“Disruptive innovation, a term coined by Clayton Christensen, describes a process by which a product or service takes root initially in simple applications at the bottom of a market and then relentlessly moves up market, eventually displacing established competitors.”
The worlds of addiction treatment and recovery mutual aid are on the brink of being radically disrupted and transformed. New recovery support institutions and bold innovations in how, when, and where recovery supports are delivered will pose unprecedented threats and opportunities for established players within the treatment and mutual aid arenas.
In our last blog, we offered five predictions about the future of recovery support in the United States.
1. Transformative innovations in recovery support will encompass high and low tech platforms and a dramatically broadened menu of products, services, and support activities.
2. An ecumenical culture of recovery will spread through new recovery support institutions.
3. Addiction treatment as a professional and business endeavor will face intensified challenges to its legitimacy as a cultural institution, due in great part to its own excesses.
4. Responding to this crisis, addiction treatment institutions will attempt to colonize new recovery support competitors and will pioneer new service menus and new technologies of service delivery.
5. Formal membership in 12-Step groups (as measured by membership surveys) will slowly decline but rate of attrition in groups such as AA will be offset by attraction of new members through non-traditional routes of entrance and the growing secular and religious wings of AA.
Below we will discuss five additional predictions and sample some of the websites, social media accounts, apps, and online mutual aid societies that point to this emerging future.
6. The definition of a valid or sanctioned recovery support “meeting” will be increasingly fuzzy, and the roles of the “meeting” and canonic literature will remain but diminish in their import to recovery initiation, recovery maintenance, and enhancement of quality of life in long-term recovery.
“Meetings” will be extended to a growing catalogue of phone- and internet-based recovery support platforms providing continuous discussions (e.g., continual teleconferences) and social activities that one can enter and exit any day and any time of day. Literature will be transformed to instantaneously-accessible audio and video formats that will provide topical guidance on managing an infinite menu of challenges and opportunities before, during, or after such encounters. This transition could be thought of as the moving from “in the rooms” to “beyond the rooms.”
Historically, recovery mutual aid focused on three delivery mechanisms: 1) “friendly visitors” (recovery sponsorship or mentorship in modern language); 2) scheduled membership meetings for story sharing, problem solving, and recovery celebration; and 3) the written literature of a particular mutual aid society. Tomorrow, such friendly visitors will arrive at one’s wrist and often include people we have never met face-to-face.
It’s not that formal recovery support meetings will cease; it is that such meetings will become a smaller part of a much larger menu of recovery support activities that one can combine and sequence according to personal needs and interests over the course of long-term recovery. A day is rapidly approaching when more people will use telephone and online recovery support than those participating in formal face-to-face (F2F) recovery support meetings. The former will dramatically widen the doorways of entry to recovery for people who cannot access or do not feel comfortable/safe within F2F meetings, e.g., women, youth, high-status professionals, people in communities lacking F2F meetings, people whose physical limitations preclude access to F2F meetings, and people who experience social anxiety, to name a few.
7. Phone-based and web-based information and screening tools will facilitate self-diagnosis of substance-related problems and dramatically expand the pool of people seeking recovery support. Service and support options will increase for people experiencing low to moderate AOD problem severity who are now rarely seen in or retained within specialized addiction treatment institutions or traditional recovery mutual aid meetings.
This population of non-dependent help seekers will spark a parallel growth in models of problem resolution that include support for the moderated resolution of alcohol and other (AOD) problems. The “abstinence only” goal of treatment and recovery support is sustainable only as long as providers of such assistance remain closed ideological systems serving only those with the most severe, complex, and chronic substance use disorders while denying the existence of the much broader spectrum of AOD-related problems. Broader population-based technologies aimed at the full spectrum of AOD problems will allow us to shift beyond clinical interventions with the most severely affected individuals to interventions with whole populations that will reduce the prevalence of this broader spectrum of AOD problems at a cultural level.
8. Geographical boundaries of recovery support, including international boundaries, will progressively dissolve as online addiction treatment and peer recovery supports expand and include simultaneous language translations among people from all over the world.
The beginnings of a global recovery community are already evident. Ironically, this emerging global recovery community may provide the connecting tissue to counter the escalating political, religious, and economic divides that threaten the very future of the world.
9. The exponential growth of recovery support will be fueled by two phenomena: positive network effects and open source recovery support.
Put simply, positive network effects suggest that the more people who use a particular recovery support mechanism, the greater its value and long-term viability as a social institution. For examples, the effects of an online recovery support service increases in tandem with the number of members using such services, the effects of participating in a recovery celebration event increase in tandem with the number of people participating in such events, etc.
The idea of open source, drawn from the history of software development, is that recovery support resources (ideas, information, techniques, helping platforms, literature, art, film, etc.) are a product of peer production: products developed within a community and shared at minimal or no cost. Examples of peer production include all the service activities (e.g., 12-Step calls, sponsorship, literature authorship, and other service work) delivered through recovery mutual aid groups by members without compensation or the free exchange of ideas and materials between recovery advocacy organizations.
Peer production is the antithesis of proprietary, fee-based, profit-driven services and products. Open source recovery resources will grow exponentially in the coming decades and survive the threats of professionalization and commercialization. The very essence of the recovery movement (“You can’t keep it unless you give it away”) is a revolutionary concept when freed beyond the bounds of a particular recovery fellowship and freed through new technologies beyond the limitations of face-to-face contact. The future of recovery support will be marked by accessibility, affordability, convenience, portability, flexibility (to one’s personal needs/values/culture), and inclusiveness. It will also be marked by a balance or shift between an expert relational model and a mutual partnership relational model.
10. New innovations in recovery support will engage both dissatisfied portions of existing recovery support markets as well as open new markets that have not been reached through the dominant systems of service provision.
We are witnessing a detonation point that will forever alter the history of recovery. And what is this defining moment? It is twofold: freeing recovery from the bounds of recovery mutual aid meetings and professionally-directed addiction treatment (via new recovery support institutions) and the extension of recovery support beyond the boundaries of space and time (via the explosion of digital recovery support platforms and content). The recovery revolution is here and we do not yet see and grasp its full implications. As William Gibson—the man who coined the term cyberspace—suggests, “The future is here. It’s just not evenly distributed.”
A small sampling of websites, social media accounts, apps, and online mutual aid societies that point to this brave new future include the following:
https://www.reddit.com/r/stop drinking/ 94,776 readers at press time.
https://www.intherooms.com/ 491,114 members. Ever-expanding menu of online secular, spiritual, and religious recovery support meetings and related services. Total member recovery Time: 2,029,267 YEARS! Year
https://recovery2point0.com/ 250,000 person online recovery community embracing a holistic approach to recovery from addiction.
Samples of Recovery Bloggers
https://www.facingaddiction.org/ (Just merged with the the National Council on Alcoholism and Drug Dependence, NCADD).
William (“Bill”) White
Emeritus Senior Research Consultant at Chestnut Health System
Read all of Bill White's Blog Posts on his website here www.williamwhitepapers.com