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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- 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
“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
The Good News: More than 22 million Americans have resolved a significant alcohol or other drug problem during their lifetime
The Problem: People in recovery from addiction continue to suffer inordinate rates of respiratory disease, kidney failure, heart disease, diabetes mellitus, hypertension, stroke, cancer, and premature death. (Eddie et al., 2019; White et al., 2013)
The Solution: At a personal level, changing unhealthy lifestyle habits can enhance life expectancy and improve quality of life in long-term recovery. At a systems level, integrating addiction treatment and allied recovery support services with primacy health care could reduce the burden of disease experienced by people in addiction recovery. One potential framework for such integration is the emerging field of lifestyle medicine.
Lifestyle Medicine/Healthcare is a relatively new medical specialty spawned by the discovery that changes in daily habits can reduce the likelihood of contracting non-infectious chronic diseases by 80% and cancers by 40% (ACLM)—all accomplished without a pill or surgical procedure. Lifestyle medicine is predicated upon six pillars:
1) Eating predominantly whole food, plant-based foods, and avoiding processed foods as much as possible – Food is medicine.
2) Establishing and maintaining regular, consistent, and age-appropriate physical activity – Exercise is medicine, too.
3) Managing unhealthy stress to avoid anxiety and depression and to bolster one’s immune system.
4) Practicing good sleep hygiene (7 to 9 hours per night) for the average adult to maintain a strong immune system and regulate metabolism.
5) Understanding social connection as essential for emotional resiliency. (Social isolation is associated with early mortality.)
6) Avoiding tobacco and other toxins that can lead to heart disease and numerous types of cancer.
There is also a sometimes-controversial 7th pillar. Many lifestyle medicine specialists contend that having a strong spiritual connection completes a holistic approach to health and wellness.
By honing these seven pillars of lifestyle healthcare and infusing them into a program of recovery, we can profoundly influence the quality of addiction recovery and population-level health.
Let us explore each of the Lifestyle Medicine/Healthcare pillars in a little more detail and relate them to the recovery community.
Nutrition This is one of the most important lifestyle changes available to enhance recovery outcomes. Poor dietary choices and irregular food intake is one of the hallmarks of addiction and the malnourishment or undernourishment that undermines long-term health. Eating mostly plant-based foods consisting of fresh vegetables, fruits, beans, nuts, whole grains, and seeds can restore the gut microbiota and help prevent/control hypertension, heart disease, and diabetes. Poor nutrition can aggravate mental health conditions such as mood disorders including anxiety and depression.
Physical Activity There is ample evidence that regular aerobic exercise can reduce illicit drug use. It is also tremendously important in preventing, treating, and even curing some of the chronic diseases that can develop during addiction and extend into one’s time in recovery. Regular physical activity can have salutary effects on cholesterol levels, hypertension, and insulin regulation. Getting such activity can be as simple as walking, gardening, dancing, or doing household chores. Exercise is currently the initial prescription by psychiatrists for patients with mild to moderate depression. Exercise can be thought of as “body prayers” to supplement the spiritual prayers commonly used in recovery.
Stress Management is an essential recovery tool that should be of immense importance to the recovery community. Excessive alcohol and drug use often begins as a negative response to a stress stimulus. Beyond abstinence, stress (distress) can lead to anxiety, depression, obesity, and immune dysfunction. Developing improved strategies for coping is an essential task within the process of long-term addiction recovery.
Sleep Hygiene is an area of lifestyle that is commonly undervalued by the recovery community and society at large. Poor sleep habits lead to sluggishness, low attention span, decreased sociability, depressed mood, increased hunger, and reduced caloric expenditure (weight gain). Think about how the life of every living organism from a huge blue whale to a tiny mosquito depends on sleep. Sleep is recovery refreshment.
Recovery mutual aid organizations emphasize the importance of the role of social connections and recovery-supportive relationships—a role that has become more difficult with the social distancing demands imposed by the COVID-19 pandemic. There is little doubt about the power of the group experience toward facilitating and augmenting sobriety ad recovery. Social relationships also promote physical, mental, and emotional health. The single most important predictor of human happiness and long life is having strong social connections—connections that also exert a powerful influence on the durability and quality of addiction recovery.
