RecoveryBlog

recoveryblog: a blog for recovery advocates!

Our recovery advocacy blog is produced by individuals in recovery!  Here you will find commentary and personal discussions on different aspects of addiction recovery and advocacy.

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Technical Host

May 13, 2022
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 
Qualifications 
  • 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 
  Skills 
  • 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 
 Experience 
  • 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  To apply, send a letter of interest and current resume/CV to nri@facesandvoicesofrecovery.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. 

Faces & Voices of Recovery’s Statement on Final FY2022 Budget

March 22, 2022

March 22, 2022

FOR IMMEDIATE RELEASE

President Biden signed the nation’s Fiscal Year 2022 budget into law Tuesday, March 15, 2022. This year’s budget received several increases in areas that directly benefit recovery support services, including:

  • $50 million to Substance Abuse Block Grant (SABG)
  • $25 million to State Opioid Response (SOR) Program
  • $7.3 million Treatment, Recovery, and Workforce Support (SUPPORT Act)
  • $3 million to Building Communities of Recovery (BCOR)

Our advocacy work began last January when the President unveiled his plan to substantially increase dollars available in the Substance Abuse Prevention and Treatment Block Grant (SABG), elevating current levels by over $1 billion. Although the House and Senate included these provisions in their original bills, they unfortunately did not reach the final bill text.

The FY2022 budget was met with primarily flat funding across the board. As a result, our members and community lost several promising provisions– including a 10% set-aside for recovery support services and the re-introduction of text prohibiting federal dollars utilized for safe supplies, like sterile syringes.

“Despite these setbacks,” says David Mineta, Board Chairperson, Faces & Voices of Recovery, “we have made clear strides with Congress, who continue to show overwhelming support for recovery support services. Our work for 2023 has already begun as we repeat the annual cycle for change. We trim last year’s vegetation and nourish the roots that have allowed the Recovery Movement to flower and grow–advocacy by the grassroots.”

Faces & Voices of Recovery has long advocated for Congress to establish a set-aside for recovery. The President’s historical push for a 10% set-aside for recovery support services and an enormous increase to the block grant would dedicate several hundred million dollars for recovery community organizations, including recovery high schools, collegiate recovery programs, recovery residences, and alternative peer groups across the United States.

“Over the last 20 years, our advocacy work has led to substantial increases in federal funding for recovery support services,” says Patty McCarthy, Chief Executive Officer, Faces & Voices of Recovery. “Within the past three years alone, our advocacy efforts have grown the Building Community of Recovery grant program from $5 million to $13 million. These increases in federal funding have allowed our communities to build and strengthen programs where it counts–in community-based settings. Looking to FY 2023, we will continue to work with Congress to ensure that the block grant receives at least a $1.7 billion increase and that 10% of block grant funds are dedicated to recovery.”

The final FY2022 budget may not be the outcome we were anticipating; many advocates did not expect Congress to deny the recommended funding levels during a time when preventable, fatal overdoses are the leading cause of death for people ages 18-45. However, this year’s budget did limit nearly all areas of federal spending. Our staff and partners redouble our efforts to strengthen new and existing programs supportive of recovery services, and we feel confident that the remainder of 2022 will present many opportunities to expand access and funding for recovery support services.

As we execute our federal priorities, we will continue to serve as a national resource to the Administration, Congress, and our community. We encourage all communities to amplify the faces and voices of recovery to ensure that all who seek wellness have equitable access to recovery support. This year onward, our timing and advocacy will be paramount to the future of people who use substances, those with substance use disorder, and their families and loved ones. For these reasons, Faces & Voices of Recovery stands ready to advocate, act, and advance.

We will continue to notify our communities of our progress and calls-to-action to support creating dedicated funding for recovery.

For more information, the FY2022 bill text can be found here.

Faces & Voices of Recovery Supports Safe Supplies for Harm Reduction

February 10, 2022

Board President David Mineta and Chief Operating Officer Philip Rutherford have released the following statement:

Communities across our country face the devastation posed by overdose deaths, now the leading cause of people ages 18-45. As a result, the exponential loss caused by preventable, fatal overdoses has led to an influx of innovative approaches that promote the general health and wellbeing of people that use drugs, including those with addiction.

This crisis continues to overwhelm families and communities through the loss of loved ones and the economic impact that fatal overdoses pose. At a minimum, fatal overdoses cost the United States $1 trillion annually. Alternatively, adequate addiction treatment dramatically reduces law enforcement and healthcare costs, including Medicaid spending, by 700%.

Faces & Voices of Recovery promotes the utilization of services that offer fentanyl test strips, access to HIV and viral hepatitis treatment, sterile syringes, and safe smoking supplies, which reduce the rate of overdose and spread of infectious diseases – minimizing the harmful effects of drug use. Additionally, these strategies promote linkages to care and facilitate services for the health and wellbeing of its participants through motivational interviewing, counseling, and peer support specialists.

Despite continued discussion around the ‘opioid epidemic,’ fatal overdoses are not confined to heroin or opioids, nor are they limited to intravenous drug use. For example, a recent report from the Commission on Combating Synthetic Opioid Trafficking, states that 70 percent of overdose deaths involve heroin or cocaine, and nearly 50 percent involve psychostimulants such as methamphetamines.

We must consider safer consumption for non-intravenous substance use when preventing overdose. Ultimately, dividing the available resources for safer drug consumption perpetuates stigma about different drugs. Historically, we’ve seen the challenges that arise from this mentality through the ‘crack epidemic,’ which led to the inherently flawed and racist practices of mandatory minimum sentencing, the three-strike policy, and ultimately mass incarceration.

