This week, I listened to an excellent interview on The Best Minds Podcast featuring Harvard trained physician and internationally recognized addiction expert Dr Robert DuPont. I was struck by his humble wisdom. He spoke about his early work with methadone patients and how many of them eventually died from alcoholism. He spoke about how narrowly focused, well-meaning care focused on opioids and not on addiction, of which opioids is only one facet. We owe Dr Dupont and others like him a great debt for their contributions and the humility of acknowledging who the experts on recovery are – people with lived recovery experience. He and others of his caliper and wisdom made space for us to talk about the value of community in recovery and strengthen recovery efforts.
Such wisdom is unfortunately rare. It reminded me of a few years back of an encounter I had with Mr. David Mactas. We brought him in as our keynote speaker for our agencies 20th anniversary celebration. He was the first Director of the Center for Substance Abuse Treatment for the US Dept. of Health and Human Services. He played a major role in establishing the federal Recovery Community Service Project – State Network Grants. The grants were vital to establishing the first recovery community organizations in America, and PRO-A was an initial recipient. Space was being made for lived experience to inform our care systems and strengthen our community. Recovery history was being made.
One of the best parts of the event was getting to spend time with him. He is a brilliant man with deep insight into treatment and recovery efforts. I spoke with him about what those grants meant for recovery community organizations across the nation and the fruit that his efforts had yielded. We spoke of the New Recovery Advocacy Movement and the progress and challenges that we had experienced.
He noted in our conversation that movements end. The words hit me like a ton of bricks and still resonate. Movements do indeed end and not necessarily with accomplished objectives. They have been in the back of my mind ever since.
How will we answer that question?
For readers who may not be aware of what the New Recovery Advocacy Movement is, I would point to to the immense contributions to our history and the conceptualization of recovery efforts by thought leader Bill White. His collection of papers can be found HERE. It would be hard to overstate the contributions he has made to our efforts to save lives and heal communities through the power of recovery community. He has also done more than anyone else to catalogue and preserve our history.
I view Bill White’s work as essentially the Svalbard Global Seed Vault of recovery. The global seed vault stores seeds in the event that pestilence, drought or other events wipe out essential food crops. It holds the food security of humanity inside its very walls. Bill White has established out recovery seed vault trough his vast collection of writings. When the new recovery movement ends, our history and the things that we have learned along the way are preserved within his vault. Accumulated wisdom for future generations to use these seeds to replant and start over.
The potential end of the new recovery advocacy movement has been very much on my mind over the course of the last year. This is not the first time I have written on this topic. Many others are concerned. I am regularly taking to people from across the nation about the myriad of ways the recovery community is currently being marginalized. Key policymakers in varying positions do not actually believe we get better because they lack lived experience. Our system is replete with academic and medical experts who lack lived experience and direct knowledge of what works in real life conditions or the wisdom and humility to listen to our community. There is a growing dialogue that treatment does not work, recovery is not for everyone with addiction, we cannot possibly help everyone and some people do not want to break out of addiction. Money related to the “opioid epidemic” which is actually an addiction epidemic never actually reached us, instead it went to large academic groups, think tanks and institutions who became interested in addiction the moment there was money to be had. The results for us have been nothing other than tragic. We are dying. It is not an academic exercise for our community it is life or death.
If there was ever a time to get our nation focused on getting more people into long term recovery, it is right now. COVID-19 is fueling some of the underlying facets that drive addiction in America. Developing and sustaining the type of care and community support system we will need to save lives and heal communities is simply not possible without meaningful inclusion of the recovery community.
To do this we need sustained, collaborative efforts focused on care that focuses on recovery in meaningful ways. If we fail this, the movement will end sooner than later and it will end without achieving our goals.
What should we focus on if we are to sustain our movement and accomplish meaningful, recovery focused changes to our care system?
- Full inclusion of persons in recovery in the design, implementation, delivery and evaluation of services in order to ensure that care meets the needs across the full spectrum of diverse persons seeking help.
- Tools to hold our care systems accountable when disparate, short term care is provided to ensure that applicable laws around access and duration of services are consistent with applicable laws.
- Long term, whole person recovery focused research that examines recovery over the long term in order to understand what works for whom and under what conditions.
- Focused effort to reorienting our entire addiction care system to fully create and sustain the five-year recovery care model as the research is showing us is that this is the point at which 85% of persons will remain in recovery for life.
I am grateful that we have a seed bank of recovery, but would prefer to be adding stock to it rather than closing the doors and preserving it in hopes that the next generation can pick up where we left off and more of us die needlessly.
What happens with the new recovery advocacy movement depends on us, and most likely what we do in the coming months. We tend to accept stigma and discrimination at the very moment we should rally against it.
The words of Harold Hughes ring in my ears:
“We in recovery have been part of the problem. We have both accepted and perpetuated the stigma that kept us from getting help and that has killed millions of addicted victims. By hiding our recovery, we have sustained the most harmful myth about addiction disease: that it is hopeless. And without examples of RECOVERING people, it’s easy for the public to continue thinking that victims of addiction disease are moral degenerates – and those that are RECOVERING are the morally enlightened exceptions. We are the lucky ones – the ones that got well, and it is our responsibility to change the terms of the debate, for the sake of those who still suffer.” – Senator Harold Hughes
Are we going to hide our recovery and descend back into the basements, tear each other up in factional disputes or continue to be coopted by outside groups?
The answer is up to us. Right here, right now.