I Am Not Anonymous: Mariel’s Story, ‘Together We Can’

Mariel-Text-1024x681(pp_w1000_h665)I’ll be finishing off Bill White’s talk this week, as well as highlighting some stories from the excellent website I Am Not Anonymous. Here’s the first of these stories.

‘My name is Mariel Harrison. I am 28 years old. I live in Point Pleasant, NJ. I am a daughter, sister, aunt, girlfriend and friend. I am also a consumer, a voter, a tax-payer, a home-renter, and a licensed/registered/insured driver.

I am a responsible, productive and valued employee. I am a diligent full-time student with a 3.9 GPA. I believe wholeheartedly in the healing properties of yoga and meditation, am a certified yoga teacher, lived in an ashram for 9-months, and hold nothing more sacred then my personal practice both on and off the mat.

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‘Experiencing Recovery – Part 3′ by William L. White: Toward a Recovery Paradigm

More of Bill White’s talk that he gave at the Harvard Addiction Conference in 2012, the Norman E. Zinberg Memorial Lecture.

Bill talks about the disconnection between recovery and treatment, and asks what do we know about the science of recovery. And how do we define recovery? He tells us how little neuroscience has told us about recovery.

‘Experiencing Recovery – Part 2′ by William L. White: The Rise of Modern Addiction Treatment

I continue Bill White’s talk that he gave at the Harvard Addiction Conference in 2012, the Norman E. Zinberg Memorial Lecture. An amazing history of recovery and treatment for alcohol and drug addiction.

‘Experiencing Recovery – Part 1’ by William L. White: Early History of Recovery in the US

Last week, I highlighted the fact that a new edition of Bill White’s classic book Slaying the Dragon: The History of Addiction Treatment and Recovery in America has just rolled off the presses. I can tell you that this is one of the best (and most fascinating) books that you will ever read.

To celebrate the ‘rolling of the presses’ and Bill’s remarkable career in the recovery field, I am going to show a talk Bill gave at the Harvard Addiction Conference in 2012, the Norman E. Zinberg Memorial Lecture. I will show one part a day for the next 10 days, taken from Bill’s excellent website.

In the first part, Bill describes shows just how far back recovery goes historically in the US – to Native American Indians in the 1730s!

‘The Year of the Dragon’ by Bill White

SlayingTheDragon_2ndEd_Cover_Reduced_2014-06-19If you are interested in this field, this is quite simply one of the best books you will ever read. Bill, thank you!

‘A new edition of Slaying the Dragon: The History of Addiction Treatment and Recovery in America has just rolled off the presses. The first edition (1998) went through multiple printings and has been used as a text in collegiate addictions studies programs.

Of even greater import has been how this history helped many people in recovery see themselves as “a people” and contributed to the rise of a new recovery advocacy movement in the U.S..

It is ironic with all I have sought to do professionally within the addictions field that my most lasting contribution will likely come from my hobby – four decades of investigating the history of addiction treatment and recovery. It is thus fitting that one of my final acts of professional service will be releasing this new edition.

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Your Recovered Life: Tim Harrington, Intervention Specialist & Recovery Advocate

‘Tim Harrington is fiercely committed to the world of recovery. He helps people get and stay sober – in whatever way works best for them AND takes daily actions aimed at reducing the shame and stigma of addiction.

The first time I saw Tim in action was at a big conference on addiction treatment. It was during a panel discussion that he raised his hand and asked a simple question.

He referenced how we, who understood addiction and treatment, were all there to learn more…but what about all the people ‘out there’ who weren’t in the know? Especially those whose lives addiction crashed into and who hadn’t a clue about the disease and even LESS about recovery. What if we had a conference for THOSE people?

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‘A Rendezvous With Hope’ by Bill White

“Life and their addictions had delivered to these women more than enough pain; what was needed was an unrelenting source of hope delivered to them by a cadre of recovering women who lacked much by way of professional credentials and polish, but who brought an inextinguishable and contagious faith in the transformative power of recovery.

These outreach workers knew recovery was possible.  They were themselves the living proof of that proposition.  And they spread the germ of recovery to women who initially caught it rather than chose it.”

outreachHere’s the latest blog from Bill White. It’s about hope.

‘Through my early tenure in the addictions field, the question of readiness for treatment and recovery was thought to be a pain quotient.  We then believed that people didn’t enter recovery until they had “hit bottom.”  If a person did not show evidence of such pain-induced readiness, they were often refused admission to treatment.