These perspectives perpetuate the continued trauma of many Black communities that were and are ignored, untreated, and incarcerated rather than having access to treatment and recovery supportive opportunities. Not only does this further disadvantage communities of color, but it also disadvantages rural communities that may experience higher levels of methamphetamine use and continues the cycle of disproportionate systems and inequitable resources to access addiction recovery.

We encourage all communities to amplify the faces and voices of recovery to ensure that all who seek recovery have equitable access to recovery supports of their choice. Especially policies that eliminate systems, structures, and constructs that marginalize people by race and ethnicity.

Where the Overdose Epidemic & COVID Collide, Peer Coaches & Specialists Face ‘Perfect Storm’

February 7, 2022

“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 TO MANAGE AND LEAD INTERNATIONAL RECOVERY DAY, ADVANCING ANNUAL GLOBAL CELEBRATION

January 13, 2022

Washington, DC 

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. 

 

For more information, visit internationalrecoveryday.org and www.facesandvoicesofrecovery.org 

 

Emily Porcelli, Marketing and Communications 

Faces & Voices of Recovery  

202-741-9392 

eporcelli@facesandvoicesofrecovery.org 

2021 ARCO Programmatic Evaluation Report

January 11, 2022

In February of 2020, I began my position with Faces & Voices of Recovery. With experience in grassroots organizing, working with RCOs and state systems, and peer training facilitation and curriculum development, I brought with me a passion to strengthen the national network of Recovery Community Organizations. As a woman in sustained recovery, I personally utilized peer services and had access to local RCOs. This personal experience helped to solidify my understanding of the vital role peers and RCOs have in building a foundation for recovery and across the recovery continuum journey.

I spent my first few months with the organization learning about our ARCO members. I learned from active ARCO members, members who opted to leave ARCO, and organizations who had unsuccessfully applied for membership. I sought a deeper understanding of their challenges and where Faces & Voices of Recovery, the RCO definition, and the 8 Criteria for RCOs and ARCO membership could improve. I grew my knowledge through rich and vulnerable conversations and by listening to understand. After a few short months, I submitted a proposal to complete a programmatic evaluation on our ARCO program with the intent to make changes that were responsive to challenges encountered by RCOs.

As the work on this evaluation began, Faces & Voices of Recovery became aware of how we as an organization, and many others in our national recovery network, failed to equitably represent Black; Indigenous; and people of color in our work to elevate and increase access to recovery. This was something I had already become aware of through the conversations I had been having with RCOs in our national system. The ARCO Programmatic evaluation grew from making responsive changes for developing RCOs into making responsive changes that were culturally congruent to BIPOC community members, LGBTQIA+ community members, People Who Use Drugs (PWUD), and harm reduction efforts that are inequitably welcomed and represented in recovery spaces.

A wise and brutally honest ARCO member expressed to me that Faces & Voices of Recovery, and the recovery movement as a whole, had a history of inequity and whiteness. This member had been a supporter of our organization for many years and continued to do so but was unabashed about his truth and experience as an African American, long-term recovering community member, and recovery advocate. This person committed to helping us do better if I committed to doing the work. You know who you are, and I thank you. It was with passion and empathy, along with support and access to resources to complete the ARCO Programmatic Evaluation from Patty McCarthy; Phillip Rutherford; and Joseph Hogan-Sanchez, that we began our journey to do better.

This report and the work conducted by our ARCO members is a mechanism to reevaluate our systems, embrace dialogue in the spirit of understanding, and challenge what we know to be true. It is a catalyst for change. It has changed our organization and ARCO membership, but more importantly, it has changed me, and I hope that it spurs change for you. Together, we can do better.

We are pleased to present to you the 2021 ARCO Programmatic Evaluation Report which can be accessed for online reading, downloading, and printing here.

 

Marianna Horowitz
Program Manager, Faces & Voices of Recovery

NRI Newsletter – October 2021

October 28, 2021

October 2021
Digital Newsletter

National Recovery Institute

The National Recovery Institute is a peer-run training and technical assistance center. Our mission is to increase the knowledge, capacity, and accountability of recovery support providers throughout the United States and territories.

The National Recovery Institute offers competency and strength-based professional development and leadership training specific to our field.  Our experienced trainers offer training accessible to all learning styles through a combination of information sharing, dialogue, and experiential activities. Through a consultative process, we will build an onsite or online training program specific to your needs.

Please check out our website for more information! We are excited to get your next training scheduled today!

More Info Here!

Mark your Calendars!

Please join us for these FREE upcoming trainings sponsored by the Opioid Response Network

RCO Bootcamp
December 7-9, 2021
10 am – 4pm EST

The RCO Bootcamp is a leadership development program for new and emerging Recovery Community Organization (RCO) directors, program managers, and board members. The Boot Camp covers all the basics to help establish policies and procedures to build the capacity of small non-profit organizations.

CEUs available

Register here!

Recovery Ambassador Training
December 14-16, 2021
10am – 4pm EST

Recovery Ambassador is a training that prepares individuals to advance public understanding and appropriate responses to addiction. The training program consists of a combination of Our Stories Have Power Recovery Messaging, the Science of Addiction & Recovery, and the Recovery Ambassador curriculum.

