The Culture of Addiction, Part 2

March 29, 2023 by

This article is the follow-up to the first part of The Culture of Addiction.

Society makes judgements about different types of psychoactive drug. As Bill White points out in his book Pathways from the Culture of Addiction to the Culture of Recovery, the social status and value attached to a particular drug by society influence several things:

  • The risks associated with use of the drug
  • The organisation of ‘tribes’ within the culture of addiction
  • The characteristics of each tribe and the impairments that members experience from both the drug and the culture itself.

Clearly, there are likely to be differences in a variety of factors for drugs that are legal (e.g. alcohol) and those that are prohibited by law (e.g. heroin). Simply by using a prohibited drug, a person increases the risks associated with this drug, relative to what it would be if the drug could be legally obtained. Whilst society applies technology to reduce the risks of using legal substances, it often withdraws technology to increase risks from use of prohibited drugs.

‘We prohibit a ‘bad’ drug on the rationale that it is dangerous, and then construct social policies that assure high risks related to the drug’s use.’ William L White

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The Culture of Addiction: Part 1

March 24, 2023 by

This is the first of two blog posts on the culture of addiction that I first uploaded to the website back in 2013. They are strongly based on the seminal writings of William (Bill) White, in particular from his stimulating book Pathways from the Culture of Addiction to the Culture of Recovery. In this book, Bill provides key insights into how we can help people move cultures—essential in their journey along the path to recovery.

‘Culture’ generally refers to patterns of human activity and the symbolic structures that give such activities significance and importance. Wikipedia

Drug users often seek out and build relationships with other people whose drug use is similar to their own. They become part of small groups within which they can nurture the rituals of drug use. These groups interact with other drug-using groups, ultimately forming a broader network of users who share common goals and attributes. These social networks constitute a fully organised culture, one that has an existence and power that transcends individual membership.

In his book, Bill White emphasises the importance of understanding the culture of addiction. He emphasises that many addicts find it easier to break their physiological relationship with the drug than to break their relationship with the culture in which they use the drug. Clearly, one needs to understand how to move someone from the culture of addiction to the culture of recovery.

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Bill White’s Writings

March 16, 2023 by

Researcher, historian, practitioner and recovery advocate William (Bill) L White has been the most prolific writer in the addiction recovery field. You only have to look at his website. The impact of his ideas, work and writings has been enormous. Here, I include links to a number of my blog posts that focus on Bill White’s writings.

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Factors That Facilitate Addiction Recovery

March 14, 2023 by

Recovery is something done by the person with the substance use problem, not by a treatment practitioner or anyone else. Whilst there are a multitude of pathways to recovery, there are a number of key factors that facilitate recovery from serious substance use problems. (9,586 words) *

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A Rendezvous With Hope: Bill White

March 14, 2023 by

Here’s one of my favourite posts from that prolific blogger William (Bill) White, addiction recovery advocate, writer, researcher and historian. Bill’s complete writings are now being hosted on a website run by Chestnut Health Systems in the US.

‘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. 

Vern Johnson then came along and convinced us we could raise the bottom through a process he called intervention.  Staging such interventions within families and the workplace was something of a revolution that brought large numbers of culturally empowered people into recovery, including a former First Lady. All of these early philosophies and technologies relied on pain as a catalyst of addiction recovery, and that was the view I brought to my work as an evaluator of an innovative network of women’s treatment programs in the 1980s called Project SAFE.

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Journeys, Part 1: Descent Into Heroin Addiction

March 14, 2023 by

Heroin users’ own accounts of their experiences help us understand why and how people start using heroin, and continue to use until they realise they have become addicted to the drug. (5,176 words) *

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Bill White on Stigma and the Recovery Advocacy Movement

March 8, 2023 by

Here is a powerful 2014 film clip on the Faces & Voices of Recovery Vimeo channel from leading addiction recovery advocate Bill White about stigma and how we can tackle the problem.

‘Almost everyone in America know someone in recovery. The problem historically is that they did not know they were in recovery which means that they can continue to maintain incredible stereotypes about who are the people who develop alcohol and other drug problems in this country and who are the people who recover and don’t recover.

There are a lot of issues about stigma that I cannot educate you out of. I can give you all the facts. I can read all the books to you. I can show you documentaries but nothing is going to change that embedded prejudice until you encounter personally someone in recovery who means something to you and hear their story.’

William (Bill) White is Emeritus Senior Research Consultant, Chestnut Health Systems. He has served as a volunteer consultant to Faces & Voices of Recovery since its founding. He has a Master’s degree in Addiction Studies and has worked in the addictions field since 1969. He has authored or coauthored more than 350 articles and monographs and fifteen books including Slaying the Dragon: The History of Addiction Treatment and Recovery in America and Let’s Go Make Some History: Chronicles of the New Addiction Recovery Advocacy Movement. Check out an online library of his writings at williamwhitepapers.com. Faces & Voices of Recovery, 2014. [5’44”]

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Visiting UK Recovery Friends: Part 2 (Mark Gilman)

November 23, 2022 by

Last month, I returned from a European trip of just under eight weeks, a trip during which I visited a number of friends who work in the addiction recovery field. In a previous blog, I described my meeting with Kevan Martin, Founder of NERAF (Northern Engagement into Recovery from Addiction).