Environmental toxins potentiate the development of chronic diseases. Such toxins include tobacco smoking and exposure to secondhand smoke. Cigarette smoke remains the leading preventable cause of death in the United States causing more than 450,000 deaths annually – approximately one in five deaths. In fact, smoking causes more deaths than the combination of alcohol, firearms, HIV, illegal drug use, and motor vehicle accidents. Additionally, more than 10 times as many US citizens have died prematurely from cigarette smoking than have died in all the wars fought by the United States (Frates, 2019). Research reviews (See HERE and HERE) reveal that people with substance use disorders and those recovering from such disorders have higher rates of smoking, are more likely to be heavy smokers, and more likely to die from tobacco-related diseases than from other substances. Equally important is research confirming that smoking cessation improves recovery rates for other substance use disorders and enhances global health of people in recovery. Spiritual growth is a common element across numerous religious, spiritual, and secular addiction recovery programs. It is just as important in Lifestyle Medicine/Healthcare to address this essential component of human existence – the discovery of life meaning and purpose and its related values and practices. Good spiritual health is important for good physical, emotional and mental health and can be nourished through such rituals as prayer, meditation, and mindful reflection.
While overcoming addiction is a laudable achievement, developing and sustaining healthy lifestyle habits enhances the quality of our recoveries and our service to family and community. Lifestyle Medicine /Healthcare offers all of us, regardless of age, socioeconomic status, ethnic identity or cultural persuasion, or geographical setting the opportunity to take control of our health naturally and inexpensively. Embracing principles of lifestyle medicine can help us embrace recovery as far more than removal of alcohol and other drugs from an otherwise unchanged life.
American College of Lifestyle Medicine (ACLM), Infographic, firstname.lastname@example.org
Eddie, D. E., Greene, M. C., White, W. L., & Kelly, J. F. (2019). Medical burden of disease among individuals in recovery from alcohol and other drug problems in the United States. Findings from the National Recovery Survey. Journal of Addiction Medicine, 13 (5), 385-395.
Frates, B., Joseph, R., & Peterson, J. A. (2019). Lifestyle Medicine Handbook: An Introduction to the Power of Healthy Habits, Healthy Learning.
Kelly, J. F., Bergman, B., Hoeppner, B., & White, W. L. (2017). Prevalence, pathways, and predictors of recovery from drug and alcohol problems in the United States Population: Implications for practice, research, and policy. Drug and Alcohol Dependence, 181, 162-169.
Rippe, J. (2018). Lifestyle Medicine: The Health Promoting Power of Daily Habits an Practices, American Journal of Lifestyle Medicine, 12(6) 499- 512.
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.
The way we communicate about addiction, its treatment, and treatment outcomes matters to individuals affected by addiction, their families, and communities.
The American Society of Addiction Medicine (ASAM)’s Journal of Addiction Medicine
and other leading journals have encouraged the use of precise nonstigmatizing
terminology. Furthermore, the International Society of Addiction Journal Editors (ISAJE)
published a recommendation statement against the use of stigmatizing terms. The ASAM
has published policy statements on the issue of terminology. The US Office of National
Drug Control Policy posted a draft statement on changing the language in our field.
Michael Galipeau recently shared with me his experience of being denied access to disaster relief for his business due to past drug offenses during his addiction years. I encouraged Michael to write an essay on his experience as it reflected what I had heard from others in long-term recovery whose businesses have been disrupted by the COVID-19 pandemic. After reading Michael’s detailed account, I asked Michael’s permission to share it with accompanying commentaries from Ryan Hampton and myself. Below are some excerpts from Michael’s essay and the related commentaries.
