recovery communities

Life In Recovery – Australia (Part 2)

Posted on by alcoholicsguide

“After over five years of intermittent relapses and struggling to re-invent myself, I can safely say that I feel at ease in my own company for the first time in my life. I trust that I will do the right thing by myself and my family”.

 

“…all levels of government need to stop focusing on the policing of drug use and distribution, and invest more in recovery services.

That would slash health care, child care and criminal justice system costs racked up by addicts, while drastically cutting crime rates and creating more valuable contributors to society, the Life in Recovery report says.

The survey, by the South Pacific Private and Turning Point treatment centres, suggests addicts in recovery are 75 per cent less likely to drive while under the influence, 50 per cent less likely to get arrested and 40 per cent less likely to perpetrate or be a victim of family violence.

They’re also 40 per cent more likely to volunteer in a community group, and tend to make more significant contributions to the community than the average person, according to the report’s author, Associate Professor David Best.

Government funding is provided for detox services but virtually no money is spent on the difficult recovery process that follows, despite relapse rates of between 50 and 70 per cent in the first year of recovery, he said.

The focus needs to switch to funding support groups and programs that help addicts get back on their feet, like finding jobs and accommodation, he said.

“None of the treatment services are sufficiently well-funded but the complete neglect of after care and recovery services is both inconsistent with the evidence and counter-productive, because it just puts people into this spiral of relapse,” Prof Best said.

from

http://www.sbs.com.au/news/article/2015/05/05/govt-policy-addicts-wrong-report

reported in

http://www.southpacificprivate.com.au/Life-in-Recovery-Survey-first-of-its-kind

Infographic  of some of the Survey Findings

 

 

 

RECOVERY STATUS There was considerable variation in how people described their recovery:

• 79.8% described themselves as ‘in recovery’

• 6.3% described themselves as ‘recovered’

• 4.5% described themselves as in ‘medication-assisted recovery’

• 3.7% reported that ‘they used to have an AOD problem but don’t any more’

• 5.7% used other ways of describing themselves

Thus, for the vast majority of participants, recovery is seen as an ongoing process.

The majority (69.8%) reported that they had accessed alcohol and other drug (AOD) treatment services meaning that 30.2% had never done so. Of those who had, 36.6% had taken medications prescribed by a health care professional to help them deal with their drug and alcohol problems.

At the time of the survey, 41 individuals (7.2% of the total sample), were currently receiving prescribed medication to deal with their drug and alcohol problems.

A higher proportion (82.0%) had attended a 12-step meeting, with 68.8% attending 12-step meetings at the time of the survey. Current 12-step group attendance involved Alcoholics Anonymous for 57.1% of the sample, Narcotics Anonymous for 24.6%, Gamblers Anonymous for 2.3% and Crystal Meth Anonymous for 1.0%.

11.3% were currently attending Al-Anon (as a loved one or family member) and 6.8% reported that they were currently attending other 12-step groups that included Sex and Love Addicts Anonymous, Overeaters Anonymous, GROW (for co-morbid alcohol and mental health problems) and Adult Children of Alcoholics. SMART Recovery was being attended by 0.5% of the survey participants.

 

1. FINANCES

Changes in financial situation from active addiction to recovery There were marked improvements in paying bills on time, in having your own place to live, in having a good credit rating and paying taxes from when participants were in active addiction to when they were in recovery.

WELLBEING & LIFE

2. FAMILY AND SOCIAL LIFE

…  there were marked reductions in the experience of family violence from around half of the participants during active addiction to less than 10% in recovery, that were accompanied by positive improvements in participation in family activities and planning for the future. There was also a clear improvement in children returning from care and a massive increase in participation of community and civic groups.

3. HEALTH

There are marked differences in health functioning as reported by participants with clear improvements in a range of self-care activities – improved engagement with GPs, regular dental check-ups, improved diet and nutrition and regular exercise. At the same time there is a clear reduction in health service utilisation indicated by marked reductions in the frequency of use of healthcare services and emergency department attendance and improvements in the rate of smoking. There is also a significant reduction in experiencing mental health side effects.

