An Interview with Maryanne Frangules of the Massachusetts Organization for Addiction Recovery (MOAR)

“Faces that are visible, voices who are vocal, will prove that recovery is valuable, and that is how we will be victorious!” – Maryanne Frangules of MOAR

Maryanne Frangules has decades of experience as a recovery community advocate and community recovery capital builder. I have long thought about doing an interview with Maryanne Frangules. I met her shortly after I got to PRO-A in the early 2010s. We both were working on Recovery Community Service Program grants through SAMHSA. Later, we served on the Faces & Voices of Recovery Policy Committee together. She has an unparalleled depth of knowledge and experience related to running Recovery Community Organization and navigating our various related systems. If you saw the movie, Tipping the Pain Scale, she has a cameo in it where she was working on some state legislation to support recovery efforts in Massachusetts. You can see her in action in 2021 on Boston City TV celebrating the 31^st anniversary of Friends of Recovery Celebration Day. In that video clip you can see her being honored with a Governor’s citation for being a recovery champion. As her work to formalize her RCO occurred in the early 1990s, her efforts were groundbreaking for many who came after. The fact that Massachusetts Organization for Addiction Recovery (MOAR) is still vital 33 years after she helped form it is testimony enough to her talents and dedication.

Maryanne is the cofounder and long serving Executive Director of the MOAR, where her priorities include community mobilization of recovering persons, friends, and families to educate the public about the value of recovery in Massachusetts. She is a true servant leader. She served on the board of directors for Faces and Voices of Recovery, the national recovery community organization from 2014 to 2021. She is a person in long term recovery from addiction for well over 3 decades. Moving from the devastation caused by addiction, she discovered the power of her voice to support recovery efforts. Since 1991, she has helped what is now MOAR build into a nationally respected organization highlighting the value of living in recovery. Maryanne looks forward to a day when the stories of recovery replace the devastation of overdoses and senseless loss. Over 33 years, she has helped mentor many individuals and families to discover the power of their voice to improve addiction prevention, treatment, and recovery support services, criminal justice policies, and health care policies.

1. MOAR has a fascinating history. As you well know, it was founded originally as the Massachusetts Organization of Americans for Recovery and was aligned with the goals of the first national recovery organization founded by Senator Harold Hugh’s, Society of Americans for Recovery (SOAR). Later it became the Massachusetts Organization for Addiction Recovery around the time the Recovery Community Support Grants were offered through SAMSHA in the late 90s. You have seen and made history in your organization. What can you share about those early days and the formation of MOAR? 

We are one of the very first. It is true that are far as I can determine, we were one of if not the first Recovery Community Organization (RCO) in the nation formed back in 1991. We were quite early in our development of an RCO and predated most other such efforts. As you know, back in that era, there was a sea change occurring in the field. One can view the public addiction treatment efforts that had been initiated a generation earlier as the first wave of a modern recovery movement in the United States. It was people in recovery who advocated for and initially formed a great deal of the addictions treatment system that grew out of their efforts. In the late 80s through the mid-90s, progress forward on what they were working on were confronted with huge challenges that began to take shape at the same time the war on drugs and criminalization of addiction became the focal point of national policy strategies and treatment and recovery became a lesser area of focus.  

That era also saw the advent of Managed Care Organizations (MCOs). We saw dramatic erosions to the addictions care system, and we saw people in our communities suffer and die. I was a clinician in those days and in the program, I was working with, I could not get authorized care beyond ten days, which as you know is well below any effective threshold. It is not even enough time for their cognition to clear. Some programs got closer to 28 days for persons, but dramatic reductions were being implemented broadly in Massachusetts and beyond. Almost no one, particularly people without the means to pay for their own care, no one with an SUD was getting anywhere near the 90 days that we know according to NIDA is the minimum effective dose of care for the average person.

