Are “recovery ghettos” really a concern?

"He left me for the glass pipe."
Beauty, Hunts Point. Courtesy of Chris Arnade. Click image for more in his series.

Cassie Rodenberg’s blog has had a couple of heartbreaking posts recently. They look at the lives of women in the culture of addiction–prostitution, pimp boyfriend, sexual assault, having to provide sex for a place to stay, etc.

It brought back Bill White’s book, Pathways and his discussion of sex within the culture of addiction. Not only does the use of sex as a vehicle to maintain access to drugs or other needs within the context of addiction detach sex from pleasure, intimacy and love, it also is a consequence and contributor to the objectification of others–people become objects to be used or avoided.

All of this got me thinking more about a post a while back where I discussed a post from Bill White on the need for “recovery spaces” and how the concept was getting some push back. DJ Mac (who is supportive of the concept of recovery spaces) titled his post, Does recovery space equal recovery ghetto? Much of the discussion seemed to be between people who are culturally empowered, mobile, do not live in a ghetto and have never been trapped in a ghetto.

Cassie’s posts reminded me that, for some, ghetto isn’t just a metaphor–it’s their world.

These people need more than harm reduction.

They need more than MI, CBT or 12 step facilitation.

They need Recovery Management.

Bill White calls on us to raise our expectations of ourselves and the system while focusing on recovery and the community as the locus of healing. [emphasis mine]

Addiction treatment must always adapt to the evolving context in which it finds itself. Such redefinition may push treatment toward the experience of retreat and sanctuary in one period and toward the experience of deep involvement in the community in another. I would suggest that the focus of addiction counseling today should not be on addiction recovery-that process occurs for most people through maturation, an accumulation of consequences, developmental windows of opportunity for transformative or evolutionary change, and through involvement with other recovering people within the larger community. The focus of addiction counseling today should instead be on eliminating the barriers that keep people from being able to utilize these natural experiences and resources. Our interventions need to shift from an almost exclusive focus on intervening in the addict’s cells, thoughts and feelings to surrounding and involving the addict in a recovering community.

Over the years Bill shifted his language to emphasize “community renewal”:

A major focus of RM (Recovery Management) is to create the physical, psychological, and social space within local communities in which recovery can flourish. The ultimate goal is not to create larger treatment organizations, but to expand each community’s natural recovery support resources. The RM focus on the community and the relationship between the individual and the community are illustrated by such activities as:

  • initiating or expanding local community recovery resources, e.g., working with A.A./N.A. Intergroup and service structures (Hospital and Institution Committees) to expand meetings and other service activities; African American churches “adopting” recovering inmates returning from prison and creating community outreach teams; educating contemporary recovery support communities about the history of such structures within their own cultures, e.g., Native American recovery “Circles,” the Danshukai in Japan;
  • introducing individuals and families to local communities of recovery;
  • resolving environmental obstacles to recovery;
  • conducting recovery-focused family and community education;
  • advocating pro-recovery social policies at local, state, and national levels;
  • seeding local communities with visible recovery role models;
  • recognizing and utilizing cultural frameworks of recovery, e.g., the Southeast Asian community in Chicago training and utilizing monks to provide post-treatment recovery support services; and
  • advocating for recovery community representation within AOD-related policy and planning venues.

It’s worth noting that, over the years, Bill has written about recovery employment, housing, education, etc,

It can be overwhelming. But, the alternative is despair.

UPDATE: This post was re-titled based on reader feedback.

13 thoughts on “Are “recovery ghettos” really a concern?

  1. The way this particular post on “ghetto culture” has been phrased in relation to addiction and stamped with a black face to is analogous to the culture of poverty argument. Moreover, using nonsensical terms like “culturally empowered” further reinforces a cultural deficit model of addiction.


    1. I’ll take a look at that. It’s the image from Cassie’s post.

      There is no “culture of poverty” argument. The post referred to a “culture of addiction” and referenced the source of the concept. The book is an interesting read. It discusses different styles of addiction and recovery and their relation to those cultures. The premise is the idea that in severe addiction, addicts tend to organize their behavior, social networks and environments around the addiction. The book (nor I) make no assertions about a culture of poverty. (Lewis’, or anyone else’s.)

      Can you explain your objection to “culturally empowered”? Would you prefer privileged?


      1. You qualify the term “culture of addiction” to apply to severe cases of addiction that render a social pattern of behavior centered on drug use without first providing a definition of culture. I find this problematic because by implication it implies that addiction is a cultural byproduct of bad values and beliefs and is intergenerationally transmitted to “ghetto addicts.” The logic is no different in many respects to the culture of poverty argument. Secondly, the narrative of your blog post on culture of addiction is skewed toward the poor, and I assume, black drug addicts—hence the euphemism–ghetto. Is there such a thing as a suburban culture of addiction? Would love to see a blog post from you on that subject matter with a white poster child on the front page.
        In closing, I would prefer a definition of how you operationalize “culturally empowered” and why you even feel the need to use such an ambiguous phrase in the first place.