Excerpt from Michael Galipeau: “The loss of such businesses for our community would cripple our ability to meet the increased need for recovery support during and post-COVID-19. In addition to exacerbating the losses experienced by our community, families, and loved ones, we will find ourselves even more vulnerable and slow to replace these essential services. In light of the future financial insecurity of government funding, there are many difficult conversations ahead about budget cuts—budget cuts that have costs in human life. Prohibiting support for small business owners in recovery is poor public policy—especially as many offender programs offer small business startups as a preferred option for seeking gainful employment upon release from prison. Individuals who now must look elsewhere for financial opportunities in a world where opportunities and funding are increasingly scarce. Businesses, like mine, that are essential for the supportive infrastructure of our community.”
Excerpt from Ryan Hampton Commentary: “Michael Galipeau is a person in long-term recovery, a mentor, and a solid community partner. He’s given years to helping others, trained first responders, and supported thousands of people as they walked the long road back from addiction. Yet he, like many other people, is denied the basic support guaranteed to American business and non-profit operators in a national disaster. The federal government is discriminating against the recovery community by refusing to support many of our grassroots organizations and small businesses. They condemn us to death when they remove the financial support that other businesses—including businesses that sell potentially addictive substances to Americans—are freely given.”
Excerpt from Bill White Commentary: “Unsuccessful addiction recovery attempts have as much to do with these stigma-influenced environmental obstacles as they do intrapersonal obstacles to recovery. How can one achieve recovery when denied access to community spaces in which people in recovery are welcomed and valued? Grassroots recovery advocacy organizations have attempted to address the issue of social stigma for more than two decades, and notable efforts have been made to put public faces and voices to the recovery experience. Michael Galipeau’s experience is one more call to go beyond attitudinal change to dismantle the machinery through which addiction-related stigma has been institutionalized for more than a century. It is time to dismantle the scaffolding through which stigma produces specific arenas of discrimination.”
Those wishing to read the full account of Michael’s experience and Ryan and Bill’s full commentaries may click HERE.
We are in a critical stage of the recovery movement in America, and we need to think carefully on what direction we go as a community and what we do to ensure that we expand recovery opportunities for the next generation. We have a stewardship responsibility to build upon the efforts of those pioneers that came before us to ensure that effective and accessible recovery support is available to the next generation. One risk to that future is the rise of recovery celebrities within recovery mutual aid organizations, other recovery community organizations, and within the larger recovery advocacy movement who seek to use their recovery notoriety as a platform for their own agenda and not as a means to further our common cause.
From nineteenth century temperance missionaries to this morning’s headlines, our history is littered with well-intentioned people in recovery who flew too high into the heat and light of public attention only to crash and burn. Resuming drug and alcohol addiction, getting arrested or simply becoming the antithesis of a good model of recovery confirms the worst biases people have about us. This often ends up causing devastating harm to our collective efforts to show that we do achieve long-term recovery and we are good citizens.
We want to show the world that recovery is the probable outcome for those of us who are able to access proper care and support. However, asserting a public face and voice of recovery presents very real risks if we promote ourselves more than the goals of the recovery advocacy movement. Good recovery is grounded in humility, open-mindedness, and inclusion. Great harm comes to us when we abandon those central tenants of recovery. It can be easy for any among us to fall into this trap in the rarified air of public attention. This is why we should strive to be custodians of recovery and not rock stars.
If we are entirely honest, many of these inherent risks come from within ourselves. All humans face risks when seeking notoriety, but it can have additional consequences for those of us in recovery. The old timers in recovery knew that this was true when they adopted values to protect the collective from the risks of those who fall into the pitfall of ego, ambition and the drive for notoriety at the expense of the greater community of recovery. Personal anonymity at the level of press, radio, TV, films, and other media technologies such as the Internet is one of the concepts that has served to protect many recovery communities from these difficult dynamics.
Social media abounds with soap opera like examples of what we do not want the outward-facing view of the recovery community to be. We can ill afford to show this ugly face of infighting and egos run amok. We need to watch out for “recovery leaders” who seek out the intoxicating limelight of the media, including social media, for its own ends rather than a means towards an end. We can and must do better.
