Forward – I recently learned that Tom Hill was retiring from government work and concentrating on his art, another one of his many talents. My first reaction was a feeling of abandonment. We tend to see some people and the roles that they serve almost as permanent fixtures. Tom Hill has been that kind of fixture in the recovery community. If Bill White is our navigator, the Switzerland of neutrality and protector of our common ground, Tom Hill is our rudder. He has always had his pulse on the community. A lot of people, present company included, have depended on Tom for his wise counsel and a whole lot of insight on our shared values and what to do to stay on course and keep our ship afloat.
I am working on a side project to explore how people in recovery serving in government are able to navigate these difficult waters and do it in ways that remain true to themselves and our community. The idea for the project came out of a conversation I had a few months ago with Bill White. Getting this interview was vital for what I want to accomplish. Tom was kind enough to set down his palette and brush and talk with me for an hour.
It now occurs to me that there is more than one way to lead. Tom is stepping away from his formal recovery community role to be true to himself. Showing us the way forward, practicing self-care and following his path of growth. As this interview reflects, one of the lessons in recovery is to keep your feet on the ground and to take that next step. Tom is practicing what he preaches. As the feeling of abandonment faded, it was replaced with deep respect and a sense of awe for how recovery unfolds in our lives and the power of letting ourselves flow in that current. Thank you, Tom!
Tom Hill retried last month from his position as senior policy advisor at the White House Office of National Drug Control Policy (ONDCP). Prior to that position, he served as the Vice President of Practice Improvement for the National Council and a Presidential Appointee in the position of Senior Advisor on Addiction and Recovery to the SAMHSA Administrator. At one point, he served as Acting Director of the Center for Substance Abuse Treatment. He also helped PRO-A, our statewide RCO here in Pennsylvania to adopt our current organizational framework. Tom has also used his role in the policy realm to develop recovery-oriented systems of care and support efforts to get more people into long term recovery. He is humble and hardworking. Tom is the recipient of numerous awards, including the Johnson Institute America Honors Recovery Award, the NALGAP Advocacy Award and a Robert Wood Johnson Fellowship in the Developing Leadership in Reducing Substance Abuse initiative.
I only ask of Tom that he lets us know of his next galley opening. I want to see what he is putting on his canvas in this new chapter. I know I am not the only one who wants to celebrate what comes next!
- Thinking back to your early days of recovery, what or whom influenced the values around recovery that shaped who you were and what you have accomplished?
I want to start by noting that my career was not a planned path, it was the one that was revealed to me over time. When I think back to those early days of recovery, it is important to note that everything about recovery went against all I had learned about how to get ahead in the world. I grew up in DC. I was taught to be tough, to always be in control, not to ask for help and that to be kind was to be weak. A lot of the business world and even government runs this way as well. Recovery introduced me to an alien world that ran counter to how I lived up to that point. This new way changed my life. This new way saved my life.
One of the important things to understand is that I never set down a plan to have a career centered on recovery or to work inside government. What happened for me was more of an organic process. I worked on the issues that had meaning to me and the rest simply unfolded. The values I learned in early recovery were foundational in both my personal life and my professional work. The values of recovery were things I had to slowly open up to. They really changed my whole world. To be able to let go of control and trust the process. To strive to be honest, to live with integrity, to have a purpose greater than oneself. The foundation of love and kindness…were not who I was before I got into recovery. I had lived contrary to these values.
I had a good sponsor, and I was in therapy. I did not have any idea of what trauma was. I remember hearing about Adverse Childhood Experiences (ACEs) and realizing I had a high score. I learned what all that was about. It made a lot of what happened in my life and how I responded to things make sense. Understanding “the why” helped, as I have matured, the why is less important now, but at the time it really helped me understand a whole lot. I began to heal.
In reflection, I think my recovery foundation really did shape me. When I think of these values, the very values that shaped so many of us, they are seen as pretty radical out in the rest of the world. Most institutions do not work under such values. We can end up in conflict fairly easily with systems that do not operate in the way we learn to do to sustain our recovery. It can be a real struggle to stay true to these values out in the world.
- You were part of the first cohort of the Recovery Community Support Project (RCSP) through SAMSHA, the first time that recovery community organizations were funded in America. What influence did that process have on you and the work you have been involved with over the last two decades?
