News About Addiction, Recovery and Advocacy

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Drug overdose deaths in the United States have risen exponentially due to sequenced drug surges: 1) prescription opioids, 2) heroin, 3) illicit fentanyl and related analogs, and 4) cocaine and methamphetamine—all used alone or in combination with other drugs. More than 66,000 American lives lost each year to drug overdose have sparked numerous initiatives ranging from increased naloxone availability and medically-supervised injection sites to expansion of addiction treatment resources. The personal stories behind overdose death statistics have helped stir public and professional alarm, but less attention has been given to the question, “What is the subsequent fate of the larger number of people who experience a non-fatal drug overdose?”

National organization aims to increase recovery support services.
Washington, DC- August 13, 2018

For many individuals with substance use disorders, the support of someone who has been there increases their chances of success. Currently, drug overdoses claim 174 lives every day and a powerful new workforce of people in recovery has come forward to use their recovery experience to help others navigate the challenges of early recovery. Evidence of the effectiveness of peer recovery support services is promising. Yet, many states and communities still lack the capacity to implement effective peer recovery support services.

…a movement is afoot that is seeking to put recovery in the wind so that it can penetrate even the most shadowed corners of the richest and poorest communities. The faces and voices of the individuals and families riding this wind are offering a simple but powerful testimony: “We are the evidence that addiction recovery is both possible and sustainable. Hope and healing pushed the sickness and suffering out of our lives. We welcome you and will show you the paths that led to our deliverance…. Recovery is in the wind. Its season has begun. (White, 2013)

Stigma has many targets. It reaches beyond people addicted to various drugs to affect family members and those providing addiction treatment and recovery support services. Such secondary stigma, for example, is the source of the peculiar pecking order within the addictions field through which status (or stigma) is bestowed across varied settings based on one’s recovery status or lack of recovery experience. It also is the source of coded conversations between those working in the addictions field and members of the larger community. As a result, addiction professionals and recovery support specialists may find their legitimacy, their value, and even their sanity challenged by professional peers and by members of the larger culture. The ways in which we respond within such conversations can mark an appeasement (passivity in the face of insult or aggression) or a challenge to addiction-related stigma.

In the past, I have written about building the infrastructure for addiction-recovery support and about roads and bridges to recovery. I intended to write more on those subjects but I’m postponing that effort. In early America, our pioneers simply headed west where there were few roads and bridges. They were guided by the words and crude maps provided by those who had gone before. In 2001, a group met in St. Paul to revitalize and continue a campaign to show our faces and put our voices behind the fact and reality of recovery from addiction. Iowa governor and later senator, Harold Hughes, was an early advocate in bringing attention to alcoholism. He convinced many notable celebrities, politicians, and others to stand up and speak out in public gatherings, telling their stories. He was a guiding force as we developed our road maps to recovery. I recall the concluding words of Robert Frost from the poem, The Road Not Taken. Two roads diverged in a wood, and I took the one less traveled by, and that has made all the difference. I would change one word in the poem, say we rather than I took the road less traveled. The road we had traveled and the journey of hopelessness was non-directional, filled with ruts, detours, and potholes. We faced barriers of progress because of stigma and discrimination. Our new road led to help, hope, and healing with a positive view that we could change America’s conversation and its experience with addiction. We left St. Paul with the charge to make some history. We did and we are.

Countless people have had their lives positively transformed by addiction treatment. But tragically, this is not the norm.

Despite decades of advancements in science, pharmacology, and technology, the continuum of evidence-based addiction treatment services remains largely unavailable to those in need. The addiction treatment system is hindered by fragmentation, outdated treatment philosophies, and a payment system that perpetuates antiquated care models and discourages the adoption of best practices in the field. The historical rise and development of the current addiction treatment system explains the evolution of a broken system, and sheds light on new solutions.

Today, drug policy leaders, frontline addiction professionals, and affected individuals and families are calling for radical changes in the design and delivery of addiction treatment. It’s time for change. It’s time to protect our families.

A bill ostensibly intending to reduce opioid overdoses passed the House last month, but rather than cheering it on, drug treatment and recovery advocates are lining up to block it in the Senate.That's because instead of being aimed at reducing overdoses, the bill is actually a means of removing patient privacy protections from some of the most vulnerable people with opioid problems, including people using methadone-assisted therapy to control their addictions.

People addicted to alcohol and other drugs see the world differently. They SEE the world differently as a result of neurocognitive changes in perception that accelerate in tandem with increased tissue tolerance, increased intensity of cellular hunger (craving), and the resulting obsession with maintaining the drug relationship at all costs. As drug seeking, drug procurement, and drug use rise to the top of one’s motivational priorities, one develops attentional bias toward words, symbols, and images linked to these substances. Perceptual preferences for drug-linked stimuli are an essential element within the neurobiology of addiction. In recovery, this perceptual preference is reframed, giving perceptual priority to words, symbols, and images that reinforce the recovery process.

On May 21, 2005, David Foster Wallace opened his commencement address at Kenyon College with the following story.

There are these two young fish swimming along and they happen to meet an older fish swimming the other way, who nods at them and says “Morning, boys. How’s the water?” And the two young fish swim on for a bit, and then eventually one of them looks over at the other and goes “What the hell is water?”

Each of us swims in a near-invisible cultural stew of words, ideas, attitudes, images, and sounds that constitute the personal stage upon which the actions of our daily lives unfold. These near-invisible contextual elements of our lives are so deeply imbedded that they rarely if ever enter our conscious awareness. Yet, they exert a profound influence on how we view ourselves and our relationship with the world. They bestow or deny personal value, convey our degree of safety and vulnerability, and impregnate us with hope or hopelessness.

A Rendezvous with Hope (Lessons from an Outreach Worker)

Through my tenure in the addictions field, the question of readiness for treatment and recovery was thought of as a pain quotient. In the earliest years, we believed that people didn’t enter recovery until they had truly “hit bottom.” If a client didn’t fit that criterion of pain-induced readiness, they were often refused admission to treatment (and if we did admit them, we often threw them out shortly afterward). Then we recognized that the reason it took people so long to hit bottom was that they were protected from the painful consequences of their alcohol and other drug use by a class of people we christened “enablers.” So we then set about teaching enablers to stop rescuing and protecting their beloved alcoholics/addicts. Vern Johnson then came along and convinced us we could raise the bottom through a process he called intervention. Intervention removed the safety net of protection and confronted the alcoholic/addict with the consequences of his or her drug use and promised additional consequences if this behavior continued. Staging such interventions within families and the workplace was something of a revolution—and later an industry—that brought large numbers of culturally empowered people into treatment. But all these philosophies and technologies were about the use of pain as a catalyst of addiction recovery. So, I brought this view to my work as an evaluator of Project SAFE.