CEUs available

Register here!
Faces & Voices of Recovery is proud to be a NAADAC Approved Education Provider.
Reduced training rates are available for Faces & Voices Affiliates and for Members of the Association of Recovery Community Organizations (ARCO).
Join Today!

NRI Newsletter – September 2021

September 28, 2021

September 2021
Digital Newsletter

National Recovery Institute

The National Recovery Institute is a peer-run training and technical assistance center. Our mission is to increase the knowledge, capacity, and accountability of recovery support providers throughout the United States and territories.

The National Recovery Institute offers competency and strength-based professional development and leadership training specific to our field.  Our experienced trainers offer training accessible to all learning styles through a combination of information sharing, dialogue, and experiential activities. Through a consultative process, we will build an onsite or online training program specific to your needs.

Please check out our website for more information! We are excited to get your next training scheduled today!

More Info Here!

Meet the NRI Training Team!

Tony Sanchez, Director of Partnerships

Tony Sanchez is a passionate advocate who works tirelessly to enhance and develop recovery-oriented systems of care for all people. As a person in long-term recovery, Tony is continually amazed by the opportunities that have come his way to use his lived experience and knowledge of recovery to serve others. Prior to joining Faces & Voices of Recovery, served as the Director of the Office of Recovery Transformation at Georgia’s Department of Behavioral Health and Developmental Disabilities (DBHDD) from 2016 to 2021. Tony lives in the state of Georgia.

Kiara Booker, Training Program Coordinator


Kiara’s passion for advocacy stems from seeing the effects of generations of family members and loved ones, both old and young, losing their lives to substance use disorder. She is passionate about educating our communities on healthy ways to support individuals with substance use and other mental health disorders. Kiara lives in the state of North Carolina.

Liam Lipham, Training Program Coordinator


Liam Lipham is a veteran, dog dad to an 11-year-old chihuahua, and proud recovery ally. His biggest passion is creating a positive change in the world and he does this through advocating, role-modeling, mentoring, reducing stigma, and volunteering. He loves snorkeling, hiking, sushi, travel, exploring, and is always trying or learning new things.  Liam lives in the state of Florida. If you’re in the West Palm Beach, FL area, come exercise with him on Monday and Thursday nights at Howard Park (@NightrunnersWPB)!

Krissi Jacob, Program Assistant


Krissi Jacob is a mom of two incredible souls, Annabelle and Eli, a person in long-term recovery for the last seven years, and an advocate for reducing stigma and healing trauma in her community. She loves yoga, reading, cooking, laughing and is thankful for everyday she has spent in recovery and the journey it took to get her there. Krissi lives in the state of Georgia.

Faces & Voices of Recovery is proud to be a NAADAC Approved Education Provider.
Reduced training rates are available for Faces & Voices Affiliates and for Members of the Association of Recovery Community Organizations (ARCO).
Join Today!

Join us October 4-6th!

This year marks the 20th Anniversary of Faces & Voices of Recovery. In 20 years, many things have changed in the Recovery Movement, but our dedication to the mission has never wavered.

Through your ongoing support we have been able to connect and help Recovery Community Organizations around the world and continue to work to change the way addiction and recovery are understood and embraced through advocacy, education and leadership.

Virtual Registration is Availaible!

Learn More Here!

CAPRSS Newsletter – September 2021

September 7, 2021

September 2021
Digital Newsletter
Now in its 32nd year, Recovery Month celebrates the gains made by those in recovery, just as we celebrate improvements made by those who are managing other health conditions such as hypertension, diabetes, asthma, and heart disease.

Each September, Recovery Month works to promote and support new evidence-based treatment and recovery practices, the emergence of a strong and proud recovery community, and the dedication of service providers and community members across the nation who make recovery in all its forms possible.

To share your events on our Recovery Month calendar and download the toolkit, click here.

Virtual Learning Community

Join us on September 8th from 12pm – 1pm EST for our CAPRSS Virtual Learning Community. In honor of National Recovery Month, this month’s topic is How We Celebrate our Teams. This topic speaks directly to the CAPRSS domain Peer Leadership Development and specifically the standard of Retention. Join Joseph Hogan-Sanchez, Director of Programs, and Nelson Spence, Accreditation Services Coordinator, who will be facilitating this conversation and share how your organization celebrates the work of its peer leaders!
Register Here!

Ethics Tip Sheet

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.

Here is a Tip Sheet that speaks to the CAPRSS domain of Ethical Framework for Service Delivery:

View & Download Tip Sheet Here!

Upcoming Webinars

Accreditation 101 – October 1, 2021 – 12pm ET

Accreditation 101 is an introduction to accreditation course, where participants will learn the mission and purpose of CAPRSS, an overview of the standards and criteria, the steps in the accreditation process, establish resources for getting your organization accreditation ready, and for completing your application for accreditation candidacy.

Register Here

Accreditation 201 – September 17, 2021 – 12pm ET

Accreditation 201 is designed to: Identify the elements of the CAPRSS standards taxonomy and how they relate. Describe the core domains and standards, and discuss how peer reviewers – and PRSS programs – will use standards, criteria, and elements of performance in the accreditation process.

Register Here

Register now for Faces & Voices’
20th Anniversary Summit

This year marks the 20th Anniversary of Faces & Voices of Recovery. In 20 years, many things have changed in the Recovery Movement, but our dedication to the mission has never wavered. Through your ongoing support we have been able to connect and help Recovery Community Organizations around the world and continue to work to change the way addiction and recovery are understood and embraced through advocacy, education and leadership.

