing out hope. It was quickly revealed that gaining and maintaining hope needs help along the risky road “home”. It is obvious that there is opportunity here to continue in the activities I know well. I can support the help and hope needed in seeking the reality of recovery from addiction to alcohol and other drugs.
I referred to the land of OZ In an early blog and will include, as Bill White terms it, a blast from the past. I found analogy related to the road to addiction and recovery in the movie The Wizard of OZ. The movie opens in black and white. Chaos, concern, worries, and stormy weather begin the story. Dorothy runs away but returns to find no family and the door to safety closed to her. Then comes the tornado, and the threats, and the spiral to who knows where. Finally, the turmoil abates and suddenly a new wonderful world appears in living color and, in my movie, the wicked witch, addiction, has been crunched. Wouldn’t it be great if life were like that; however, the flying monkeys are out there. They snatch you up and fly off to relapse land. There are temptations from lots of kinds of witch’s brew and other bewitching stuff. Fear not, it is a journey worth taking and there can be some lion-hearted, courageous, professionals and peers to show the way. Persevere, and you get your brain back, your courage back, and your heart back. Promise. My name is Merlyn, a person in long-term recovery. I’m not a wizard and have no magic wand. There really is no wizardry on the road to recovery. Its just you, being willingly involved in the work required. My magic is in my recovery story and the magic in stories of millions of others who have trudged destiny’s happy road. On the way, the magically positive and powerful stories must be shared with young people. Our “munchkins” are our future. We need to prepare them for the storms but help them see the natural rainbows— without any mind-altering chemicals.
California’s past is noted for it’s dreamers and schemers. To many, a scheme suggests some devious plan not designed for the common good but for ill-gotten gain. However, by definition, a scheme is a systematic plan or arrangement for attaining some particular object or putting a particular idea into effect. In 2001, a group of schemers and dreamers met in St Paul. Minnesota. From that gathering came the plan to put a face and a voice on recovery and to evolve a strategy to accomplish that. Emotion became notion, notion was put in motion, and a recovery movement was born. The recovery movement grows and thrives today. Faces & Voices of Recovery has a national presence and voice in Washington but with its roots in communities through the Association of Recovery Community Organizations (ARCO). The Phoenix, in my new community, is a member. Upon my arrival in California I was prompted by an important activity for a Peer Coach—to be a resource liaison. I went searching and was pleased to find resources for prevention, treatment and recovery. I noted familiar terms like Medically Assisted Recovery (MARS), Peer support— from peers with lived experience and training— sober living homes, celebrations of rehab successes, and an alphabet soup of support groups. In my previous work in California, I was administrator of an alternative sentence program and supported the use of early drug court programs. The justice system has changed. I will review California’s prop 47 and its effect. There is still purpose and value in the courts dealing with misdemeanor alcohol and other drug offenses to provide reason and resources to reduce recidivism.
In carrying the message of recovery, there is no substitute for the power of story. As a recovery ambassador, I will continue to carry the message of the reality of recovery for millions across the country. California may be noted for areas of difference and indifference, but it holds a share of those millions. It is a story that must be told. Do tell.
We recently explored the idea of “recovery cascade”—a sudden surge in personal change that sparks recovery initiation in the heels of past efforts or a collective surge in recovery prevalence at a community or cultural level. While there are examples of the latter in U.S. history (e.g., the explosive growth of the Washingtonian Temperance Society in the early 1840s), the most recent and dramatic example of such a population-level recovery cascade is the growth of Narcotics Anonymous and other recovery communities (e.g., Congress 60) within the Islamic Republic of Iran.
As the toll of the opioid epidemic in the U.S. rises to ever-horrific levels, the question of how to promote a counter-surge of recovery initiation and stabilization is a critical public health issue. Much in this regard can be learned from what has occurred within the Islamic Republic of Iran. Few countries have experienced such sustained opioid problems (since the 16th century), and no country has experienced as rapid a growth of Narcotics Anonymous as has Iran.
First introduced in 1990, there are now more than 24,000 NA meetings in Iran—a third of all NA meeting worldwide and, with the exception of the NA Basic Text, Iran consumes more NA literature than all other countries combined. The 2018 NA World Convention drew 24,000 participants; the most recent NA Convention in Iran drew 32,000 participants.
Exploring contextual factors and key strategies linked to exponential surges in recovery prevalence in Iran could aid strategic counter-responses to surges in drug addiction in the U.S. I was pleased to recently collaborate with Dr. Marc Galanter and Brooke Hunter on a comparative study of NA members in the U.S. and Iran that was recently published in the Journal of Addiction Medicine. That study afforded an opportunity to explore some of the factors that have contributed to NA growth in Iran—an issue of import given the paucity of attention given to the potential role of NA in discussions of U.S. responses to the opioid epidemic.
Based on the history of NA in Iran and my study of growth patterns within other recovery mutual aid organizations, I would propose the following factors as critical to surges in recovery mutual aid membership and parallel population surges in recovery prevalence.