Two days later, I spent the afternoon in Manchester with Mark Gilman, who many of you know. Mark was North West Regional Manager for the National Treatment Agency (NTA) for Substance Misuse, and more importantly one of the leading recovery advocates in the UK, when I first met him in 2008. He had established Recovery Oriented Integrated Systems (ROIS) in the North West, on the basis of the ideas of George de Leon. The latter’s proposition was that by coming together as part of a therapeutic community, people can learn how to live right.

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Reflections on the Lessons of History: Bill White

April 14, 2022 by

Slaying the Dragon: The History of Addiction Treatment and Recovery in America by William L. White isn’t just a fascinating and enjoyable read, it has also taught me so much. Bill White’s book, his other writings, and our meeting in the UK in 2009, have been so inspirational for me.

I’m currently trying to write a book about addiction recovery, which includes details of my own journey (experiences, thoughts and emotions) as I learnt about the field and tried to develop an initiative (Wired In) which I hoped would help individuals, families and communities. Writing the book is quite a challenge and I have done a good deal of reflecting, a fair amount of writing, and lots of correcting!

Today, I pulled Slaying the Dragon off one of my bookshelves to read the last parts. I knew they would help inspire me and provide the fuel for more reflections on the structure of my book. It also made me realise that I needed to post the last sections of Bill’s book in a blog because they are so important for all of us working in this field. I hope they help you in your work and in reflecting on what you do. I can strongly recommend purchasing Bill’s amazing book.

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‘Recovery Landscapes’ by Bill White

January 18, 2022 by

Here’s an excellent blog that leading recovery advocate Bill White posted in March 2014. I love the phrase ‘Recovery Landscape’. I first posted this blog on Recovery Stories on 14 March, 2014.

‘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. Researchers are beginning to suggest that reaching the tipping point of addiction recovery may have as much to do with community factors as intrapersonal factors.  Recovery advocates and clinicians are calling for creation of a “healing forest” – “naturally occurring, healing environments that provide some of the corrective experiences that are vital for recovery.”

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‘An Intervention Gone Wrong’ by Bill White

June 23, 2021 by

I first spotted an earlier version of this article on Bill White’s website in 2013. The article really made me laugh so I couldn’t resist posting it. Since then, Bill has posted this version of the little gem (in 2017), so I decided to post it.

‘The most famous and controversial treatment for addiction in the 19th century was Dr. Leslie Keeley’s Bichloride of Gold Cure.  Dr. Keeley franchised his cure procedures through more than 120 Keeley Institutes scattered across North America and Europe.  These Institutes became the preferred drying out institutions for the rich and famous in the 1890s. But the problem then (as today) was this: Even where there are financial resources to pay for such treatment, how can the afflicted person be convinced to enter such a treatment institution?

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Bill White’s Norman E. Zinberg Memorial Lecture, 2012

June 4, 2021 by

Researcher, historian, practitioner and recovery advocate William (Bill) L White has been the most prolific writer in the addiction recovery field. Bill’s fascinating book Slaying the Dragon: The History of Addiction Treatment and Recovery in America is a classic. You can see the Table of Contents here.

As many can testify, Bill is an amazing public speaker. Here is the Norman E. Zinberg Memorial Lecture, Experiencing Recovery, he gave at the Harvard Addiction Conference in 2012. Bill’s lecture is on YouTube, divided into ten parts:

Part 1: Early History of Recovery in the U.S.

Bill describes just how far back recovery goes historically in the US—to Native American Indians in the 1730s! (13’36”)

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Addiction Recovery

April 27, 2021 by

Here is a section about the nature of addiction recovery from my new eBook, Our Recovery Stories: Journeys from Drug and Alcohol Addiction.

“There have been various definitions of recovery proposed over the years. For the purpose of this chapter, I am going to use a definition proposed by leading addiction recovery advocate William (Bill) L White [1]:

‘Recovery is the experience (a process and a sustained status) through which individuals, families, and communities impacted by severe alcohol and other drug (AOD) problems utilize internal and external resources to voluntarily resolve these problems, heal the wounds inflicted by AOD-related problems, actively manage their continued vulnerability to such problems, and develop a healthy, productive, and meaningful life.’

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‘From Trauma to Transformative Recovery’ by Bill White

March 5, 2015 by

Trauma to Transformation Image‘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.