At the same that the service system was being gutted by managed care, people in recovery were being pushed out of the very field that they had created a generation earlier. They were being replaced with licensed social workers and licensed clinicians who at that time were not prepared for the work or recovery. They received little formal training on addiction and knew nothing about how we recover and what it takes to support recovery. Recovery is both a community and a culture and it is vital that we have people fluent in recovery working in this space and increasingly we saw this was not the case. Barriers were being set everywhere and it was having a huge impact. I later learned that groups similar to ours began to organically form around the nation as so many of us were seeing similar challenges and were compelled to do something about what we were all experiencing.

Our recovery community began to meet to discuss the challenges and what could be done so our people could get the kinds of help they needed. I learned about these meetings that a man named Leroy Kelly was holding to figure out solutions and I asked if I could attend. He openly invited me to do so. These meetings initially focused on efforts to professionalize our SUD workforce, but over time evolved into a focus on what our communities needed. It was an eye opener for me to understand just how profound the impact of negative perceptions about addiction has on all of us. From those seeking help, to the services offered, the barriers to wellness and extending to people in recovery across diverse communities.

It was in that era I really became aware of how prevalent unaddressed or underdressed substance use conditions are in our carceral systems in our healthcare systems and beyond. All of which were compounded by the misunderstanding that the tradition of anonymity in 12 step fellowships meant you could never talk about your own recovery. Anonymity at the group level was seen as extending to individuals so that few people acknowledged that we heal and were open about it. Our communities only saw the pathology because collectively we were hiding our own recoveries.

These challenges and the solutions the community dreamed of as we sat in those meetings were the roots of what is now the Massachusetts Organization for Addiction Recovery MOAR. We realized we needed to do something that focused on our needs across our communities in ways that included our voices in ways our systems just did not offer. In that era, we knew about Harold Hughes, who had been the Governor of Iowa and later served in the US Senate. Openly in recovery, he was the architect of Operation Understanding and the holder of the hearings that helped pass the first federal block grants that supported research and treatment efforts across America. After he left the Senate, he had formed the first National Recovery Community Organization, The Society of Americans for Recovery (SOAR).  

Given the example of SOAR, we named our fledgling organization the Massachusetts Organization of Americans for Recovery. They were relatively new as well. Johnny Allem, who I know you interviewed a few years ago was running the day-to-day operations at SOAR. He did not initially understand what we were doing and perhaps saw us as a threat to their work. He filed a cease-and-desist order to get us to follow their model or close. They even formed a competitive chapter here in MA. Over time, Johnny as well as the person running their MA chapter became our friends.

Over time it was realized that there was room for us and we all wanted similar things and would be best served by supporting each other rather than infighting. SOAR folded for lack of funds a few years later but inspired what later became Faces & Voices of Recovery, our national recovery organization, itself formed by the efforts of the national recovery community. Johnny and I have often laughed about that initial conflict as he became a friend. In retrospect, we were all in recovery and had similar ways of looking at things, like the notion of principles over personalities helped us navigate through those differences.   

• Who was Leroy Kelly? Is there a special memory you have about those early days?

Leroy Kelly was a clinician and an educator. He was an independent thinker. He was both well respected and at times someone held at arm’s length by our systems of care as he used his voice to raise concerns about things he saw. He was a founding member of the Massachusetts Association of Alcohol and Drug Abuse Counselors (MAADAC) which is affiliated with NAADAC, the Association for Addiction Professionals. He also served on the faculty at both the University of Massachusetts Boston and Cambridge College. Through those initial meetings to bring together our community, we both began to see how important it was to form a community organization, one we now consider a recovery community organization. We cofounded MOAR and he helped people across our community to give voice to their concerns and use their energies to collaborate on common goals. He was an incredible person we lost in 2016. In those early days, he was instrumental to our formation. He was also clear with me that his energies to focus on MOAR were time limited and that to build it and sustain it, I would need to have a lot of stamina and to bring others on board who could be dedicated to our mission over the long haul. Our thinking at that time can still be seen in our mission which is “To organize recovering individuals, families and friends into a collective voice to educate the public about the value of recovery from alcohol and other addictions.” His influence lives on as embodied in our mission.