*Social Density of Addiction Exponential growth of recovery mutual aid follows periods of peak per capita addiction, e.g., Iran has the highest worldwide rate of opiate addiction. Recovery prevalence rises after, not in tandem with, peak personal and social consequences of addiction within a community/culture. A major public health goal is to minimize the time lag between surges in addiction and surges in recovery initiation. Shortening addiction careers reaps untold rewards for individuals, families, communities, and societies.
*Population Demographics Addiction recovery mutual aid growth often crests during peak concentrations of populations reaching the age of cumulative consequences of youthful drug use (e.g. ages 25-44). The aging of Baby Boomers in the U.S. and tandem growth of treatment industry fed the growth of NA, AA, and other recovery mutual aid groups in 1980s and 1990s.
*Cultural Congruence Growth of a recovery mutual aid organization is influenced by the congruence between its core values and the cultural context in which it operates or the degree to which it represents needed values within that culture. The congruence between NA values and the Persian value placed on family, mutual help, hospitality, and service helped fuel NA growth in Iran. Growth of recovery mutual aid groups is contingent upon rights of citizens to voluntarily assemble without governmental oversight and the absence or minimization of obstacles to such gatherings (e.g., early police surveillance of NA meetings in the U.S.; “loitering addict” laws in the U.S. in the 1950s and 1960s).
*Decentralization of Leadership NA, like other 12-Step groups, utilizes a leadership rotation scheme as a means of avoiding the pitfalls of centralized and charismatic leadership that can push organizations toward cult-like systems at risk of eventual implosion. Multiple leadership roles and the ease with which new groups can be formed help fuel member growth and retention through these mechanisms of leadership development and succession.
*Minimization of Political/Religious Resistance Recovery frameworks that do not pose threats to existing political and religious institutions have increased probabilities of survival and rapid growth. NA’s position of “no opinion on outside issues” and NA leaders meeting with political, religious, and professional leaders minimized such resistance and set the stage for NA growth in Iran.
*Delineation of Peer and Professional Support Roles Aligning itself as a potential adjunct to professional treatment (e.g., post-treatment continuing care) rather than a competing alternative minimizes professional resistance to 12-Step groups and other recovery groups. Such positioning allowed NA to grow in tandem with professional treatment resources in the U.S. and Iran while maintaining NA independence from these institutions. Professional support is enhanced by scientific studies showing mutual aid participation elevates long-term treatment/recovery outcomes and quality of life of individuals and families. More scientific studies of NA have been conducted in Iran than anywhere in world, including in the U.S. and U.K.
*Local/National Mainstream and Social Media Coverage Recovery-focused media coverage can serve as a direct catalyst for recovery seeking, e.g., growth of AA following 1939 Cleveland Plain Dealer series and 1941 Jack Anderson Saturday Evening Post article in early AA spread nationally. Active NA PR (public relations) committees have played an important role in surges in NA membership.
*Recovery Literature Codification of core recovery literature can spur exponential growth of recovery mutual aid organizations and protect program integrity (e.g., avoidance of dilution, and corruption). Publication of the AA “Big Book” and NA “Basic Text” were critical to subsequent AA/NA growth worldwide, and translation of the NA Basic Text into Farsi was a key catalyst for NA growth in Iran as was Iran’s extensive use of other NA literature.
*Sponsorship and Recovery Induction Use of “home groups,” sponsorship, guidance in completing core recovery activities, and celebrations of recovery milestones have all served to aid engagement and retention within recovery mutual aid groups. NA in Iran has several unique adaptations that played a role in its unprecedented growth, e.g., sponsors regularly meeting with sponsees in groups distinct from regular NA meetings, focused attention on completing Step work, and celebrating completion of Step work rather than an exclusive focus on duration of abstinence.
*Service Ethic and Service Structure Recovery mutual aid growth is greatest in settings with a strong service ethic and a service structure that allows frequent service opportunities via service committees and expectations of larger service to the larger community. Recovery surges are contingent on reaching a critical mass of people achieving sustained recovery—living proof within the overall culture and visible to those seeking help. Defining need for long-term recovery support combined with a strong service ethic assures such availability and visibility and enhances organizational stability and sustainability.
*Membership Diversification Recovery mutual aid growth is aided by the advent and expansion of demographic, cultural, and special interest groups, e.g., women, young people, cultural minorities. Diversification and growth of specialty meetings attracts new populations and retains populations that might otherwise be lost due to failure of mutual identification.
*Recovery Culture The growth of a recovery mutual aid society is aided by development of a distinct recovery culture with its own core ideas, language, rituals, symbols, history, iconic figures, memorial sites, etc. Distinct recovery mutual aid cultures are sometimes followed by emergence of an ecumenical culture of recovery within the larger society. This broader culture may set the stage for further population surges in recovery prevalence.
*Organizational Integrity Sustained growth within recovery mutual aid societies requires forging a set of principles of organizational management that help groups avoid the organizational pitfalls that can feed explosive growth in the short run only to then rapidly decline and experience institutional death, e.g., rise and fall of the Washingtonians, Synanon, and other recovery mutual aid groups.
