Learning From Wired In To Recovery

As part of our Wired In strategy, my colleagues and I launched the Wired In To Recovery online community in November 2008. Our initial aims with Wired In To Recovery were to:

  • Highlight role models who show that recovery from addiction is possible, and illustrate the multitude of paths to recovery.
  • Provide information and tools that help people better understand and use the options they have to overcome the problems caused by their own, or a loved one’s, substance use.
  • Create an environment in which people can inspire and learn from each other and provide mutually beneficial support.
  • Establish a ‘people’s journalism’, or Voice of Recovery, which acts as a strong source of advocacy both for recovery and the Recovery Movement.
  • Identify key individuals who would join, or collaborate with, Wired In to help us realise our ambitions.

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Recovery as an Organising Construct – Bill White Interviews Larry Davidson

William L White and Larry Davidson are two of my recovery ‘heroes’. In this 2013 paper from his website, Bill interviews Larry about mental health recovery. As the former says, Larry was ‘one of the earliest pioneers in studying and promoting the concept of recovery related to severe mental illness.’ Here are Larry’s answers to two of Bill’s questions. [I have shortened the paragraphs for easier online reading.]

‘Bill White: How is the emergence of recovery as a new organizing paradigm changing the design and delivery of mental health services in the United States?

Larry Davidson: I think the biggest change that the recovery paradigm has introduced, and the change that poses the most difficulty for traditional clinicians to understand and accept, is that recovery is primarily the responsibility of the person rather than the practitioner.

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How Do I Know a Treatment Service is Recovery-Oriented?

Some treatment services today say they are doing recovery—using recovery-based care—when they are not in fact doing so. So how do you know that you are going to receive genuine recovery-based care when you sign up to a treatment service claiming to be recovery-oriented?

Here is some help from Mark Ragins about what to look for in a service offering recovering-based care. Mark may be talking about mental health recovery, but what he says is also of relevance to addiction recovery.

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‘The Four Stages of Recovery’ by Mark Ragins

Here’s a blog I first posted back in May 2013, not long after this website first launched. Mark Ragins is a leading recovery figure in the mental health field. He was a pioneer in setting up MHA Village, a recovery community based in Los Angeles. His writings are well worth a read. Here is what Mark has to say about stages of recovery in an article entitled The Road to Recovery. What Mark says here is just as relevant to people recovering from addiction.

‘Recovery has four stages: (1) hope, (2) empowerment, (3) self-responsibility and (4) a meaningful role in life.

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An Illustration of the Manner in Which Factors Facilitating Recovery Interact

This blog post is taken from part of a chapter in my recent eBook Our Recovery Stories: Journeys from Drug and Alcohol Addiction.

Research I conducted with Lucie James back in 2008 provided important insights into factors that facilitate behavioural change and a person’s path to recovery from addiction. This study involved a qualitative analysis of the views and experiences of clients on the RAPt treatment programme [1] in one male and one female prison. 

Transcripts of the semi-structured interviews with 15 males and 15 females were analysed with Grounded Theory in order to reveal identified concepts and themes. Four inter-related themes were derived from the analysis that were labelled: ‘Belonging’, ‘Socialisation’, ‘Learning’, and ‘Support’. Each of these themes impacted on a fifth theme, ‘Personal Change’, which had two key components, motivation to change and self-esteem.

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Voices in my Head: Eleanor Longden

To all appearances, Eleanor Longden was just like every other student, heading to college full of promise and without a care in the world. That was until the voices in her head started talking. Initially innocuous, these internal narrators became increasingly antagonistic and dictatorial, turning her life into a living nightmare. Diagnosed with schizophrenia, hospitalized, drugged, Longden was discarded by a system that didn’t know how to help her. Longden tells the moving tale of her years-long journey back to mental health, and makes the case that it was through learning to listen to her voices that she was able to survive. [14’18”]

Recovery from Mental Disorders, A Lecture from Patricia Deegan

Patricia Deegan PhD is a psychologist and researcher. She was diagnosed with schizophrenia as a teeenager. For years, Patricia has worked with people with mental disorders in various ways, to help them get better and lead rewarding lives. This film trailer features a lecture by Patricia Deegan on the subject of her own route to recovery. [4’09”]

Learning About Addiction Treatment, Part 7

I continue my story about what I learnt about addiction recovery and treatment from Noreen Oliver, and her staff and clients, during my visits to the structured day care programme at BAC O’Connor back in 2004. (See here for my first blog post relating to these visits).

The majority of the clients at BAC O’Connor had severe and chaotic drug and/or alcohol use, a variety of other problems, including being homeless, and a strong engagement in criminal activities. Many referrals came from criminal justice services. The supported housing programme allowed BAC O’Connor to house and rehabilitate this particularly vulnerable population of clients.

