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High degrees of variability in the pathways and styles of addiction recovery obscure shared mechanisms of change across such healing processes.

The American Society of Addiction Medicine (ASAM) recently released Standards of Care: For the Addiction Specialist Physician.  The Standards outline the responsibilities of addiction medicine specialists in the areas of assessment and diagnosis, withdrawal management, treatment planning, treatment management, care transitions and care coordination, and continuing care management.  There is one sentence in the Standards that deserves particular acknowledgement:  “Recovery check-ups by addiction specialist physicians, just as those by primary care physicians or other providers, may promote sustained recovery and prevent relapse” (p. 13).

Stigma Reduction Through Contact Strategies
Justice Ginsburg’s observation offers observed testimony to the power of contact strategies—public disclosure of personal stories by individuals who share a concealable stigma for purposes of changing social attitudes and social policies.

The threats to health that occur during active addiction have been widely communicated in the popular media and in the scientific literature, but the health profile of  people in long-term recovery from substance use disorders remains something of a mystery.  While one might assume that physical and emotional health rapidly improves following recovery initiation and stabilization, a health survey of Philadelphia and surrounding counties just published in the Journal of Psychoactive Drugs reveals a more complex and ominous picture. 

The addiction recovery experience has been sliced and diced in all manner of categories: secular, spiritual, and religious; natural recovery, peer-assisted, and treatment-assisted; and abstinence-based, moderation-based, and medication-assisted, to name just a few. Recovery achieved through any of these frameworks is often referred to as a pathway of recovery. The growing consensus that there are multiple pathways of long-term addiction recovery marks an important public and professional milestone within the alcohol and drug problems arena.

Historically, family members were more likely to be viewed by addiction professionals as causative agents of addiction or hostile interlopers in the treatment process than people in need of recovery support services in their own right. Overcoming such attitudes has taken on added urgency due to the rising prevalence, morbidity, and mortality of opioid addiction in the United States and its rippling effects upon families and communities.

With the federal passage of the FIRST STEP Act, we finally see action on criminal justice reform! The FIRST STEP Act recently passed and was signed by the President. This was historical. For years, Congress had attempted to pass criminal justice reform legislation, such as the Sentencing Reform and Corrections Act (SRCA) introduced in 2015 by Senators Chuck Grassley (R-Iowa) and Dick Durbin (D-Ill.).

Original Blog Date: September 12, 2014

I have spent more than four decades providing, studying, promoting, and defending addiction treatment, but remain acutely aware of its limitations. As currently conceived and delivered, most addiction treatment programs facilitate detoxification, recovery initiation, and early recovery stabilization more effectively and more safely than ever achieved in history, but most fall woefully short in supporting the transition to recovery maintenance and the later stages of recovery, particularly for those who need it the most–those with the most severe and complex problems and the least recovery support within their natural environment.