I think back to those early RCSP days, and it was really a miracle that this group of people came together. There were so many amazing people in the first and second cohort. It was really incredible when you think about it. SAMHSA Grant officer Cathy Nugent and June Gertig, Project Director for the RCSP Technical Assistance Project helped focus us in ways that focused our work. One of the most remarkable things was that they had a deep understanding of the power of community. Valuing community is fundamental to developing effective strategies, but often times our institutions approach things from a top-down approach, not including communities in solutions at all, or only in pro forma way.
Community needs to be central player in change strategies, but it often ends up as window dressing as other “legitimate” institutional goals are pursued. If you really want to help a community, you provide it with the resources and support it needs to solve its own problems. That is what works and what government repeatedly fails at. Agendas are rolled out and conducted in ways that far too often fail to harness the power of community by engaging it in its own healing process. Top-down approaches tokenize the recovery community, with the message that people, families, and communities are not capable of finding their own solutions. Communities from all around have proved this wrong. The recovery community has proved it wrong in capital letters.
The Recovery Community Support Program is an excellent example of one of those rare instances in which government valued “community up” solutions. What a miracle was that – the right people were in the room. The cohort included people like Don Coyhis, Phil Valentine, Joe Powell, Bev Haberle and Dona Dmitrovic. You had grant officers who understood how community up problem-solving works and you had this amazing group of people assembled from across the country who all came together. This SAMSHA project that was really run on a shoestring budget, it sort of bumped along. But it had its champions, like Dr H. Westley Clark CSAT Director and Rick Sampson, the Director of the Division where the RCSP was housed. Without their support it would not have achieved what it did.
The back story was that when the project was conceived, there was a sense that SAMHSA would facilitate this project, people and organizations would be developed and the focus would be to remove barriers to treatment. This was in the era when recovery month was focused on Treatment Works! as a slogan. The thing was, when all these people came together, it was realized that this is not what our communities wanted to do. There were such varied pathways to recovery, many included treatment, many did not. The cohort wanted to focus on strengthening recovery. The miracle was that, by listening to the reports from community leaders, the government started trusting and valuing the lived experience and wisdom of the recovery community. At the end of the day, that is the miracle that gave the recovery community a foothold in government.
- You have had quite an impressive career in government. You were one of the highest government officials openly in recovery. How have you navigated the values of recovery representation in these positions?
As we have talked about, I never had a master plan to do this. I honestly think I was called to this work, as I think you and many of us have been. Occasionally, messengers show up and give us a nudge. The truth is that when I was initially asked a few of years back if I wanted to pursue an available position within government, I said no. I couldn’t really picture myself in that role. Working for a government contractor doing technical assistance, I felt that I had more freedom working directly with the recovery community.
After I said no, the agency official came to me again and asked if I would consider a time-limited role, as a political appointee. I certainly saw that there was potential for me to further some of the objectives of the recovery movement, alongside my friend and colleague, Tom Coderre, who was already serving. I got on the phone and ran the idea by many of my colleagues and decided that I could not afford to turn down the offer. The idea was very compelling, I ended up saying yes, not once but twice. So, I ended up in government.
Earlier I spoke about how the priorities of government and the values of recovery can come in conflict. It can make the work difficult, and I believe that it is beyond helpful to have a program of recovery to navigate these conflicts. Without that, I know I would lose their way quickly. Government works at its own speed. You often do not know how well you are carrying the water because everything is so heavily steeped in politics and frequent changes are constant. “Keeping it simple” can seem impossible in an arena of complicated decision-making and a variety of changing factors. Because government moves very slowly, working to make sustainable policy and systems change takes both short-term and long-term strategies, along with a whole lot of patience and stamina. Seeing a project gain momentum and then sputter can be disheartening, requiring us to keep our determination fixed on the end goal, which may take substantial time to realize.
For me, it has been important to stay rooted in recovery values in all the places I have worked and especially in government. At the end of the workday, I have to ask myself questions like: was I honest, was I fair, did I listen well, did I do what I said I was going to do, was I kind to everyone – things like that. These questions can be especially difficult in work environments that are not designed to uphold recovery values.