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Learning About Addiction Treatment, Part 6

I earlier began a series of blog posts (starting here) describing what I learnt about addiction, addiction recovery and addiction treatment after I had closed down my neuroscience laboratory in the early 2000s. I started visiting a local treatment agency, local treatment agency West Glamorgan Council on Alcohol and Drug Abuse (WGCADA), in Swansea, South Wales. At the same time, I was conducting an evaluation of projects supported by the Drug and Alcohol Treatment Fund in Wales.

I continue this series of blog posts by describing what happened, and what I learnt, after I first visited the treatment agency BAC O’Connor in 2004. Here is the start of a new story, one where I saw recovery literally oozing out of the walls of a building.

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‘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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Treatment and Recovery Disconnection

William White describes how somewhere in the process of the professionalisation of addiction treatment in the US, treatment got disconnected from the larger more enduring process of long-term recovery.

He points out that we are recycling large numbers of people through repeated episodes of treatment. Their problems are so severe and recovery capital so low, there is little hope that brief episodes of treatment will be successful. We end up blaming them for failing to overcome their problems.

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‘Experiences of a Mother of Two Young Heroin Addicts’ by Mark

A very moving blog which first appeared on Wired In To Recovery (WITR) in May 2009. Mark blogged regularly on WITR until the community closed. I also published this on Recovery Stories in June 2013.

‘We found my 20 year old brother dead of an overdose. He had just kicked the habit so tolerance was low. He started a job and the first payday was his last. Mum wrote this after I got clean. Copy and use it anywhere it can be of use.’ Mark

‘What is it like being the mother of an addict? (Experiences of a Mother of Two Young Heroin Addicts)

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‘A Journey Toward Recovery: From the Inside Out’ by Dale Walsh

I’ve been away visiting family this weekend and haven’t had a chance to prepare a new set of blog posts for this week. I therefore thought I would re-post some of my old favourites from the past this week, which will give me time to prepare new ones for next week. 

One of my favourite articles about recovery was written by Dale Walsh back in 1996 which really summed up what recovery and recovery principles mean to a person who has been suffering from mental health problems. I thought I would highlight some of the main points here. 

The Problem
‘For many years I believed in a traditional medical model. I had a disease. I was sick. I was told I was mentally ill, that I should learn to cope with my anxiety, my depression, my pain, and my panic. I never told anyone about the voices, but they were there, too. I was told I should change my expectations of myself and realize I would always have to live a very restricted life.

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Judith Herman: Trauma and Recovery

511+Nl1uNdL._BO2,204,203,200_PIsitb-sticker-arrow-click,TopRight,35,-76_AA300_SH20_OU01_1. Principles of recovery (healing)
‘The core experiences of psychological trauma are disempowerment and disconnection from others. Recovery, therefore, is based upon the empowerment of the survivor and the creation of new connections.

Recovery can take place only within the context of relationships; it cannot occur in isolation. In her renewed connection with other people, the survivor re-creates the psychological facilities that were damaged or deformed by the traumatic experience. These faculties include the basic operations of trust, autonomy, initiative, competence, identity, and intimacy.

Just as these capabilities are formed in relationships with other people, they must be reformed in such relationships.

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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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Anna’s Moment of Clarity

In two recent blog posts starting here, I focused on a qualitative research project we conducted with family members who have been indirectly affected by substance use problems.

Years after this research was conducted, I received a story written by Anna, who lives here in Australia, which relates how her family coped with her brother’s heroin addiction. I published Anna’s Story on  Recovery Stories and recently updated it in my eBook Our Recovery Stories: Journeys from Drug and Alcohol Addiction. Anna’s story highlights the need for family members to accept that they cannot take ownership of their loved one’s addiction. They are not responsible for the addiction and they cannot do recovery for their loved one.

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The Drug Experience: Cocaine, Part 3

Dan Waldorf and colleagues were ‘pleasantly surprised’ by the relative ease with which so many cocaine users managed to quit. Their research emphasises the importance of one’s personal and social identity in influencing drug use. (895 words)


In the last two Briefings, we focused on the most comprehensive ethnographic study of heavy cocaine users, conducted by Dan Waldorf and colleagues in Northern California. They interviewed 267 current and former heavy users of cocaine, a sample that did not include people in treatment programmes or in prison. Most of the respondents were ‘solidly working- or middle-class, fairly well-educated, and steadily employed.’

This research challenged many of the prevailing myths. In the present Briefing, we look at the process of giving up use of cocaine. Waldorf and colleagues interviewed 106 quitters—30 of these had received some form of treatment, whilst 76 stopped using cocaine without treatment.

When respondents were given a list of personal reasons for quitting, the most common (47% of sample) was given as health problems. The next most cited reasons were financial problems (41%), work problems (36%) and pressure from spouse and/or lover (36%). Only 7% cited actual arrest, although 28% cited fear of arrest as a reason for quitting.