Eve Tushnet recently suggested in an essay entitled What 12-Step Programs Can Teach Us about the True Meaning of Work, “in the recovery world, the normative worker—the person whose job best expresses the inherent nature of work, its purpose and even its beauty—is the janitor.” The very idea of janitor or custodian conveys the values of humility, simplicity, and dedicated service as expressions of responsibility to a larger organization, community, or cause. The custodian role is not about joy of self-expression, but joy found in the work itself and in the higher purpose it serves. It demands moving beyond self-performance or expressions of personal rebellion to obedience to a cause beyond service to self. In contrast, the celebrity role is an imprisonment of self—an I-focused abyss that feeds ambition, competition, envy, resentment, and anger rather than collaboration.
The custodian role properly places the focus on what is being maintained and off the person or persons doing the maintaining. This is a healthier place for us to be in rather than in the role of celebrity or rock star. What does it mean to be a custodian of recovery? It is servant leadership. In servant leadership, the “leader” exists to serve the cause and not the other way around:
- Sharing power, putting the community first and helping others to grow and thrive.
- Consensus building around things that support recovery for everyone at the expense of no other group (do no harm)
- Modeling the aspirational values of the recovery movement (walk the talk)
- Focusing on the movement and not the the advocate
- Taking the time to understand as deeply as possible the potential consequences of what is being advocated for before we act to avoid such unintended consequences (Advocacy without understanding the potential benefits and the potential harms is simply fire-starting.)
- Serving with humility and integrity
- Honoring all pathways of recovery
- Modeling inclusion, compassion, resiliency, and hope
- “Pulling each other up” in constructive ways so we all do a better job and not get ourselves into trouble or putting others down so we look better.
- Not shaming, belittling, or bullying people or working behind their back to get our own agendas passed
- Creating and sharing platforms where other people in recovery can represent the recovery experience and the needs of people seeking and in recovery.
Four daily rituals can help keep us centered on the larger meaning of our advocacy work as well as help sustain our personal health and perspective. Centering rituals, whether in the form of prayer, formal meditation, or just quiet reflection, help us “keep our eyes on the prize” and allow us to remain grounded. They help us narrow the gap between aspirational recovery values (humility, honesty, integrity, tolerance, gratitude, forgiveness, etc.) and our daily actions. Mirroring rituals allow us to commune with kindred spirits for mutual support, for feedback on the quality of our advocacy work, and to rekindle our passion for recovery advocacy. Acts of self-care and personal responsibility allow time for self-repair and caring for the needs of our families and others of importance in our lives. Unpaid and unacknowledged acts of service help keep our egos in check and allow us to remain focused on the value of service to others and to our own recovery.
William Shakespeare once said that past is prologue. What has come before sets our stage, but does not define our future. We decide what happens next in this play. We control what happens in the next act and ultimately how our story collectively unfolds. This is the truth of recovery, we can and do change the past by redefining our future. We do this through careful reflection and painfully gained knowledge of our own hubris and shortfalls and the humility of understanding that we are not immune to repeating our own mistakes.
We know that fame and notoriety can be intoxicating. This is a particular risk for people in recovery. Those of us operating in the public space to advocate for others are at greater risk for harm because the work can be intoxicating. History is replete with examples of public figures in recovery using drugs and alcohol after proclaiming themselves in recovery or some other bad thing like stealing money or getting arrested. This harms all of us. We must tend to dual risks: 1) assuring that our authentic voice is not hijacked by our own ego, and 2) avoiding seduction by puppet masters who want to control our message to serve their ideological or financial interests. Custodians remain faithful to their mission. They respect with deep humility the purpose of what they do, taking the work seriously without preoccupation with self.
Let’s be custodians of recovery and leave being rock stars to rock stars.
Recent essays in this series predicted the effects of the COVID-19 pandemic on the future of addiction recovery and celebrated the resilience of communities of recovery as they transitioned from face-to-face to online recovery support meetings. This brief article calls attention to those potentially left behind in this transition to digital support and explores the ethical and effective implementation of digital recovery support platforms. (For a more expansive version of this blog, click HERE.)