Despite all the challenges, the role can be rewarding. I have been able to open doors and invite diverse representatives of the recovery community to important meetings where expertise informs critical decision-making. Getting the right people – and the right combination of people – to the table is an art that requires intention and follow-through. And including people with lived experience as experts has been a game-changer. Demonstrating this can be as simple as setting up a workgroup participation list that omits credentials behind people’s names. Oh, this can really ruffle feathers. We know that people work hard for their PhD and other degrees but eliminating academic credentials is a way of leveling the playing field. It communicates that everyone comes to the table with equal value, no matter who they are or how they got there.
Being open about your recovery while working in government can still be difficult. There is a lot of stigma and implicit bias. Sometimes you can see it, sometimes you can feel it. Our professional language is still peppered with thoughts and assumptions that are stigmatizing and outdated. Even as the concept of recovery has gained traction in the government, attitudes from colleagues can come off as unrealistic or not fully developed and are often overly romanticized and patronizing. Because much of this happens in a work environment in which people are afraid to ask what they don’t know, I have often taken the responsibility to correct, inform, and educate.
We need people who have the skills and aptitude to take up service within government. Everything we do takes sustained effort. Look at what we have done over the past twenty years. Recovery voices are now for the most part included. There is increased awareness of harm reduction pathways. We have made progress with recovery support services, despite our concerns about areas where their authenticity and community-centeredness is compromised. Our world is better off because of our efforts. It is far from perfect, we never get 100% of what we want, but we stay at it. We stay the course. We need people in recovery who have strong recovery values and who can balance out all these challenges and stay focused on our shared goals to serve in this way.
- What would you tell young people in recovery who may be considering working within government to strengthen recovery efforts?
The recovery community and government each have cultures that often clash. To work effectively in this space as a person in recovery requires skill in working cross culturally – to find common ground and build bridges. Not everyone can do this. It is important to learn how to work like a bureaucrat without becoming one. It is easy to fall into this trap and become the barrier instead of breaking it down. Bureaucracy is a very powerful force, and it can overwhelm even the most well-intentioned advocates. This is why staying true to our values and practicing self-care is so important for those of us working in this space. If you are not careful, you can find yourself being part of the problem before you realize what has happened.
It can be so easy to lose your way if your own self-care does not come first. If you are not grounded in recovery, you can easily get lost in government. The first important consideration is to have a uncompromised practice of self-care. The second is to work government in ways that serve our community and not to end up being worked by the government.
- What are the most important values that recovering persons serving in government should consider to shape policy and strengthening recovery efforts at the state or national level?
Back in the first question, we were talking about how radical the values of the recovery community can seem to those in the larger world. So many of us in recovery value shared decision making, diversity, fairness, shared power and consensus. These ways can run contrary to the machinery of government. It can be really frustrating when you know that these values will get the best yield, but other people don’t trust or believe it. At times it feels like we are making no progress, and even that things are going backwards. The key is to stay true to those values. This is how we make incremental change. Sometimes our influence is very subtle but will take hold over time if we are persistent.
It is especially important to stay true to these values while operating in a political environment. I think many of us who have chosen this path can struggle with the political facets. It can take a lot of energy to stay true to our values while operating in the unforgiving and the sometimes-mean-spirited environment of politics. I mentioned I grew up in DC, and then moved to New York. New Yorkers are very direct people and you usually know where you stand with them. In the world of government and politics, things are more indirect: you have to read and talk between the lines. There are times when people may seem to be throwing up roadblocks when they are actually trying to help you behind the scenes. Other times, an initiative will have full support and gain momentum, only to be pulled in the final hour. The bottom line is to not become disheartened and to be as sincere as possible and authentic to yourself and the movement. It is very easy to be corrupted by power – act with integrity and don’t take yourself too seriously.
- Looking back on your career, what are you most proud of accomplishing?
The recovery movement – including recovery-oriented systems of care and peer recovery support services – is on the map in ways we have never been before. I am honored to have played a part in making that happen. It is true that we have a long way to go. You and I have spoken about a number of the problems in the way that peer services are being conceptualized and implemented. In many cases, the community elements of peer work are being undermined in favor of a much simpler and less effective annexation to the workforce. There are a lot of mistakes being made that the next generation are going to need to clean up. Yet it is also true we have people in recovery working within our care systems in roles that are based on their lived experience. This is a huge accomplishment and must be carefully guarded so that the lived experience of recovery remains key.