Then we recognized that the reason it took people so long to “hit bottom” was that they were protected from the painful consequences of their alcohol and other drug use by people we called “enablers.”  We then set about teaching enablers to stop rescuing and protecting their beloved but addicted family members. 

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‘Doctors with addictions: double standards?’ by djmac

Doctor-Addiction‘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.

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‘Brain Surgery as Addiction Treatment?’ by Bill White

Lobotomy‘In 1935 – the founding year of Alcoholics Anonymous, Portuguese neurologist Egas Moniz introduced a surgical procedure into psychiatry that came to be known as the prefrontal lobotomy (recall One Flew Over the Cuckoo’s Nest).   Drs. Walter Freeman and James Watts pioneered the use of this technique in the United States in 1936. 

By 1960, 100,000 psychosurgery procedures had been performed in the U.S.  Patients targeted for this procedure included those judged to have “compulsive hedonias” – alcoholism, drug addiction, excessive eating and sexual deviations.  

The prefrontal lobotomy procedure severed the connecting nerves between the thalamus and the prefrontal and frontal lobes of the brain.  Its intent was to induce significant changes in thinking and personality that could alter the course of intractable psychiatric illness.

The total number of people with substance use disorders who underwent this procedure is unknown.  One could assume that the prefrontal lobotomy is one more chapter of “harm in the name of help” long ago cast into the dustbin of addiction treatment history in the U.S., but when exactly did use of this procedure stop?  The following story suggests it may have gone on much longer than once thought.

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‘Lost lessons from an earlier era’ by Bill White

Lessons from an Earlier EraMy 2009 monograph outlined in considerable detail the history, theory and status of peer recovery support services (PRSS) in the United States.  In the years since the monograph’s publication, voluntary and paid recovery support services have dramatically increased in the US and internationally. 

Such growth has recently prompted me to reflect on the pre-professional days of addiction counseling in the United States (1965-1975) when people in recovery constituted the core workforce within newly arising addiction treatment programs. 

The current expansion of PRSS raised the following question:  What experiential lessons from this earlier era could inform the present implementation of PRSS?  Here are my top 20 answers.

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‘Four Examples of Expensive Rehabs That Spread Stigma, Not Recovery’ by Tom Horvath

shaming‘Eliminating stigma against people in recovery appears to be a universally supported goal within the recovery community, and for good reason. Recovery is hard enough without this additional burden.

The unspoken assumption is that stigma is the fault of the “outside” world – not of other people in recovery. But the recovery community has failed to provide effective leadership on this issue. And one component of the community—treatment providers—frequently reinforces stigma. How can we expect the world at large to change when we don’t change?

I operate a treatment system with two residential facilities, a sober living home and outpatient services. Because relapse is common, we often see clients who have been to other facilities. Most are frustrated, and often furious, at how they have been treated elsewhere. They generally report that they were viewed by staff as entirely lacking good judgment or a capacity for self-management. Therefore their requests and perspectives were easy to dismiss, even ridicule. They often have not been treated with much hospitality, either.

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‘Recovery is too hard and dangerous. Solution: methadone for life’ by DJ Mac

w600_817157f479b2b1cb43e6a6646b8f7efcWell worth checking out excellent new blog, Recovery Review, by DJ Mac. Here’s a sample:

‘Berlin, like many big cities has a heroin problem. People presenting for help are being prescribed opioid replacement therapy (ORT) in greater numbers. That’s a good thing isn’t it? Well it depends on what you think is the end goal of treatment.

At the start of this interesting recent German paper “Why do patients stay in opiod maintenance treatment?”, Dr Stefan Gutwinski and colleagues say that the scientific literature indicates the point of ORT is: “to increase survival and bring stabilization to patients, in order to enable them to reach abstinence of opioids.” The Scottish Government’s drugs policy and the UK policy agree.

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Trailer for “OPEN DIALOGUE,” an alternative Finnish approach to healing psychosis

Check out this important film from Daniel Mackler.

‘In the far north of Finland, a stone’s throw from the Arctic Circle, a group of innovative family therapists converted the area’s traditional mental health system, which once boasted some of Europe’s poorest outcomes for schizophrenia, into one that now gets the best statistical results in the world for first-break psychosis. 

They call their approach Open Dialogue.