To achieve an inclusive recovery community, we must be mindful of persons or communities for whom virtual platforms are unavailable or unsuitable. To achieve the maximum range of person-platform fit, we must insist on engagement of diverse recovery communities in the design, implementation, and evaluation of these new resources. PRO-A in Pennsylvania provides an example of standards for the delivery of ethical and inclusive e-recovery support in its 10 Assurances statement.
Problems of Access In our celebration of the explosive growth of online meetings and other virtual recovery supports, we should not forget those who lack access to such platforms. Those at risk of exclusion include: 1) people who are homeless, 2) people in rural and frontier communities, 3) people who rely on public facilities for internet access that are now closed due to pandemic mitigation measures, and 4) older adults in recovery and others who lack knowledge and skills in navigating online resources.
Problems of Comfort Put simply, there are many people who have access to digital recovery support but find the digital experience less helpful than face-to-face recovery support media. The potential size of populations using digital recovery support as a primary recovery support mechanism compared to those who use digital recovery support as an adjunct to face-to-face meetings remains unclear.
Recovery support comes in multiple media, including one-on-one communication, group interactions, print resources, and video/audio media. Successful recovery often involves combining and sequencing multiple activities across the stages of long-term recovery. The key for each person is to find a stage-appropriate fit between themselves and those ingredients that best serve to strengthen recovery initiation, maintenance, and enhanced quality of personal and family life. At a systems level, the key is to increase recovery prevalence within affected populations by assuring the broadest possible menu of recovery support options.
Problems of Vulnerability New e-treatment and e-recovery support media, like all digital media, raise privacy and security concerns. A particular concern is the potential of such media as tools of manipulation, exploitation, or harassment. In the delivery of e-counseling services, we must assure that the protections built into face-to-face counseling (e.g., informed consent, confidentiality, delivery of evidence-based practices, clinical supervision, standards of ethical practice, etc.) are not lost within the e-counseling process. In the delivery of peer recovery support, we must make group values, communication guidelines, and member expectations as transparent as possible (e.g., anonymity, crosstalk policies, etc.) at the outset of participant involvement and use our collective conscience as a guide to refine online recovery support norms and etiquette.
E-Recovery Limitations and Side Effects The transition from face-to-face to online recovery support has inherent limitations and potential risks. Much could be lost in this transition, such as pre- and post-meeting socializing, reduced depth of sharing from some and oversharing for others, erosion of sponsorship relationships to brief text exchanges, serial virtual performances without the sense of real connection and closeness, and a reduction or loss of service activities linked to face-to-face meetings.
When humans connect, something vital happens that brings us together in a powerful manner. We are only beginning to understand the science behind how and why these connections occur. As recent paper on autonomic mimicry and neurocognition suggests one key that we experience emotional contagion through body language, eye contact, and the subconscious sharing of information. The digital medium available to us today may be limited in its capacity to transmit such subtle information and may result in a less powerful sense of connection.
As creatures of excess, there is a parallel risk of seduction into this digital world (e-addiction)—a risk enhanced by the now infinite number of online meetings and the advent of marathon meeting formats. Hyper-connection could result in an erosion of social skills and our comfort with face-to-face communication.
The future of e-recovery support hinges the pace of improvements in the technologies used in these media and the development of ethical guidelines to govern their operation.
E-Services within Larger Systems of Care and Support How will the rapid expansion of e-treatment and e-recovery support services effect larger systems of care for substance related problems? One concern is that funding authorities facing pandemic-spawned economic austerity may cut funding for traditional face-to-face services. The rationale for such action would likely be that online services can be delivered with less costs and by peers in recovery rather than by paid service professionals. E-recovery support should represent an expansion rather than a contraction of choices within the service menu. We know that 85% of us who are able to sustain recovery for five years stay in recovery for the rest of our lives. Digital support services may well augment and extend our current care strategies in meaningful ways to help even more of us reach that critical five-year benchmark mark.
Reaching Those at Risk of Being Left Behind
Digital recovery support is a cool—low touch–medium of communication. Our challenges are how to warm it up to fit the existing culture of recovery and how to reach people who are unable or uncomfortable in the digital world. Below is a summary of what we envision as possibilities.