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‘A Personal Tribute: Ernie Kurtz, 1935 – 2015’ by Bill White

February 2, 2015 by

EK Photo 2008‘Ernest Kurtz, who made landmark contributions to the study of addiction recovery, died January 19, 2015 of pancreatic cancer. Following publication of Not-God:  A History of Alcoholics Anonymous in 1979, Kurtz focused his studies on the growing varieties of recovery experience, the healing of shame and guilt, and the role of spirituality in addiction recovery.

 
Ernest Kurtz was born in Rochester, New York, September 9, 1935 – only two months after the meeting of two desperate alcoholics in Akron, Ohio marked the birth of Alcoholics Anonymous.  Kurtz attended St. Bernard’s Seminary and College and was then ordained as a Catholic Priest in 1961.

Following five years of parish work, he began his graduate studies at Harvard University where he completed an M.A. in philosophy and a Ph.D. in the history of American civilization. His Ph.D dissertation on the history of A.A. marked a turning point in the scholarly study of A.A. and the larger arenas of addiction recovery and recovery mutual aid societies, both legitimizing such studies and setting a benchmark by which future studies would be evaluated.

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A great loss: RIP Ernie Kurtz

January 22, 2015 by

ernie_kurtz_egyptI was saddened to recently hear that Ernie Kurtz passed away on 19th January. Ernie was a brilliant and inquisitive man who helped very large numbers of people better understand AA and spirituality. Bill White recently described Ernie in the following way:

‘One of the distinctive voices within the modern history of addiction recovery is that of Harvard-trained historian Ernie Kurtz.

Spanning the 1979 publication of his classic Not-God: A History of Alcoholics Anonymous to the just-released Experiencing Spirituality (with Katherine Ketcham), Kurtz has forged a deep imprint in studies of the history of A.A. and other recovery mutual aid groups, the varieties of recovery experience, the role of spirituality in addiction recovery, and the personal and clinical management of shame and guilt.

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The Recovery Scholarship of Ernie Kurtz

January 16, 2015 by

Ernie GLAATC InterviewHere’s some great reading for you, from one great scholar and storyteller about another. Bill White starts the New Year with this excellent posting on his blog. Enjoy!

‘One of the distinctive voices within the modern history of addiction recovery is that of Harvard-trained historian Ernie Kurtz.

Spanning the 1979 publication of his classic Not-God: A History of Alcoholics Anonymous to the just-released Experiencing Spirituality (with Katherine Ketcham), Kurtz has forged a deep imprint in studies of the history of A.A. and other recovery mutual aid groups, the varieties of recovery experience, the role of spirituality in addiction recovery, and the personal and clinical management of shame and guilt.

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‘Prison-Based Recovery Advocacy (The San Quentin Story)’ by Bill White

December 9, 2014 by

San Quentin ARC Group Counseling Image‘The stage is set for a recovery-focused advocacy and peer support movement within the U.S. prison system.

The mass incarceration of drug offenders in recent decades, the growth of prison-based addiction treatment, the growth and diversification of prison-based recovery mutual aid, increased disillusionment with incarceration as a policy strategy of addiction containment, and the rise of grassroots recovery community organizations in local U.S. communities have all been part of this incubation process.

There is a growing critical mass of people in correctional institutions who are initiating and sustaining addiction recovery and who are pursuing service to others as part of their recovery processes.  Leaders are rising to articulate ideas and launch programs that address the particular needs and aspirations of people seeking recovery within the shadow of the criminal justice system.

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‘A Different Kind of Evidence’ by Bill White

December 5, 2014 by

Addiction Journals Credit Wiley Asia BlogMore wisdom from Bill White.

‘Some years ago, a noted research scientist was invited to speak at a local community forum on the subject of addiction. The presentation to more than one hundred interested citizens consisted of a sweeping overview of modern scientific studies on addiction and its clinical treatment.

In the question and answer session that followed the presentation, a member of the audience posed a question about the effectiveness of recovery mutual aid groups like AA, NA, Women for Sobriety, and SMART Recovery.

The speaker responded that there had been few randomized trials comparing the differences in long-term recovery outcomes between these individuals who had achieved recovery with and without mutual aid participation.  The scientist declared that no definitive scientific evidence yet existed on the effectiveness of such groups.

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‘Addiction Treatment (By Itself) is Not Enough’ by Bill White

September 15, 2014 by

‘I have spent more than four decades providing, studying, promoting, and defending addiction treatment, but remain acutely aware of its limitations. As currently conceived and delivered, most addiction treatment programs facilitate detoxification, recovery initiation, and early recovery stabilization more effectively and more safely than ever achieved in history, but most fall woefully short in supporting the transition to recovery maintenance and the later stages of recovery, particularly for those who need it the most – those with the most severe and complex problems and the least recovery support within their natural environment.

Addiction treatment as a stand-alone intervention is an inadequate strategy for achieving long-term recovery for individuals and families characterized by high problem severity, complexity, and chronicity and low recovery capital.  In isolation, addiction treatment is equally inadequate as a national strategy to lower the social costs of alcohol and other drug-related problems.  Here’s why.

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