Systems change is hard and complicated work. Most systems are designed to self-perpetuate and create stasis to sustain its equilibrium, even when that balance is unhealthy. Let’s not forget the initial – an in some cases, ongoing – resistance to implementing a recovery-orientation and the inclusion of people with lived experience. How many years has it taken just to have these conversations out in the open? And yet there are numerous examples of federal, state, and county recovery-oriented initiatives that are promising. So, yes, our efforts have been worthy, and I have hope that the recovery community will continue to point to True North. In this regard, the next generation will achieve remarkable things if they stick to recovery values, carry forth our community goals and work to navigate these difficult waters in order to continue to expand recovery opportunities for thousands of Americans.
So over 20 years ago, a few people were bold enough to talk about highlighting recovery in a whole new way and dared to dream that the recovery community could make some positive changes in helping more people access recovery. The fundamental power of recovery is that one individual helps another, and by doing so helps heal themselves. This basic concept is one of the most powerful forces on earth. This spiritual principle is ultimately what will heal our communities, and this is the philosophy that peer support is built upon. If peer workers are not anchored in this, then it will never begin to approximate authentic peer practice. This is what so many people still don’t get: that recovery is a radical transformative process that redirects the life energy of people, families, and entire communities.
- I know that in retirement, you are focusing on your art. Art is often about advocacy. How do you see these things come together in your next chapter of life? Is your advocacy for the recovery community and LGBT community going to show up in your art?
I’ve been fortunate to live a really full life and retirement is simply a new chapter. What is essentially means is that I am liberated from having to earn a wage. A friend of mine refers to it as “going rogue.”
Except for a brief period when I was in graduate school and then started my career as a social worker and community organizer, I have always practiced my art and used it to express myself through my recovery process. My advocacy work and my art have always been connected, they come from the same place in me. One of the things I have learned as I have grown older is to stop trying to force things, to trust the process and let the universe direct the traffic. In the past, I may have focused more on the details. Now, it is about the flow. My art, my queerness and my recovery are all inseparable parts of me that focus on being authentic in the world. For me, the gift of recovery has really been about self-forgiveness, self-acceptance, and letting go of how I am perceived. I am excited about the work I am doing in the studio right now because it is about me looking the world directly in the eye and taking my place in it, without embarrassment and without apology. At least, that is the goal!
I feel good about my decision to retire. I stepped aside from a career as an artist when I answered a call to do this recovery work. After considerable prayer and meditation, I became confident that the call has shifted. Time to step aside, let others take the helm, and get back into a routine of studio practice. So I feel really confident that I got the timing right on this. And leaving a gig at the White House ain’t a bad way to cap off your career!
I have never been very good at beginnings, middles, and ends, but I am working on creating boundaries. I have also not been so good at saying “No,” either because I did not want to disappoint people or I was afraid that I would miss out on fun and opportunities. So, when asked if my work in this recovery movement stuff is over, my answer has been, “For now.” I have learned that nothing is set in stone and you never know what is around the corner.
Since my last day of work in February, I have been in the studio every day, setting up new routines and practice, and being there makes me really happy. I love having the time, space, and resources to see this new work evolve. And to answer your question, yes, there are definitely threads of social justice coursing through this work, and because I am representing no one but myself, I feel free to create work without constraint, making it as irreverent, humorous, and unrestrained as it needs to be. After years of diplomacy, it feels really liberating to unleash a set of unfiltered truths.
In closing, I’d like to remind everyone that this phase of the recovery movement began with just a few people talking about how to realize the power of the recovery community in more universal ways. It took some time for this conversation to evolve and for others to feel a part of it. Over time the spark ignited into a small flame which became a bonfire. We have yet to set the world on fire, but it is, without a doubt, coming.
The next generation has grabbed the torch and is adding new ideas and elements that are deepening the discussion, asking questions about race and inequity, arrest and incarceration, and the tensions between abstinence and harm reduction approaches. Through this exciting work and change, vigilance needs to be the watchword, along with the knowledge that we can’t give what we don’t have. We need to keep close guard on our recovery values and ensure that they are never compromised by and through our work with others. Finally, we need to keep the fitness of our recovery fresh and vital. In all the work we do in recovery advocacy and systems change, our daily spiritual practice is our most powerful tool and the compass that directs us to True North.