*Including the voices of people in recovery in all decisions related to the design and conduct of digital recovery support platforms
*Providing digital devices to people in recovery who cannot afford them
*Workshops and one-one-one tutoring by recovery community organizations on mastering online recovery support media
*Providing online access via recovery community centers
*Greater reliance on recovery literature, including manual-guided recovery protocol replete with personal recovery stories
*Renewed and expanded access to earlier-era resources, e.g., recovery talks on cassettes and CDs
*Expanded availability of e-counseling services (e.g., telephonic or video counseling)
*Smaller face-to-face meetings with modified meeting rituals (using physical distancing precautions)
*Home visits by recovery coaches (using physical distancing precautions)
*Telephonic recovery check-ups and smaller telephonic recovery support meetings arranged by recovery coaches
*Expanded recovery literature distribution
*Use of traditional mail service for recovery support communications
*Expanded use of recovery magazines and newsletters as vehicles of recovery support
*Creating and communicating consensual ethics and etiquette of online recovery support
*Creating ethical guidelines for organizations hosting e-counseling and e-recovery support services, and
*Creating ethical complaint and disciplinary mechanisms for e-recovery support services.
The key is that we engage the digital champions, the digital doomsayers, and everyone in between with viable recovery support choices. We must aspire to a recovery standard that supports all pathways of recovery, all platforms, all modes of recovery, and all people who seek recovery. The future is not at all clear in respect to e-recovery support, but what is clear is that it will be an increasingly visible platform of recovery support. What is not clear is how effective and authentic it will be and who it will include and exclude. The answers to those questions are up to us.
The coronavirus (COVID-19) pandemic has revealed deep-seated inequities in health care for communities of color, and amplifies social and economic factors that contribute to poor health outcomes. Recent news reports indicate that the pandemic disproportionately impacts communities of color, compounding longstanding racial disparities. Learn more about the impact of COVID-19 on Black and Latino communities in the U.S. from SAMHSA’s Office of Behavioral Health Equity new resource document.
We might try to explain the phenomenon of the plague, but, above all, should learn what it had to teach us. –Albert Camus, The Plague (1948)
The novel coronavirus pandemic will exert profound effects on the future of addiction treatment and recovery. Based on the pandemic’s anticipated reach, severity, and duration, we will likely witness the following in the months and years to come.
*Recovery support needs will increase as direct and indirect consequence of the pandemic by accelerating substance use disorder (SUD) progression and increasing SUD vulnerability among a larger pool of people self-medicating pandemic-related distress.
*Recovery support service needs will intensify due to the closure of local addiction treatment programs that lack sufficient capitalization to weather the loss of service income.
*The movement of recovery support to a primarily digital culture and the expansion of E-treatment and E-recovery support services will accelerate exponentially, exposing the value, limitations, and unintended consequences of this shift.
*The economic impact of the coronavirus pandemic will be far greater and more prolonged than presently anticipated, which will extend the historical focus of recovery communities on emotional and social recovery support into the arena of financial and employment assistance.
*The strong service ethic within communities of recovery will be extended in more formal ways to address the larger needs of local communities.
*Increased international contact among people in recovery sharing digital recovery support platforms and improved digital language translation technologies will contribute to the rise of a global recovery community.
*Increased knowledge of public health concepts and technologies will spur increased interest in population-based interventions to prevent and mitigate alcohol and other drug problems across the spectrums of severity, complexity, and chronicity.
*The elevated status of scientists and science-grounded professional helpers emerging from the pandemic will spur increased expectations for research reporting on methods of addiction treatment and recovery support and a backlash against, highly promoted products and services confirmed to be unhelpful or harmful.
*The coronavirus pandemic’s exposure of the weaknesses of the U.S. healthcare system will accelerate demands for health care reform—reforms that will potentially exert profound effects on the future of addiction treatment and recovery support.