Respondents were also given an open-ended summary question on the most important reason or reasons to quit. A total of 61% mentioned some form of psychological problem or stressful state caused by cocaine as the most important reason to quit. The next most common reasons were financial problems (23%), and severe or recurrent health problems or concerns (19%).

There was great diversity in actions that respondents took to quit using cocaine. Some made a number of attempts to stop before they actually succeeded. They despaired over the hold the drug had over them and had great difficulty in maintaining a resolve to stop using.

However, over a half of the sample stopped using on their first try, although this was not always easy. Two-thirds of the untreated cases stopped on their first attempt, whilst only one in five of treated cases did so.

More than 40% of all quitters reported making some sort of geographic move as part of their successful attempt to quit. Two-thirds of these people said they moved to another city or state, at least in part to help them stay away from cocaine.

The most frequently used strategies for stopping to use cocaine were social avoidance strategies. Nearly two-thirds of the quitters said they had stopped going to places where cocaine was being used, or had made conscious efforts to avoid seeing cocaine-using friends. Over 40% had also sought out new friends who did not use cocaine.

More than 75% of the sample became more concerned about their physical health whilst quitting, and acted upon these concerns. Two-thirds improved their eating habits, and a half undertook new programmes of physical conditioning.

Over half of the quitters sought out new interests, with 39% participating in sports to help them avoid using cocaine. Similarly, 55% of the sample used informal help, such as family or friends, to stop using cocaine.

Only 17% of the sample started using other drugs after quitting cocaine. Of those that did, the majority used only marijuana, which almost all had used before and during their cocaine use. Whilst 21% drank more alcohol, most drank less after giving up cocaine.

Most of this diverse sample had used cocaine heavily for a good number of years—but few were ever merely cocaine abusers. Moreover, their use had not led them to becoming stigmatised. The majority worked regularly, maintained homes, and were responsible citizens:

‘… a commitment to their everyday lives gave them a stake in normalcy and bonded them to the conventional world.’

The sample were different to heroin addicts in other studies, many of whom came from disadvantaged backgrounds, had been criminalised and stigmatised, and had few private resources (e.g. education, jobs).

For many of the present sample, prolonged use of cocaine stopped being fun and started disrupting, rather than enhancing, everyday lives. Since these lives had meaning and value, the difficulties caused by cocaine became powerful spurs for cessation.

The researchers were ‘pleasantly surprised’ by the relative ease with which so many cocaine users managed to quit. Their strategies were in general fairly common-sensical social avoidance strategies, designed simply to put distance between themselves and the drug.

Most of the quitters were able to manage the cravings they experienced after stopping cocaine use. They realised that cravings were only transitory—distractions caused them to subside. New interests and activities provided such distractions. Many quitters found cravings:

‘… little different from yearnings one might feel for an old lover – one feels the desire, but with time it subsides and one thinks of him or her less and less.’

These findings emphasise the importance of one’s personal and social identity in influencing drug use. A commitment to a conventional identity and everyday life helps form the social-psychological and social-organizational context within which control and cessation of drug use is possible.

It is commonly stated that drugs come to dominate identities and lives. This was true in the most problematic cases in the Waldorf study.  However, for the bulk of the sample, identities and lives usually dominated drug use. This is a critical fact that must be remembered when we try to help people overcome problems caused by drugs and alcohol.

Recommended reading:

Cocaine Changes: The Experience of Using and Quitting by Dan Waldorf, Craig Reinarman and Sheigla Murphy. Temple University Press, USA.

> pdf document

Factors Facilitating Recovery: Overcoming Stigma

This is eighth post in this particular Series, which comes from my book Our Recovery Stories: Journeys from Drug and Alcohol AddictionIt ties in nicely with a previous blog, Nothing to mourn; just a drug addict, by Dr David McCartney.

Stigma can be defined as social disapproval of personal characteristics, actions or beliefs that go against the cultural norm. It can occur at a variety of levels in society, i.e. individuals, groups, organisations and systems. A person can be labelled by their problem (e.g. addiction to drugs and/or alcohol) and they are no longer seen as an individual, but as part of a stereotyped group, e.g. a junkie, alkie, etc. Negative attitudes and beliefs toward this group create prejudice which leads to negative actions and discrimination. 

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

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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Factors Facilitating Recovery: Gaining a Positive Identity

People with serious substance use problems lose a lot of the roles or personal characteristics that help define their normal identity (e.g. loving son, athlete, generosity, intelligence) as their dependence on their substance(s) increases, relationships wither and isolation increases. Eventually, their identity as viewed by others may become ‘a useless, dirty addict’. They will also have personal views of what they have become and these views can lead to lowered self-esteem or even intense hatred of oneself.

On the basis of qualitative research with over 100 heroin addicts who had recovered from their addiction without professional treatment, Patrick Biernacki argued that: ‘To change their lives successfully, addicts must fashion new identities, perspectives and social world involvements wherein the addict identity is excluded or dramatically depreciated.’ [1]

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