JOIN US
OCT 3 – 6, 2021 This Recovery Leadership Summit will be held virtually over the course of three days and is filled with exceptional presentations, critical discussions and optional early morning and evening activities.

Register and learn more here!

QUESTIONS

We are here to support Peer Recovery Support Service programs achieve and succeed. If you have questions or would like to schedule a time to chat about CAPRSS, feel free to contact our Accreditation Services Coordinator, Nelson Spence, at nspence@facesandvoicesofrecovery.org.

OFFICIAL ANNOUNCEMENT – Summit is going virtual!

September 1, 2021

Faces & Voices Update
September 1, 2021

ANNOUNCEMENT
The 20th Anniversary Summit is Moving to a Virtual-Only event

We’ve been closely monitoring the situation regarding COVID-19 and associated variants, and we have come to the difficult decision to move our 20th Anniversary Summit to an all-virtual format.

After many conversations with constituents, presenters, and staff, the consensus is that conditions are such that it would be a challenge to ensure the health and safety of participants, especially because our community is at higher risk for serious complications of the COVID-19 virus. Although we are disappointed that we won’t be able to get together in person again this year, we believe this to be the safest course of action.
The good news is that we plan a vibrant online event with many opportunities for networking, participation, and education, as we did last year. All the events that were scheduled for the physical event will be included in the virtual event.
The virtual format eliminates travel costs for attendees, so we welcome you, your colleagues, and peers to register today for the 20th Anniversary Summit!

We’ll release the full schedule shortly, but some of our speakers include:

  • William L. White – Distinguished Recovery Historian
  • Dr. Miriam Delphin-Rittmon – Assistant Secretary SAMHSA
  • William Cope Moyers – VP of Public Affairs & Community Relations for Hazelden Betty Ford
  • Tom Hill – Senior policy advisor at the White House ONDCP
  • Tracie Gardner – Legal Action Center’s VP of Policy Advocacy
  • Dr. John Kelly – Founder & Director of Recovery Research Institute
  • Dr. Nora Volkow – Director of NIDA
Visit here for more Information & Registration

Posts from William White

Ernie Kurtz, Recovery, and the Power of Story

September 4, 2020

Harvard-trained historian Ernest Kurtz loved stories. The power of story and the role of storytelling in personal identity and addiction recovery filled his writings on Alcoholics Anonymous (A.A.), and they were central themes in the books he co-authored with Katherine Ketcham: The Spirituality of Imperfection and Experiencing Spirituality.

I apprenticed under Ernie’s guidance for more than two decades in hopes of mastering the art and science of historical research. Sitting across from him in his office, I must have asked Ernie a thousand questions. His most frequent response was to lean forward in his chair, eyes twinkling, arms and hands in motion, to share a story in a voice that would have done Moses justice. Ernie was at heart and above all a spellbinding storyteller.

Ernie was fascinated with how life stories were, by necessity, reconstructed as part of one’s recovery from alcoholism. He often commented on how the A.A. story style helped newcomers construct a new life story from the fragments of their brokenness. The new story helped make sense of experiences that were otherwise inextricable, helped fire hope, salvaged self-esteem, and bolstered the commitment to sobriety.

One of the many themes within Ernie’s historical research was the role of memory in storytelling—writ small (personal identity) and large (collective history). Aware that much of my recounting of the modern history of addiction treatment and recovery flowed from interviews with key players within that history, Ernie cautioned me to think of memory as more construction site than storage drawer. He often discussed the potential loss of objective history due to the filtering of memory through efforts of self-enhancement, institutional interests, and contemporary political and cultural wars. His admonition? Verify everything!

Ernie was equally intrigued by the role of memory as scaffolding for addiction and recovery. He suggested that how we select and attach meaning to events in our life exert a profound effect on our future. The selection and deselection of life events to form a coherent narrative in his view could support either addiction or recovery.  An essential feature of the journey between the former to the latter was thus a process of story reconstruction and storytelling. Ernie suggested: change the story, change the life—a process aided by both skilled clinical intervention and participation in a community of recovering people with whom one could identify.

Ernie also explored how recovery stories changed over time, marking a prolonged process of healing and reconstruction of personal character and values. In The Spirituality of Imperfection, he identified six experiences/traits expressed in these evolving stories—all keys to this long-term reconstruction of self: release, gratitude, humility, tolerance, forgiveness, and being-at-home. As is evident, Ernie understood addiction recovery as a process involving far more than the deletion of drugs from an otherwise unchanged life.

During my last visit with Ernie before his passing, he shared with me a number of private documents. Included was 145 pages of raw notes on story and storytelling. This elaborately coded document contained quotations and summaries from all his related readings as well as many of his own reflections, only some of which appeared in his published work. I have cherished these notes for the past five years and have decided, with permission from Ernie’s wife, Linda Ferris Kurtz, to share some excerpts from these notes. Below are just a few of Ernie’s prized discoveries and reflections on story, memory, and storytelling. I share these as a way of continuing to honor what Ernie meant to so many of us. To review selected excerpts from the Kurtz notes on Story, Memory and Storytelling, click HERE.

SAMHSA’s BRSS TACS releases directory of peer recovery coaching training and certification programs

September 4, 2020

SAMHSA’s BRSS TACS releases directory of peer recovery coaching training and certification programs

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) Bringing Recovery Supports to Scale Technical Assistance Center Strategy (BRSS TACS) recently released their State-by-State Directory of Peer Recovery Coaching Training and Certification Programs. The directory provides detailed information about certification processes for peer recovery coaches, including training requirements, curricula, exam criteria, fees, and program descriptions. The directory also identifies recovery coach supervisor training requirements and supervisor training courses.