*When the viral dust settles and the body count is complete, the health disparities between Black and White and between the wealthy and poor and working class people will expose wrenching realities we as a culture can no longer ignore.
Click HERE to read an expanded discussion of these predictions.
Change can be regressive or progressive, and change always carries the shadow of unexpected consequences. We must move gently into the brave new world that is upon us, taking care that we do not abandon long-held core values in our efforts to survive, at the same time we capitalize on new opportunities to expand the reach of recovery.
Based on what you have observed in your local community, what predictions would you add to this list?
People in addiction recovery possess multiple vulnerabilities as they face the personal challenges of the novel coronavirus pandemic. Compared to the general population, they are older and have higher rates of co-occurring health conditions. Those in early recovery may have limited capacities for coping with the emotional, relational, and financial distress imposed by the pandemic. And many people in recovery face the loss of the social support that has been central to their recovery—access to regular face-to-face recovery support meetings, meetings with recovery mentors, and socializing with others in recovery. Recent articles and commentaries have highlighted these vulnerabilities, but there is a larger, less told story: the remarkable resilience of people in recovery and communities of recovery as they face the threats posed by the pandemic.
People in recovery are turning the threats of the pandemic into opportunities for reflection, growth, and service to others. They are on the frontlines battling this epidemic in their roles as physicians, nurses, allied health professionals, police officers and other first responders, postal workers, bus drivers, farmers, grocery and food delivery workers, National Guard members, and numerous other essential service roles. They are donating money to pandemic relief efforts, sewing masks, volunteering at food banks, checking in on their most isolated family members and friends, and providing personal support to the most vulnerable members of the recovery community.
Yes, some people in recovery will become sick and some will die from complications of COVID-19. Yes, we need to support the sick and mourn those we have lost, but we also need to recognize and honor the resilience and courage of those giving back at the height of this pandemic, and we need to celebrate how communities of recovery are adapting to this pandemic.
At a collective level, the resilience and creativity elicited by the pandemic is evident in the speed at which recovery support has moved from face-to-face to digital platforms. This is evident from the movement of existing face-to-face mutual aid meetings to online meetings either through the creation of new online meetings via platforms such as Zoom and other digital meeting platforms or the rapid membership growth within existing independent online recovery support meeting platforms such as In The Rooms.
In The Rooms is a free-standing online recovery social network available 24 / 7 / 365 founded by Ken Pomerance and Ronald Tannebaum in 2008. Its purpose is to “give recovering addicts a place to meet and socialize when they’re not in face-to-face meetings.” In the Rooms brings together members of the global recovery community to experience a vast array of tools that can enhance and expand one’s recovery experience and social connectedness. In The Rooms offers live meetings, discussion groups, and other recovery support forums to more than 650,000 people from around the world. It offers 153 live online meetings a week representing 40 different fellowship groups, including 65 AA meetings, 30 NA meetings, many other 12 Step meetings, Non-12 Step recovery support groups, and numerous specialty meetings. In the Rooms is designed to assure anonymity, with options for use of nickname, avatar, or silhouette with no personal identifying information.
In The Rooms experienced dramatic increases in participation beginning in March—from a pre-pandemic average of 200 new member registrations per day to more than 2,500 per day, as well as an explosive increase in the number of people participating in each online meeting—now as many as 500. In The Rooms has responded to these changes by:
*extending meeting times to give more participants time to share,
*adding ten new NA meetings,
*creating Marathon AA and NA Meetings that run from 9 am to 10 pm on weekends, and
*adding new ACA groups, a coronavirus support group, a NAMI support meeting, a She Recovers meeting, a Chemsex meeting, and an illness and recovery support group meeting.
Recent changes in membership, participation levels, and new support media provided via In The Rooms illustrate the remarkable adaptability of people in recovery and recovery support organizations as they respond to the coronavirus pandemic.
People in recovery and communities of recovery will come out of this pandemic stronger than ever—more confident of their resilience, more ecumenical in embracing diverse pathways and styles of recovery, and more globally interconnected. We will mourn our losses, but step into the future more assured of our capacity for survival and service.