• What White’s writings on the goals of NRAM Towards a New Recovery Advocacy Movement in the year 2000 – was what Bill said accurate in your opinion? How did MOAR fit into this?  Do you see MOAR as aligned with NRAM as it formed across the US? What did people get right at the time? What if anything was missed?

Bill White was a key force in what came together and how it moved forward. He is a remarkable writer, historian and his views were reflective of what many of us were thinking in that era. I am not sure we could fostered the kinds of change we accomplished collectively around the nation which is known as the New Recovery Advocacy Movement without Bill. As we got closer to the year 2000, the spread of oxycontin was leading to overdoses and small groups concerned about addiction were forming. There was a growing recognition that recovery was not getting the focus it needed. There was a profound lack of access for people who need help were experiencing, not just here in MA, but in every state across the country. There was a recognition that anonymity was a challenge and we needed to develop a collective voice.

As you have written about, the Recovery Community Support Grants that came out of SAMHSA and helped found your organization, PRO-A and others around the country were key to what came together. We were all reading what Bill was writing and largely agreeing with the perspectives he was raising. His writing was so good because he knew history like no one else and he was a gifted listener and observer to what was unfolding. We got a lot right as evidenced by what we all have collectively accomplished. We have fundamentally changed how America sees addiction by highlighting the lens of recovery. As a result, we elevated the probability and prevalence of recovery when people have access to healing resources. We all did that, together.

At MOAR, we focused on helping people learn to navigate our systems. We provided support for persons in our jails and prisons to get help. We provided support for people in our healthcare system to access help and then we began to celebrate avenues to wellness and eventually recovery itself. This work was simply not being done elsewhere. We made a lot of headway. There is still a whole lot more to do.

The visibility of our community through public events began with efforts at SAMHSA to communicate that Treatment Works, which was the initial iteration of Recovery Month. We all, across the nation made that change by noting to SAMHSA that we wanted to focus beyond treatment on recovery itself. To their credit, they listened. The history we made is visible in all of the public celebrations of recovery in thousands of community’s coast to coast. I am hard pressed to identify something we fundamentally got wrong about what we did and how we did it. We are a community that gets things done. Yes, we got a whole lot right!

• My research into our own history shows that there are inherent tensions that can occur regionally and beyond, this was true in the era of Marty Mann and the NCA and other eras in US recovery movement history as well. Reflecting back, what helped pull groups together as MOAR formed and developed? What challenges could have pulled things apart? How did you overcome these challenges? What can you share with future leaders on how to bring diverse groups together in the pursuit of common purpose?

What drew us together and get us unified at MOAR is our mission. It is community centered. We are all about forming a collective recovery community voice. It is true that we rarely all agree on everything, but we always agree on some things in respect to challenges we face and outcomes we all want. Through our experience, we have learned to value diverse perspectives as well as to support a broad range of strategies to get us to where we need to go. Our diversity is a strength. Our capacity to see each other is a strength. We only can harness these strengths when we come together and work together. That is what history shows us. It is a lesson we can ill afford to forget.

The concept that boils down to principles before personalities has helped us steer towards collective goals. Another steering concept is the importance of staying in our lane. Our lane is long term recovery. We support a myriad of other efforts. These include things like efforts to expand family support, treatment, prevention, and harm reduction strategies among many others. We do not need to be experts on all of these things. We stay in the recovery lane and collaborate with groups focused on these other interests. All we need to do is be the best at supporting recovery that we can, and then honor the efforts of others in these various other lanes.

I have also learned that we cannot take ourselves too seriously. We need to watch our egos and keep them in check. In reflection, one major thing we had going for us in that era is that we had all read Slaying the Dragon. We were all quite aware of how fragile the work we were doing was because we were aware of all the recovery movements that had come before our own. Egos are one of the main challenges that can lead to rifts, division and dissolution of recovery movements. We did not want that for ourselves. We knew we owed as much to all who came before us and all that come after us to keep our egos in check and work towards common ground solutions.  

• You have a very long institutional knowledge in the recovery space. What are you most pleased with having seen over the course of your efforts? What are you most surprised about?