      2. The book talks about people who are culturally enmeshed, bi-cultural and culturally detached.

        The narrative you’re attributing to me is not something I intended or believe. The use of the word “ghetto” came the title of the post pushing back against the idea of recovery spaces with the implication that they are “recovery ghettos”. When reading Cassie’s posts, I reflected on those posts and found it ironic that a bunch of apparently privileged people are discussing the hazard of creating “recovery ghettos” when the people in Cassie’s post live in a real “ghetto” and could use some recovery spaces.

        There are nearly 2600 posts in this blog. I don’t think you’ll find me advancing that narrative in them. I try to be sensitive to the fact that “otherness” and victim-blaming are the fuel of stigma and I go out of my way to avoid addiction “porn”. Cassie’s posts speak to truths we hear from women every day at Dawn Farm. These truths get lost during discussions of evidence-base practices that focus on reduced use, reduced disease transmission, reduced incarceration, etc.

        I’ll try to respond to some of the questions that are implied in your comments.

        Do I believe that there are social determinants of health? Yes.

        Do I believe that social determinants cause addiction? No.

        Do I believe that these determinants influence the onset, course, severity and response to treatment? Yes.

        Do I believe that the number of problems an addict endures influences the onset, course, severity and response to treatment–requiring treatment that is more complicated, broad, intense and long? Yes.

        Do I believe that there is intergenerational transmission of not just genes, but also culture? Yes.

        Am I concerned that recognizing these social determinants could backfire and fuel stigma and different standards of care? Yes.

        Do I believe there are predominantly white cultures of addiction? Yes. (Check out the book. I’ve frequently referred to The Wire recently. Look at the culture of addiction around alcohol in the police force.)

        Have I done posts that include images of culturally enmeshed addicts of other races? Yes and yes.

        I like the term “culturally empowered” and the first time I read it, I immediately thought it clearly communicated a potentially wordy concept. Privilege has become more widely used, maybe that’s better. At any rate, the writing here is not academic–it’s more stream of consciousness–and your won’t find me operationalizing concepts here.

        All the best,



  2. A contradictory response if there ever was one with continued problematic use of the term culture (e.g., white culture?). Based on your initial premise underpinning your use of the “culture of addiction” as stated in your last post you still go on to needlessly confound addiction within an American cultural context with a deeply racialized “culture of addiction.” Again, the issues is your ‘streaming’ of terms like “culture of addiction” and “culturally empowered” without any real ‘consciousness’ of how these conceptually-loaded words “prime” misconceputalizations about the poor and racial groups, and in effect, reinforce and fuel stigma about them and addiction. Otherwise, I think you would be more careful about how you’re putting these terms to use for your audience in order to increase understanding about culture and addiction, which would require you to operationalize such concepts.

    Anyway, I am still a fan of your blog and appreciate your writing, Jason.
    Take Care


    1. Just to be clear I never referred to “white culture”, though I did refer to depiction of “a predominately white culture of addiction around alcohol use in a police department” to demonstrate that the concept, in and of itself, is not racialized. (Though, that seemed to have affirmed your impression that there’s a troublesome subtext in my thinking and the concept.)

      I get the feeling we’re talking past each other, so I’ll stop explaining myself.

      Clearly, I don’t see the concept as racialized. (And, though I haven’t read the book in a long while, I’d be surprised if you found it to be deeply racialized or lacking in consciousness.)

      How should we think about, talk about and respond to the needs of the kinds of people Bill describes as “culturally enmeshed“?

      No pressure to respond, as this exchange has gone on longer than either of us probably intended, but I’d be interested in your thoughts or links to other writing.


  3. Jason, your posts have made all the difference for me. You were generous and educational in your response to Mr. Ward. Thank you.


  4. This is so true.. my personal struggle was coming from a community and culture where using was the norm, unfiltered sex was the norm. A space where recovery was unseen of and unheard of. When I arrived in Ann Arbor it was a culture shock, not because of race or socioeconomic status but because of recovery. I was able to learn and grow into a life of long term recovery from drug and alcohol use.

    Having a safe space to learn and grow in recovery made all of the difference.. for me!


    1. Thanks for the comment. You know, we hear a lot about “food deserts”. That concept would apply to recovery too. Some areas could be called “recovery deserts”.


  5. So when I saw the headline I was offended. Because some an unwritten rule were broken. It’s the same rule that allows black people to call each other the ‘n-word’ but doesn’t allow white people to use it all. The same rule applies to the word ‘ghetto’. It’s a word that white people aren’t allowed to use.
    So I think that’s what Chris was trying say, because I felt that Jason explained his use of the word and answered all of his questions.
    I think the point of the post was to say that recovery needs to look beyond the individual and lift the community also therfore making it easier to recover. Having said that I feel that the choice in title is unfortunate.


  6. Got it.

    And, you got my point.

    The other thing, I guess I was trying to push back against was this idea that creating recovery spaces would create recovery “ghettos”. It bugged me.

    At first because it seemed like a dismissive, smarty-pants specious argument.

    Then after reading Cassie’s posts, it bugged me because I felt it ignored the fact that, unlike the privileged people making the argument, there are people who really are isolated and limited because of social, legal, or economic pressure.

    I was pushing back on their appropriation of the word to make their (IMO) specious argument.

    At any rate. My use of the word has become the focus for some readers rather than the needs of the kind of people Cassie wrote about about. No disrespect was intended.


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