 

BRSS-TACS_State-by-State-Directory-of-Peer-Recovery-Coaching-Training-and-Certification-Programs_8_26_2020

Dying of Morbid Shyness? Social Anxiety and Addiction Recovery

August 27, 2020

Social anxiety/phobia, often mischaracterized as extreme shyness, constitutes a potential pathway into addiction and a major obstacle to addiction treatment and recovery.

Robert and Kaisha could not be more different at a quick glance, but they shared the curse of what others perceived as extreme shyness. Robert and Kaisha dreaded any social situation filled with strangers, the expectation of conversation, or any undue focus upon themselves. Just the thought of entering such a situation induced a trembling voice, a racing heart, sweaty hands, a blushing face, dizziness, nausea, extreme self-consciousness, and fears of embarrassment and humiliation. In social situations that could not be escaped, they sought invisibility, shunning as much contact as possible, avoiding eye contact, speaking very little or not at all, and spending inordinate time afterwards harshly judging their social performance.

Robert and Kaisha found something of a solution for their social anxiety. They discovered magic elixirs that lessened or dissolved their fears and loosened their tongues. The problems only came when their increasing dependence on ever-increasing dosages and frequencies of these elixirs created all manner of other problems in their lives. When these escalating problems forced them to seek help, imagine their mortification to hear that their “treatment” would involve group therapy and participating in recovery mutual support groups in their local community.

The situation faced by Robert and Kaisha is by no means rare. A study by Book and colleagues found that 37% of people entering addiction treatment also experienced clinically significant social anxiety. The 37% figure would extrapolate to more than 740,000 individuals entering addiction treatment each year. The Book study raises several important questions.

Of 21.7 million Americans in need of help for a substance use disorder in the past year, only 2.3 million received specialized SUD treatment.  What portion of those not receiving treatment were dissuaded from seeking help due to social anxiety and the group-orientation of addiction treatment and recovery mutual aid?

Since 1999, more than 770,000 Americans have died from drug overdoses. What portion of those lost lives chose not to seek help due to social anxiety and the group-orientation of addiction treatment and recovery mutual aid?

Since 1999, nearly one million individuals died from alcohol-related causes. What portion of those lost lives chose not to seek help due to social anxiety and the group-orientation of addiction treatment and recovery mutual aid?

There are an estimated 1.4 million suicide attempts and more than 47,000 deaths by suicide in the United States each year. What portion of these people suffer from a substance use disorder and fail to seek help due to social anxiety and the group-orientation of addiction treatment and recovery mutual aid?

The situation faced by people who need help for a substance use disorder but who shun such help due to social anxiety could be improved if:

*Addiction professionals assessed the presence and degree of social anxiety of every person seeking help for a substance-related problem.

*Integrated addiction and mental health services existed that could concurrently treat SUDs and anxiety disorders via potential combinations of psychosocial support and medication.

*Treatment adjuncts/techniques potentially helpful to those with social anxiety (e.g., thought-stopping, reframing, biofeedback, systematic desensitization, situation rehearsal, progressive relaxation, breath training) were routinely available in addiction treatment programs.

*Outpatient individual counseling was universally available as an alternative to the dominant group-oriented intensive outpatient and residential models of addiction treatment.

*Prescriptive bibliotherapy and self-guided manuals were more widely available as adjuncts and alternatives to addiction treatment.

*E-therapy and e-recovery support services, including online recovery support chat rooms and online meetings (e.g., In the Rooms) were assertively promoted to people with social anxiety.

*Each person with social anxiety was assigned a recovery coach as a personal travel guide into the social worlds of addiction recovery.

*People with social anxiety were phased in to recovery-focused social contact, beginning with orientation to program literature and rituals, one-on-one contact, and large speaker meetings where there is no expectation for participation prior to exposure to smaller closed meetings.

Social anxiety constitutes a major obstacle to addiction treatment and recovery. Human connection is a key mechanism of change within addiction recovery, but people with social anxiety may need special support to access such connection. Scientific research, careful clinical observation, and personal lived experience may offer such people improved solutions for the future.

 

Acknowledgement: Thanks to members of the Recovery Rising Book Club for comments on an early draft of this blog.

 

References

Book, S. W., Thomas, S. E., Dempsey, J. P., & Randall, P. K. (2009). Social anxiety impacts willingness to participate in addiction treatment. Addictive Behaviors, 34, 474-476.

Substance Abuse and Mental Health Services Administration, (2019). Treatment Episode Data Set (TEDS): 2017. Rockville, MD: Substance Abuse and Mental Health Services Administration.

White, A. M., Castle, I-J., P., Hingson, R. W. & Powell, P. A. (2020). Using death certificates to explore changes in alcohol-related mortality in the United States, 1999-2017. Alcoholism: Clinical & Experimental Research. 44(1). 178-187.

Further Reflections on Acute Care Models of Addiction Treatment

August 20, 2020

I believe we live in the greatest era of snake oil salesmen in the history of mankind. —Michael Crichton, Next, 2006

The addictions treatment field has grossly oversold the effectiveness of a single episode of brief clinical intervention. For more than two decades, calls have increased for a radical redesign of addiction treatment and related recovery support services—a shift from acute care models of intervention to models of sustained recovery management (RM) nested within larger recovery-oriented systems of care (ROSC).