It means everything to me when a person randomly walks up to me at a public event and begins to talk about things we were doing at MOAR that helped them, ten, fifteen, twenty years ago. My heart warms when I hear that what we did played even a small part in their journey in recovery. The thing that perhaps I am most surprised at is that when we come together, we are powerful enough to change perceptions and policy that impact our communities now and moving forward. When we show up and when we speak out, we can and do alter the course of history. We help save lives and heal whole communities. Again, that is what our history teaches us.

• As a person with a great deal of experience in this space, what do you think is the most important thing for recovery community organizations to focus on in order to thrive in our current era?

There are now more opportunities for community-oriented groups in the broader space. This provides groups an opportunity to figure out what they want to do and focus their energies on it. In our state, because of the Opioid Settlement funds, we have grants to support groups becoming 501C3 Orgs. Our Governor required that local governments include impacted groups in determining how funds are used. We can assist groups who want to be recovery community organizations but there is also an entity to support groups who want to do other things. I am pleasantly surprised to see the proliferation of community groups and the diversity they bring to our collective efforts.

For groups passionate about recovery and forming a recovery community organization, the advice I would offer is make sure you can sustain the energy it takes over the long run. There will be times when it gets very difficult, and you will need to draw on that energy to get through those times to periods that are relatively easier. I would also suggest when you are considering what you focus on to keep it simple and do it well instead of taking on too much. I would also recommend seeking help. You don’t need to do it alone. Find people whose talents complement yours. It is also vitally important to pay attention to cultural and other diversity so that you have many voices with many perspectives involved in your work. Having a lot of perspectives will improve the effort in a myriad of ways.

• In reflecting on you and your life’s work, one of things that is really evident is that you have managed to stay vital and effective over spans measured in decades. As you know, work in this space can be very difficult and it can take its toll on people. Our history is replete with examples of leaders who burned out and even more tragic outcomes. What insights do you have on self-care for new leaders in this space?

It is really important to find and maintain your own support. The work can be very difficult. Having “me” time is vital for my wellness. For myself, this means regular walks in the woods. Nature recharges me. I make sure I have enough of the things that I need to take care of myself, and I make the time to use these resources a routine priority. I find I need my personal space. I have my close associates who I can lean on, and I have mentors I can call on when I need some assistance with direction and insight. Wellness is not a secondary consideration in this work, it is a primary responsibility for everyone in the space. History also shows us that a lot of damage to our collective efforts can occur when we crash and burn. The advice I would give to people moving into this space is to figure our what brings you joy and make sure you do those things for yourself, regularly. It is really important to do so.

• Our recovery history is important, some have likened our history to that of the civil rights movement. What lessons do you think are the most important for emerging leaders to understand about our past that would help prepare them for the future?

We should think of ourselves as a civil rights movement. People need to know that they have a right to speak up. They have a right to be seen, and to be seen as more than their past but for their full self. Our movement in many ways is about speaking out our truths about recovery and the barriers in place across society to getting more people into recovery and creating space for others to do the same while working to fix the myriad of barriers to recovery.

In thinking about ourselves as a civil right movement, MOAR has had to face the challenges of what does it really mean to be a proponent of Diversity, Equity, and Inclusion. This required consultation and training to own up to biases and make real changes. We are committed to doing the work necessary to address the struggles and inequities diverse groups of people face while seeking recovery services. Systemic racism, prejudice, and bias have been deeply ingrained in the history of the American healthcare system. MOAR is committed to working to create a collective voice for those seeking recovery for all people who have been historically underserved, marginalized, and oppressed.

I think everyone in our space needs to read Slaying the Dragon. It offers readers a deep understanding of all that have come before our own across many generations back to and prior to the formation of our nation. When one understands our history and all that has come before, it lends itself to a sense of humility. Many have walked the road we are on, and we share their hopes, dreams, their challenges and their human flaws. We have a great deal to learn from those who came before us. We are the message carriers of recovery for this generation, no more, no less. It is enough if one understands the history our efforts are grounded in. Knowing so deepens one’s humility.

