The effects of a drug depend on an interaction between drug, person (set) and social context (setting). These three factors also influence the likelihood of addiction and recovery from addiction (2,200 words).
Reflections on Recovery
March 8, 2021
Looks at the development of the recovery paradigm and how solutions to severe substance use problems are manifested by millions of people who have recovered from addiction (1,800 words).
‘Community Recovery’: Bill White
March 4, 2021
An excellent paper by Arthur Evans, Roland Lamb and Bill White, highlighted in a blog by the latter, which I originally posted in December 2013.
‘In the Red Road to Wellbriety, the individual, family and community are not separate; they are one. To injure one is to injure all; to heal one is to heal all.’ The Red Road to Wellbriety, 2002
As a field, we have long known that the effects of personal addiction ripple through families, social networks and organizations. But might whole communities and whole cultures be so wounded by prolonged alcohol and other drug problems that they are themselves in need of a sustained recovery process? This suggestion is the premise of a new paper co-authored by Dr. Arthur Evans, Jr., Roland Lamb and myself just published in Alcoholism Treatment Quarterly.
‘From Trauma to Transformative Recovery’ by Bill White
March 5, 2015
‘Between 1986 and 2003, I served as the evaluator of an innovative approach to the treatment of addicted women with histories of neglect or abuse of their children. Project SAFE eventually expanded from four pilot sites to more than 20 Illinois communities using a model that integrated addiction treatment, child welfare, mental health, and domestic violence services. This project garnered considerable professional and public attention, including being profiled within Bill Moyers’ PBS documentary, Moyers on Addiction: Close to Home.
My subsequent writings on recovery management and recovery-oriented systems of care were profoundly influenced by the more than 15 years I spent interviewing the women served by Project SAFE and the Project SAFE outreach workers, therapists, parenting trainers, and child protection case workers. This blog offers a few reflections on what was learned within this project about the role of trauma in addiction and addiction recovery.
‘Experiencing Recovery – Part 10′ by William L. White: Recovery Paradigm and Addiction Treatment
July 17, 2014
The last part of Bill White’s 2012 Norman E. Zinberg Memorial Lecture from Harvard. Bill says he is not a teacher of these issues about recovery, but still a student. He encourages us all to be students of this rapidly changing ecology of recovery in the US. Bill also looks at what we need to do in the future in relation to recovery and recovery-based care.
‘A personal and social model of recovery’ by David Best
June 12, 2014
Here’s another excellent article from David Best which is essential reading for people trying to facilitate recovery.
‘There has been a subtle change to the role of recovery in UK addictions research, policy and practice in recent years, with a transition from the periphery to centre stage. But it can be argued that, for all the bluster, we still have a limited evidence base and we have not come far in developing an integrated or testable theoretical model.
Humphreys and Lembke (2013) have done a good job in summarising the ‘what works’ of recovery – focusing on three areas: peer-inclusive interventions, recovery housing and mutual-aid groups – so this article will not revisit that evidence.
What I will do is overview three key component parts of a theoretical model of recovery, then draw them together to derive conclusions about what we should do next to make policy and practice stronger in this area.
- Recovery capital – personal and social resources – the journey of growth
- Social identity and social contagion in recovery – the role of friends and connections
- Therapeutic landscapes of recovery – the role of location.
‘Doctors with addictions: double standards?’ by djmac
May 13, 2014
‘Doctors get addicted to alcohol and other drugs; there’s plenty of evidence of that. My question is: Do doctors with addictions get the same kind of treatment and outcomes as their patients? The British Medical Association estimates that there are 10,000 to 13,000 addicted doctors in the UK. Most of them will be in practice.
What is the expectation for doctors coming to treatment in the UK? Well, the goal of abstinence is pretty much accepted as a given (even for IV opiate addicts) and their access to quality treatment of adequate duration is greater.
Outcome studies from the USA consistently show recovery rates of 80% and there is evidence from the Practitioner Health Programme (PHP) in London this is also true in the UK. Most doctors in recovery return successfully to work.
‘The Potential of Recovery Capital’ by David Best and Alexandre Laudet
January 22, 2014
Here’s a classic text from David Best and Alexandre Laudet on recovery capital. This paper is part of the RSA project on recovery. Here is an introduction to the paper from the RSA.
‘The addictions field is now overflowing with references to ‘recovery’ with service providers and workers increasingly designated as ‘recovery-focused’, although in many areas there is confusion as to what that may mean in practice and what needs to change.
There is an increasing awareness that people do recover, but we have limited knowledge or science of what enables this to happen or at what point in the recovery journey. There is also the recognition that recovery is something that is grounded in the community and that it is a transition that can occur without professional input, and where professional input is involved, the extent of its role is far from clear.
‘Personal Failure or System Failure’ by William White
December 17, 2013
‘In my writings to people seeking recovery from addiction, I have advocated a stance of total personal responsibility: Recovery by any means necessary under any circumstances. That position does not alleviate the accountabilities of addiction treatment as a system of care. Each year, more than 13,000 specialized addiction treatment programs in the United States serve between 1.8 and 2.3 million individuals, many of whom are seeking help under external duress. Those who are the source of such pressure are, as they see it, giving the individual a chance – with potentially grave consequences hanging in the balance.
Accepting the mantra that “Treatment Works,” families, varied treatment referral sources and the treatment industry itself believe that responsibility for any resumption of alcohol and other drug use following service completion rests on the shoulders of the individual and not with the treatment program.
‘Community Recovery’ by Bill White
December 10, 2013
Another excellent paper by Arthur Evans, Roland Lamb and Bill White, highlighted in the latter’s recent blog.
“In the Red Road to Wellbriety, the individual, family and community are not separate; they are one. To injure one is to injure all; to heal one is to heal all.” The Red Road to Wellbriety, 2002
As a field, we have long known that the effects of personal addiction ripple through families, social networks and organizations. But might whole communities and whole cultures be so wounded by prolonged alcohol and other drug problems that they are themselves in need of a sustained recovery process? This suggestion is the premise of a new paper co-authored by Dr. Arthur Evans, Jr., Roland Lamb and myself just published in Alcoholism Treatment Quarterly.
‘The Work of Recovery’ by Bill White
August 27, 2013
I missed this very important recent posting on Bill White’s website which is well worth reading.
‘Research on addiction recovery is quite scant compared to the volumes of research on addiction-related pathologies and clinical interventions. Additionally, some of the most important research on addiction recovery is buried in academic journals, rarely if ever read by the people who need it most – addiction treatment professionals and people needing, seeking or in recovery. Such is the case of studies on the role of work in addiction recovery.
In 2011, Dieter Henkel of the Institute for Addiction Research at the University of Applied Sciences in Frankfurt, Germany, conducted a comprehensive review of international studies on the relationship between substance use and employment that was published in Current Drug Abuse Reviews (4, 4-27). Henkel drew the following conclusions from his review of more than 130 scientific studies:
Facilitating recovery with peer support
June 3, 2013
I emphasise three main elements to helping people recover from addiction to alcohol and other drugs.
Firstly, we must empower people, as recovery comes from the person (not the practitioner). They do the work in overcoming their substance use problems. We can empower people by providing hope, understanding and a sense of belonging.
Secondly, people need internal resources (e.g. self-esteem, resilience) and external resources (e.g. family support, peer support) – recovery capital – to help them on their journey to recovery. They also need the basic essentials of living, i.e. roof over their head, money, someone who cares about them.