Defining Acute Care: Acute care (AC) models of addiction treatment encompass service interventions that intervene at a late stage of problem development via services focused on brief biopsychosocial stabilization that lack sustained support across the stages of long-term personal and family recovery. AC models of intervention that have dominated specialized addiction treatment since its inception in the mid-nineteenth century share distinct characteristics:

*Services are delivered “programmatically” in a uniform series of encapsulated activities (screen, admit, single point-in-time assessment, minimally individualized treatment, discharge, brief “aftercare” as an afterthought, termination of the service relationship).

*Clinical intervention is focused on symptom elimination for a single primary problem.

*Professional experts direct and dominate the assessment, treatment planning, and service delivery decision-making.

*Services transpire over a short (and historically ever-shorter) period of time—usually as a function of a prearranged, time-limited insurance payment designed specifically for addiction disorders and “carved out” from general medical insurance.

*The individual/family/community is given the impression at discharge (“graduation”) that “cure has occurred”: long-term recovery is viewed as personally self-sustainable without ongoing professional assistance.

*The intervention is evaluated at a short-term, single-point-in-time follow-up that compares pretreatment status with discharge status and short-point-in-time post-treatment status.

*Post-treatment symptom recurrence and needed readmission are viewed as failure of the client rather than flaws in the design or execution of the treatment protocol. Treatment in subsequent admissions is essentially the same as that of the first admission.

Why Acute Care? The modern addictions treatment field migrated toward an acute care model in the 1970s and early 1980s. The model reflected a bid for professional credibility of an emerging field, a needed response to the surge in public funding for addiction treatment, and a strategy to acquire private insurance reimbursement for such treatment. The resulting scheme of treatment and related funding policies resembled the acute care hospital, with duration of treatment becoming ever briefer following the advent of aggressive systems of managed behavioral healthcare. Detoxification programs were modeled on the hospital emergency room, inpatient and residential programs were modeled on acute care wards of the general hospital, and outpatient programs were modeled on the outpatient medical clinic. The resulting model prescribed a series of clinical steps all compressed in as little time as possible.

Potential Value of Acute Care: AC models of SUD intervention are very appropriate for people with low to moderate substance use disorders (SUDs) who also possess substantial recovery capital. Millions of people fitting this profile are today in long-term stable recovery who express unending gratitude for the AC treatment they received. For people with more severe SUDs, acute care is one critical stage in what needs to be a multi-staged process of sustained recovery support.

Unintended Consequences of AC Model: Failure to meet SUD severity criteria denies access to care for many people with mild to moderate substance-related problems and substantial recovery capital. People with the most severe, complex, and chronic SUDs are being repeatedly recycled through AC models of care whose low intensity and duration of services offer little hope of sustainable SUD recovery. (58% of people now admitted to addiction treatment in the U.S. have one or more prior treatment episodes, TEDS Data). I have regularly compared AC models of addiction treatment to providing inadequate dosages or duration of antibiotics in the treatment of bacterial infections. In both cases, treatment leads to temporary suppression of the symptoms but inadvertently leads to resurgence of the condition in a more intractable condition.

Cost-ineffectiveness of AC Model

Millions if not billions of dollars allocated to AC treatment is wasted due to the lack of earlier intervention into alcohol and other drug problems and the lack of long-term post-AC recovery support services. Service utilization and related profits within inpatient and residential treatment programs would plummet if improved recovery rates dramatically reduced multiple treatment admissions. Knowledge of that fact is a major obstacle to needed systems transformation within the addiction treatment industry. Ideally, dollars now allocated almost exclusively to AC treatment of addiction in the U.S. would be reapportioned across the stages of long-term personal and family recovery.

Ethics of Acute Care: Acute care models of addiction treatment that lack assertive outreach to shorten addiction careers and recovery support services across the stages of long-term recovery should be called out for what they are: clinical incompetence and financial exploitation, by consequence if not intent. The practice of recycling people with severe, complex and chronic SUDs repeatedly through AC-limited services is more money machine than “treatment “ and should be professionally and publicly exposed as such.

Alternative to AC Models of Care:

The alternative to the AC model that leaders in the addictions field are exploring is a model of recovery management nested within larger recovery-oriented systems of care.

Recovery management (RM) is a philosophical framework for organizing addiction treatment services to provide pre-recovery identification and engagement, recovery initiation and stabilization, long-term recovery maintenance, and quality-of-life enhancement for individuals and families affected by severe substance use disorders.

Recovery-oriented systems of care (ROSC) are networks of formal and informal services developed and mobilized to sustain long-term recovery for individuals and families impacted by severe substance use disorders. The system in ROSC is not a local, state, or federal treatment agency but a macro-level organization of a community, a state, or a nation. ROSC initiatives provide the physical, psychological, cultural, and social space within local communities in which personal and family recovery can flourish.