• Is there one thing that you now know that you wished you had known at the beginning of your work in the recovery space / any parting words of wisdom as we close out this interview?

I would want them to know that you do not have to do this work alone! Find others who share your passion and do it with them!  Find people who have different skill sets than you have so that collectively your capacity to do things is increased. At times I found myself with fewer people around and slogging through things that were not in my wheelhouse. These were some of the most difficult times for me. It can be avoided or reduced if you focus on inclusion of people with varied talents. As I noted before, diversity should always be something you are looking at, so you do not end up with a monoculture that misses vital components. I would also tell them to make sure you have fun along the way. One way that this work is analogous to recovery is that it is about the process and not just destination. As Joseph Cambell once said, “the quest is the grail you seek”

Below is a poem I often think about, it focuses on a man but has relevance across our community. I like poetry and things that rhyme, this one resonates with me.

Keep Going – Edgar Quest  

When things go wrong, as they sometimes will,

And the road you’re trudging seems all uphill,

When the funds are low and the debts are high,

And you want to smile, but you have to sigh,

When care is pressing you down a bit,

Rest if you must, but don’t you quit.

Life is queer with its twists and turns,

As every one of us sometimes learns.

And many a failure turns about

When he might have won had he stuck it out.

Don’t give up though the pace seems slow,

You may succeed with another blow.

Often the goal is nearer than it seems

To a faint and faltering man.

Often the struggler has given up when he

Might have captured the victor’s cup,

And he learned too late when the night slipped down,

How close he was to the golden crown.

Success is failure turned inside out,

The silver tint of the clouds of doubt,

And you never can tell how close you are.

It may be near when it seems afar.

So stick to the fight when you’re hardest hit.

It’s when things seem worst that

You musn’t quit.

Keep Going – as published in the Detroit Free Press, March 4^th, 1921

And in the spirit of keep going, I am pleased to say, I will be part time staying on as Massachusetts Recovery Historian, .

We have found a “MOAR” than capable new Executive Director, Noel Sierra, who can strengthen our mission to organize people in recovery, families and friends into a collective voice to educate the public about the value of living in recovery. Noel will be committed to work to create a collective voice for those seeking recovery for all people who have been historically underserved and oppressed.

Sources

Bor, J. (1993, June 13). Former U.S. senator advocates national sobriety movement. Baltimore Sun. https://www.baltimoresun.com/1993/06/13/former-us-senator-advocates-national-sobriety-movement/

Boston City TV. (2021, October 4). MOAR and Friends 31st Recovery Month Celebration. https://www.youtube.com/watch?v=qd0k1wxesRo

National Institute on Drug Abuse. (2014). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). https://nida.nih.gov/sites/default/files/podat-3rdEd-508.pdf

“Operation Understanding” 1976. (n.d.). Vimeo.com. https://vimeo.com/189132637

Stauffer, W. (2021, July 26). Interview #8 – Johnny Allem Reflections on the Historic 2001 Recovery Summit in St. Paul, Minnesota, and the Start of the New Recovery Advocacy Movement. https://recoveryreview.blog/2021/07/26/interview-8-johnny-allem-reflections-on-the-historic-2001-recovery-summit-in-st-paul-minnesota-and-the-start-of-the-new-recovery-advocacy-movement/

Vivifi Films. (2021, November 20). Tipping The Pain Scale – Official Trailer (2022). YouTube. https://www.youtube.com/watch?v=6tnoz616ex0

White, W. L. (1998). Slaying the dragon: The history of addiction treatment and recovery in America. Chestnut Health Systems/Lighthouse Institute. https://www.chestnut.org/store/products/5/slaying-the-dragon-the-history-of-addiction-treatment-and-recovery-in-america-second-edition/product-details/ White, W. (2000). Toward a New Recovery Movement: Historical Reflections on Recovery, Treatment and Advocacy. Presented at Recovery Community Support Program Conference “Working Together for Recovery”. https://www.chestnut.org/Resources/55a42f16-0715-4b5f-90a4-d406cb4568db/2000TowardaNewRecoveryMovement.pdf