Considerable time is invested within professional and public policy arenas exploring factors related to population-level surges in substance use and related disorders. Perhaps it is time similar attention was devoted to exploring the conditions and strategies that could spark population-level surges in recovery initiation.
Reference: Galanter, M., White, W., & Hunter, B. (In Press). Cross-cultural acceptability of the Twelve Step model: A comparison of Narcotics Anonymous in the USA and Iran. Journal of Addiction Medicine.
What is the number of serious attempts required to achieve stable resolution of a significant alcohol or other drug (AOD) problem? Previous studies of addiction treatment populations suggest prolonged addiction careers, and a substantial proportion (over half) of people in the United States admitted to addiction treatment indicate one or more prior treatment admissions. These reports stand as justification for the characterization of addiction as a “chronic relapsing” disorder. Such clinical studies, however, may not be representative of the larger pool of people experiencing AOD-related problems.
Convenience studies of community populations of “people in recovery” reveal a different profile. A recent Canadian study found that more than half of those surveyed reported no problem recurrence after the first initial recovery attempt, and that only 15% of those surveyed required six or more attempts prior to achieve stable recovery. But it has been unclear whether such convenience samples accurately represent the experience of all people who have resolved AOD problems, including those who do not embrace a recovery identity.
Having normative information about recovery attempts prior to successful AOD problem resolution is critically important to the individuals and families affected by such problems, to the multiple professionals and institutions seeking to help such individuals and families, and to drug and health care policy makers. A newly published study by Dr. John Kelly and colleagues provides the first available data on recovery attempts based on a national representative sample of people who have resolved a significant AOD problem. Findings and implications of this landmark study include the following.
- In contrast to public and professional perception, the number of recovery attempts to achieve stable resolution of an AOD problem is actually surprisingly low, with most people surveyed achieving resolution within the range of 1-2 attempts. The range of time in recovery within the study sample was from a few months to 40+ years and it may be likely – particularly for those in the early phases of recovery – that there could be further AOD problem recurrence and thus additional recovery attempts made that could add to the estimated tally of serious recovery attempts. The researchers found that those with more stable recovery (5+yrs) were no different than those in the first 5 years of recovery – for both groups of individuals the median number remained at 2 and the mean was still just over 5.
- A greater number of recovery attempts is associated with greater problem severity and complexity, to include a history of mood and anxiety disorders, past history of treatment services and mutual help group participation, greater social isolation, and/or higher levels of current psychological distress. While this pattern of high problem severity, complexity, and chronicity is seen as the norm, most people with AOD problems do not experience this pattern.
- Interestingly, the number of recovery attempts to resolve AOD problems is far lower than the number of attempts required to successfully stop smoking—the latter ranging from 6-30 attempts depending on the study methodology (Chaiton, et al., 2016).
- The difference between the mean (average) recovery attempts (5.35 attempts) and the median (2 recovery attempts) indicates wide divergence in characteristics of those experiencing AOD problems and the presence of outliers with high problem severity and low recovery capital that require a much higher number of recovery attempts prior to successful problem resolution. Reporting average recovery attempts produces a distorted representation of the intractability of AOD problems, whereas reporting the median conveys more positive expectations for problem resolution.
- “…a treatment system designed around the mean clinical profile would have 2 unforeseen consequences: overtreating those persons with lower severity patterns and high recovery capital and undertreating those with high problem severity patterns but minimal recovery capital.” (Kelly, et al., 2019)
- The characterization of all AOD problems as a “chronically relapsing disease” erroneously conveys an image of endless recovery attempts with limited likelihood of success when, in fact, successful recovery with a low number of attempts may well be the norm with the pattern of prolonged “chronic relapse” the exception to this more positive general rule.
Data from the Kelly study should spur optimism among people seeking resolution of low to moderate AOD problems, their families, and their service providers. The study also encourages persistence and possibility among those with the most severe and complex problems. Recovery is possible in both circumstances though with varying levels of effort.
Future reports on recovery attempts and reported treatment history should report both the mean and median of such episodes to assure that the prospects of problem resolution are not over or under estimated. AOD problems are not a single clinical entity and representing them as such may do great disservice to both those with the lowest and highest levels of problem severity.
Chaiton, M., Diemert, L., Cohen, J. E., Bondy, S. J., Selby, P., Philipneri, A., & Schwartz, R. (2016). Estimating the number of quit attempts it takes to quit smoking successfully in a longitudinal cohort of smokers. BMJ Open, 6:e011045.
Kelly, J. F., Greene, M. C., Bergman, B. G., White, W. L., & Hoeppner, R. B. (2019). How many recovery attempts does it take to successfully resolve a drug or alcohol problem? Estimates and correlates from a national representatives study of recovering U.S. adults. Alcoholism: Clinical & Experimental Research. May 15. doi: 10.1111/acer.14067. [Epub ahead of print]