Distinctive Features of RM and ROSC

The emerging RM & ROSC vision calls for:

*strengthening the infrastructure of addiction treatment to ensure sustained continuity of support and accountability to the individuals, families, and communities served by addiction treatment institutions;

*more proactive systems of identifying, engaging, and ensuring service access for individuals and families at the earliest possible stage of AOD-related problem development;

*individual, family, and community needs-assessment protocols that are comprehensive, strengths-based, and ongoing;

*the utilization of multidisciplinary and multi-agency service models for supporting long-term recovery for those individuals, families, and neighborhoods experiencing severe, complex, and enduring AOD problems;

*the reconstruction of the service relationship from an expert model to a partnership model involving a long-term recovery support alliance;

*expanding the service menu, with an emphasis on evidence-based and recovery-linked service practices;

*ensuring each client and family an adequate dose and duration of pre-treatment, in-treatment, and post-treatment clinical and recovery support services;

*exerting a greater influence on the post-treatment recovery environment by shortening the physical and cultural distance between the treatment institution and the natural environments of those served, and by intervening directly to increase family and community recovery capital;

*assertive linkage of clients and families to recovery mutual aid groups and other indigenous recovery support institutions;

*post-treatment monitoring (recovery check-ups for up to five years following discharge from primary treatment), ongoing stage-appropriate recovery education, sustained recovery coaching, and, when needed, early re-intervention; and

*the systematic and system-wide collection and reporting of long-term post-treatment recovery outcomes for all individuals and families admitted to addiction treatment.

RM and ROSC system redesign would integrate the now isolated siloes of primary prevention, harm reduction, early intervention, treatment, and recovery support services.

People in personal/family recovery and a vanguard of addiction professionals are working diligently across the country to make this vision a reality. If I had another lifetime to devote to the elevation of the quality of addiction treatment in the United States, this is what I would be trying to achieve.

References:

Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) Discharges, 2015. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2018. Accessed February 13, 2020 at https://wwwdasis.samhsa.gov/dasis2/teds_pubs/TEDS/Discharges/TED_D_2015/teds_d_2015_codebook.pdf

Kelly, J. & White, W. (Eds., 2010). Addiction recovery management: Theory, science and practice.  New York:  Springer Science

White, W. (2008).  Recovery management and recovery-oriented systems of care:  Scientific rationale and promising practices.  Pittsburgh, PA:  Northeast Addiction Technology Transfer Center, Great Lakes Addiction Technology Transfer Center, Philadelphia Department of Behavioral Health & Mental Retardation Services

Recovery Journalism

August 13, 2020

Until the lion learns how to write, every story will glorify the hunter. –African Proverb

From Lin-Manuel Miranda, Hamilton: “Why do you write like you’re running out of time?”

Me: “Because I am.”

In the late 1990s, I experienced an epiphany of sorts—a sudden awareness that the addiction field had acquired a massive body of scientific and professional knowledge about alcohol and other drug problems and their clinical treatment but possessed little knowledge of the prevalence, pathways, styles, and stages of long-term personal and family recovery. Being over fifty seemed a strange time to plot a new career direction, but that is what I did. My decision was clear: whatever remaining time I had would be devoted to the scientific study of recovery and pushing the addiction field’s organizing center from a focus on pathology and the nuances of clinical intervention to a focus on the lived experience of long-term recovery. Fortunately, I was not alone in either this awareness or that commitment. The subsequent years witnessed the rise of recovery-focused research scientists and a new generation of recovery advocates. Today, recovery journalism–from the scientific journals to the growing legion of recovery blogs–is coming of age.

When I entered the addictions field in the 1960s, there were two distinct classes of workers:  “professionals” (doctors, nurses, psychologists, and social workers) and “paraprofessionals” (people with lived experience of addiction and recovery). There was little consideration that one could be both a professional AND a person in long-term recovery: you were one or the other. If you had a foot in each world, your legitimacy could be and often was questioned within each—seen as too broken in the professional world and not broken enough in the recovery world. Over time, people in recovery working in the field were extruded as addiction counseling became more professionalized and as those in recovery, as an act of self-protection, hid their recovery identity behind a smokescreen of increasing credentials.

Now for a present story. A lively discussion recently ensued among a group of people in recovery when the name of a prominent recovery advocate came up. The discussion entailed back and forth arguments over whether the person was a “real addict” [in recovery] or an “academic.” Again, notice the binary choice here—a remaining shadow of the past.

Historically disenfranchised people face the stigmatizing judgement of others in ways that limit the vision of their own potential as individuals and as a people. Black children who excel academically are castigated by some of their peers as “acting White” in oppressed, wounded worlds where Blackness and academic achievement are perceived as incongruent. In a similarly distorted worldview, a person with an advanced degree could not be a “real addict” or a “person in recovery.” In that view, academic achievement and eloquent writing are incompatible with the status of addiction recovery. The good news is that such warped views of self and the world are breaking down.

Under the influence of a vibrant recovery advocacy movement and new recovery support institutions (e.g., recovery high schools, collegiate recovery programs, recovery-focused academic mentoring), legions of people in recovery are pursuing college, university, and graduate training, and they are doing so as visible people in recovery. The result is an explosion in recovery-focused writing that spans memoirs, scientific studies, professional papers, popular journal articles, and social media posts. The perception that academic excellence and exemplary writing are incompatible with recovery status is fading among people in recovery, in the professional world of addiction treatment, and among the public. That is a remarkable achievement of historical significance.

I am part of a community of physicians, nurses, pharmacologists, psychologists, social workers, research scientists, historians, authors, educators, addiction professionals, and community activists. AND we are all people in  long-term addiction recovery. If you are a person in recovery, you can be anything you want to be—and still be a person in recovery. Recovery is a launching pad, not a restrictive cage. Don’t let anyone foist you into such a cage.

