The boundaries of recovery

In response to recent discussions about reclaiming recovery, Bill White has a thoughtful post on the conceptual boundaries of recovery. I encourage you to read the whole thing.

He highlighted a few things. First, a survey of people who identify themselves as in recovery about how they define recovery.

. . . a landmark survey of more than 9,000 people in recovery has just been published by Dr. Lee Ann Kaskutas and colleagues.  The majority of those surveyed defined recovery in terms of 1) abstinence (no use of alcohol, non-prescribed drugs or misuse of prescribed drugs), 2) recovery essentials (e.g., self-honesty, drug-free coping, avoiding other destructive dependencies), 3) enriched recovery (e.g., personal growth and development, inner strength and harmony, social contribution, self-care), and 4) spirituality of recovery (e.g., gratitude, service, tolerance, self-transcendence).

Picture3Second, he describes some of the pressure from activists to expand the boundaries of recovery to include non-problematic use.

Third, he highlights the contradictions involved in defining smokers as in recovery while excluding others due to their substance use.

He draws from one of his older articles to highlight the stakes and makes the case that everyone affected or concerned by alcohol and other drug problems should have a seat at the table to define recovery.

Imposed or self-embraced words that convey one’s history, character, or status have immense power to wound or heal, oppress or liberate. At a personal level, a definition of recovery will attract or repel people seeking to resolve AOD problems, provide a benchmark for when this state of recovery is achieved, and convey directly or indirectly what actions are required to sustain this status. A particular definition of recovery, by defining who is and is not in recovery, may also dictate who is seen as socially redeemed and who remains stigmatized, who is hired and who is fired, who remains free and who goes to jail, who remains in a marriage and who is divorced, who retains and who loses custody of their children, and who receives and who is denied government benefits (White, Journal of Substance Abuse Treatment, 2007, p. 230).

Picture4I think ongoing dialogue with people who identify as being in recovery about how the concept should be defined is valuable, but it seems to me that being too inclusive invites some problems.

I view the concepts of addiction and recovery as inextricable. It’s clear that some of these advocates who want to radically redefine recovery, also want to redefine addiction.

Is that really the discussion we want? I go back to the climate science analogy. If there were a conference or decision-making body related to climate research and policy, would it make sense to give time and attention to global warming skeptics?

So, there’s the issue of whether expand the boundaries to accommodate critics who don’t view addiction as a disease and are likely to use it as an opportunity to argue for the redefinition of addiction. Then there’s the issue of whether addiction (not just an AOD problem) is a prerequisite for recovery.

I think it is. Do people who moderate excesses tend to form a long term identity around their moderation? Or, even people who abstain because they got married, had a child or got a “real job” and it was time to grow up? Is this identity something that they  want? Or, is it just some advocates with broader agendas?

At any rate, read all of Bill’s post. As always, he takes a topic that many people take for granted, examines the layers we tend not to notice and explains it in simple language in a way that makes it seem easy.