‘Women: Drinking and Recovery’ by Dr David McCartney

My good friend Michael Scott, of Michael’s Recovery Story, and I attended a Public Awareness Meeting of Alcoholics Anonymous (AA) in a Perth suburb today. I was asked to talk for five minutes about my recovery work over the years. I also described some of the factors that facilitate recovery.

We listened to a number of AA members share their stories and I have to say that I was blown away by the high quality of the shares. They were moving, inspirational and insightful. More women than men spoke. It was such a good meeting and I really enjoyed talking to people after the actual meeting ended.

Imagine my surprise when I got home to find that my good friend Dr David McCartney had just uploaded a blog post about women, drinking and recovery.

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Factors Facilitating Recovery: (Gaining) Recovery Capital

Here’s the last of the 11 factors facilitating recovery that I wrote about in my book Our Recovery Stories: Journeys from Drug and Alcohol AddictionJust because it is last, does not mean it is the least important factor. In fact, it is one of the most important!

Recovery is better predicted by someone’s assets and strengths, rather than their ‘pathologies’, deficits and weaknesses. People can make progress by identifying and building on their personal assets and strengths. Interventions to facilitate recovery must focus on helping individuals build their recovery strengths, more often referred to as ‘recovery capital’. 

Recovery capital is the quantity and quality of internal and external resources that one can bring to bear on the initiation and maintenance of recovery [1]. It takes three main forms:

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Addiction Recovery

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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It’s Not Just About the Drug, Part 3

I continue my series of blog posts focused on drug, set (the person) and setting (the social context) [Part 1 is here]. Drug, set and setting is not only of relevance to addiction, but also to overcoming addiction.

The path into and out of addiction
The ‘person’ and ‘social context’ factors influence early substance use and the likelihood that a person will develop problematic use and addiction. In general, individuals are less likely to develop substance use problems if they have fewer complicating life problems, more resources (social, personal, educational, economic), and opportunities for alternative sources of reward.

One explanation is that these individuals develop a weaker attachment to the substance in that for them substance use does not serve as many emotional, psychological or social needs.

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It’s Not Just About the Drug

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).

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Reflections on Recovery

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).

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‘Community Recovery’: Bill White

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.

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‘From Trauma to Transformative Recovery’ by Bill White

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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‘Experiencing Recovery – Part 10′ by William L. White: Recovery Paradigm and Addiction Treatment

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.

‘Recovery: What Do We Know and Where Might We Go?’ by David Best

Dr David Best of Monash University gives the Keynote Speech at the CSARS Conference at the University of Chester in 2014. Well worth watching, particularly as David is one of the world’s leading recovery researchers.

The talk ends after 65 minutes, after which there is a panel discussion.

‘A personal and social model of recovery’ by David Best

Unknown-1Here’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.

  1. Recovery capital – personal and social resources – the journey of growth
  2. Social identity and social contagion in recovery – the role of friends and connections
  3. Therapeutic landscapes of recovery – the role of location.

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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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‘The Potential of Recovery Capital’ by David Best and Alexandre Laudet

17a01ef7-2d9e-46cf-b051-57d841da3abd-620x372Here’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.

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‘Personal Failure or System Failure’ by William White

System Failure‘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. 

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‘Community Recovery’ by Bill White

Wellbriety Movement 2Another 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.

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‘The Work of Recovery’ by Bill White

employmentI 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:

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Facilitating recovery with peer support

2007_0118walpole0167I 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.

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