Medical Burden of Disease Among Individuals in Recovery From Alcohol and Other Drug Problems in the United States: Findings From the National Recovery Survey

August 10, 2020

Eddie, Greene, White, & Kelly, 2019 (Medical Burden)

Whether, when, and to whom?: An investigation of comfort with disclosing alcohol and other drug histories in a nationally representative sample of recovering persons

August 10, 2020

Earnshaw, Bergman, & Kelly, 2019 (Comfort Disclosing)

Digital Recovery Management: Characterizing Recovery-Specific Social Network Site Participation and Perceived Benefit

August 10, 2020

Bergman, Kelly, Hoeppner, Vilsaint, & Kelly, 2017 (Digital Recovery)

Attitudes Toward Opioid Use Disorder Medications: Results From a U.S. National Study of Individuals Who Resolved a Substance Use Problem

August 10, 2020

Bergman, Ashford, & Kelly, 2019 (Opioid Medication Attitudes)

The Paradox of Power in 12-Step Recovery

August 6, 2020

At the very heart of addiction lies the search for power, control, comfort, relief, and pleasure. At first, the drug is a secret superpower that heals, emboldens, and frees us, but as it feeds on us, it becomes stronger and we become progressively weaker. In the end, we worship the drug at the exclusion of all else as we become one with the drug. We are in its power, feeling more possessed that master of our fate. It is thus little wonder that the issue of personal power is at the center of multiple pathways of addiction recovery.

Mainstream 12-Step recovery, drawn from the experience of first-generation, predominately White male AA members who had lost their personal and cultural empowerment due to alcoholism and the Depression, rests on a deep acceptance of one’s powerlessness. Complete surrender to this state of powerlessness is the beginning and very crux of recovery within the 12-Step program. Later frameworks of recovery, drawn primarily from the collective experience of addicted women, people of color, young people, members of the LGBTQ community, and other historically disenfranchised populations, proffered the assertion of power and control as the central recovery catalyst. These later frameworks also emphasized much greater reliance on discovering power within oneself rather than sole reliance on power beyond the self. (For full discussion, see White and Chaney Metaphors of Transformation.)

Twelve-Step critics, drawn primarily from alternative recovery mutual aid societies and from the professional disciplines of psychology and psychiatry, allege that the core concepts and practices of 12-Step programs are disempowering at personal, cultural, and political levels. On the surface, it would seem that the effect of embracing powerlessness and extolling surrender would result in a lost sense of personal power, but early 12-Step members discovered a remarkable paradox. In the act of openly admitting their powerlessness over a drug (alcohol in A.A.) or a process (addiction in N.A.), they mysteriously acquired an unprecedented level of power and control over their lives. Early 12-Step literature speaks to this: “Such is the paradox of A.A. regeneration: strength arising out of complete defeat and weakness, the loss of one’s old life as a condition for finding a new one.”

Long-tenured members of AA, NA, and other 12-Step fellowships suggest that there is something quite liberating to peel away one’s drug dependence and shed the related monetary extortion and corruption of personal character. In their experience, freedom lies in the clarity that one has not been, is not, and can never be in control of the drug relationship. They argue that the only way to be free of Sisyphean attempts to control the drug relationship is to sever that relationship completely and irrevocably. They also note a sense of exhilaration in the full realization that all they can ever hope to be and do—both duration and quality of life—hinges on one single issue and related daily priority.

While different perspectives on power and powerlessness exist across religious, spiritual, and secular recovery mutual aid organizations, I am most interested in the contrast on these issues that exist between professional service organizations and recovery mutual aid organizations (and more specifically 12-Step organizations). There would seem to be some value in comparing what “empowering” alternatives 12-Step critics have to offer as a solution to severe substance-related problems. In short, what are the major differences in “power” across professional and peer support contexts? I would argue that the peer support context offers considerably more power and freedom than that found in the professional service relationship.

Twelve-Step members control the pace of emotional intimacy through their choice of meeting styles, meeting frequency, degree of socializing outside of meetings, and choice to have or not have a sponsorship relationship and with whom. In the professional context, the service professional prescribes the frequency and intensity of contact. Twelve-Step programs are accessible around the clock, including evenings, weekends, and holidays—something unheard of in the professional context. Twelve-Step programs are geographically accessible even when traveling the world; historically, the professional service relationship is rooted to a single location. There are no fees attached to 12-Step participation—only small volunteer contributions to support maintenance of the group. In contrast, professional recovery support can involve tens of thousands and potentially hundreds of thousands of dollars. Twelve-Step programs maintain no record of one’s support activities; professionals maintain extensive records that are not in control of the “patient.” Peer relationships within 12-Step programs rest on a foundation of reciprocity of support and equality of power; professional relationships are hierarchical with greater power placed in the role of the professional. Twelve-Step relationships are potentially enduring; professional relationships are almost universally time-limited and ever-briefer within the current service funding environment. Where 12-Step programs limit invasiveness and levels of personal disclosure (via discouragement of crosstalk and discouragement of taking other people’s inventories), professional treatment often involves pressure for a heightened degree of personal disclosure.

I do not intend to contrast 12-Step and other mutual aid groups and professional interventions into a binary either/or choice or in a contrasting superiority/inferiority judgment. Both have value as mechanisms of recovery support. I am simply pointing out that people have far more personal power in the recovery mutual aid context than in the professional context. Moreover, it is hypocritical for professionals to castigate 12-Step groups as “disempowering” only to offer an alternative in which individuals have far fewer choices and find themselves at the bottom of a hierarchical service relationship characterized by substantial fees, limited accessibility, and short duration of support followed by what many may experience as “clinical abandonment.”