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Unrecognised Facts About Psychiatry

I really like the Council for Evidence-Based Psychiatry website, in particular their Unrecognised Facts About Psychiatry. They say:

‘Most people assume that psychiatry is just like any other branch of medicine, with objective tests for diagnoses and drug treatments that cure real diseases.  In reality, however, psychiatric diagnoses and treatments differ enormously from diagnoses and treatments for say cancer or diabetes, since, for mental disorders, there are no known biological ‘diseases’ for psychiatric drugs to ‘treat’.

Here we highlight various Unrecognised Facts about modern psychiatry which every patient, practitioner and policymaker ought to be aware of.’

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‘Stop kicking people out of addiction treatment’ by Bill White

Kicking Image‘In 2005, my colleagues Christy Scott, Michael Dennis, Michael Boyle and I co-authored an article entitled It’s Time to Stop Kicking People out of Addiction Treatment. The latest (2002) data then available confirmed that 18% (288,000) of all persons admitted to specialized addiction treatment in the U.S. were administratively discharged (“kicked out”) prior to treatment completion.

Those persons whose treatment was terminated in this manner were often those with the most severe and complex addictions and the least natural recovery support resources – in short, those most in need of professional treatment.

The most frequent cause for administrative discharge (AD) over the past half century has been continued use of alcohol or other drugs during treatment in spite of threatened consequences, e.g., the central symptom of the disorder.

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‘No More Graduation’ by Bill White

Something toGraduation reflect upon in Bill White’s latest blog.

‘The acute care (AC) model of intervention that, with few exceptions, has dominated the modern treatment of addiction involves a brief – and seemingly ever-briefer – period of professional intervention followed by cessation of the service relationship. 

As addiction professionals working within this model, we are trained to screen, assess, admit, treat and discharge each person we serve.   And as we approach the end of this sequence, we are trained to address “termination” issues in the counseling relationship, prepare “discharge” plans and, in many of our settings, participate in a “graduation” ritual that signals the end of primary treatment and the service relationship.

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‘Overcoming the stigma of depression’ by Douglas Bloch

dblochAn excellent article on stigma and on how people with depression can feel shame. Stigma and shame are roadblocks to depression.

“The last great stigma of the twentieth century is the stigma of mental illness.” Tipper Gore

One of the roadblocks to recovery for those who suffer from depression is our culture’s tendency to stigmatize depression and other mental health disorders.

After my first hospitalization, I remember the dilemma I faced in trying to explain my three-day absence to my employer. If I told the truth – that I was being treated for anxiety and depression – I stood a good chance of losing my job. Instead, I reported that I had been treated for insomnia at a sleep clinic.

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‘Recovery Landscapes’ by Bill White

Recovery LandscapesExcellent new blog from Bill White. I love the phrase ‘Recovery Landscape’.

‘Interventions into severe alcohol and other (AOD) problems have focused primarily upon altering the character, thoughts, feelings, and behaviors of individuals.

Far less attention has been given to influencing the environment in which such factors are birthed, sustained or changed.  But interest in the geography of recovery is increasing.

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‘Open source sobriety: Getting past chauvinism in early recovery’ by Matt Robert

woman-in-cellHere’s the latest posting on Marc Lewis’s blog, a guest blog from Matt Robert.

‘Here’s another guest post, and it’s a winner. Sincere thanks to Matt Robert, a  SMART Recovery facilitator I met last June in Boston….

I’ve been spending a lot of time these days going in and out of locked detox units. And it’s interesting because, in most important ways, they haven’t changed very much at all. But I’ve changed, and the reason for my going into them has changed as well. Now I go into them because I want to, and I leave because I can.  I go into them now to talk about recovery.

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‘Dying of a Heroin Overdose Does Not Make You a Scumbag’ by A. Thomas McLellan, Ph.D.

Unknown-6Great article in the Huffington Post by one of the leading addiction treatment researchers involving the loss of one of my favourite actors.

‘In the wake of the tragic death of Philip Seymour Hoffman, I am shocked by the vast range of opinions and emotions that have been voiced in the public discourse. Media outlets of all shapes and forms are weighing in on his death – and specifically, the foolish, self-destructive choices he made associated with his addiction.

The explosion of speculation and moralizing surrounding this death brings to light how conflicted our feelings, as a society, are about this disease. And the science is clear on this point.

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