4. LEGAL ISSUES

Changes from active addiction to recovery in offending and criminal justice system involvement There are very striking transitions in involvement with the criminal justice system and overall offending with the most marked transition from 82.9% reporting driving under the influence while in active addiction to fewer than 5% while in recovery. Likewise, while more than half of the sample had been arrested in active addiction, this dropped to around 2% in recovery, leading to significant reductions in family disruption as well as significantly reduced costs to society. This is also reflected in the more than 90% reduction in imprisonment from active addiction to recovery, while there were considerable improvements in re-obtaining both professional registration and the right to drive once in recovery.

5. WORK AND STUDY

Missing work and being fired or suspended, which had been frequent occurrences in active addiction, were extremely uncommon in recovery, as was dropping out of school and university. In contrast, there were clear improvements in positive job appraisals, in further education and in remaining in steady employment.

 

THE SOCIAL NETWORKS AND SOCIAL IDENTITIES OF ACTIVE ADDICTS AND PEOPLE IN RECOVERY

Here the position is even more dramatic with the vast majority of participants reporting no contact with people in recovery while they were active addicts, but that this situation is reversed to the extent that 36% of people in recovery have a social network made up only of people in recovery.

This is reflected in ‘qualitative social capital’ – in other words the number of people individuals can rely on. At the peak of their addiction, 38.3% of participants reported that they had nobody they could discuss important things with compared to 2.0% who reported the same in their recovery. By contrast, while 8.6% of participants reported that they had four or more people they could discuss important things with in active addiction, this increased to 65.9% in their recovery. This is reflected in changes in social group membership – a proxy for connectedness and wellbeing.

…our participants’ social identification with addiction had not diminished but their social identification with recovery had grown enormously.

 

PERSONAL ACCOUNTS OF RECOVERY

THE EXPERIENCE OF ADDICTION

he pain and trauma of addiction is clearly illustrated in the reports of participants. Active addiction is seen as having destroyed the person’s own lives and taken many of the lives of their peers.

“Active addiction completely destroyed any semblance of normality in my life. Everything was reduced to absolutes: the need to get drugs so I could not feel sick, and the use of drugs to numb any emotional or physical pain”.

“Ruined my life in all areas, physically, mentally, emotionally and spiritually”

“I am alive, none of my peers from that time are alive. Only 5 of the 33 people I was in rehab with are still alive”.

THE JOURNEY TO RECOVERY

This journey is not perceived as a quick or easy journey by most of the participants. Many recognised that they have had persistent problems long into their abstinence. However, for most people it is a generally positive transition.

“After over five years of intermittent relapses and struggling to re-invent myself, I can safely say that I feel at ease in my own company for the first time in my life. I trust that I will do the right thing by myself and my family”.

 

“Addiction was part of my journey, I don’t regret it but recovery is so much more comfortable”.

THE EXPERIENCE OF BEING IN RECOVERY

Building on the previous section, this was generally very positive and the following examples illustrate the perceived benefits. Many people spoke of what they had achieved since starting their recovery journey.

“I am a productive member of society today: a good partner, parent, employee, daughter, sibling and friend, and I was not any of those things before”

“I experience long periods of peace of mind. I can manage problems really well. I am less inclined to react negatively to adverse events. I have recovered from Hepatitis C. I have deep and meaningful relationships with friends and family. I feel a wide range of emotions and can (mostly) sit with them. I have experienced 15 years of being engaged with and liked by the community instead of being a pest to society and that is absolute gold”.

POSITIVE ROLE OF TREATMENT OR MUTUAL AID

There were a striking number of comments supportive of 12-step groups, as illustrated by the following:

“AA saved my life because I gradually changed and got my self-respect back”

“AA saved my life; I would be dead without AA”

“I have a brand new life thanks to AA. For me, my children and my grandchildren. I am responsible at work and pay my bills”

“In nearly 30 years I have literally witnessed many hundreds of people turn their lives around from chaos and mayhem to lead similarly fruitful lives to the one I live today, overwhelmingly through the agency of their involvement in 12 step programs”

“I could not stop drinking on my own. AA has shown me a new way of living. Life is not perfect but I can now live like a ‘normal’ person. I have self-respect and dignity and I am a good worker and mother”

COMBINED APPROACHES Furthermore, as is consistent with the literature, a number of respondents talked about the benefits of bespoke and blended support from both mutual aid groups and professional treatment services.

“I am an active participant in the AA program – the 12 steps are my program for recovery. Putting the 12 steps in my life and putting the skills I learned at South Pacific Private into my life have given me a life that is full of understanding, patience, great relationships and love”.

“Detox set me on the path to recovery and AA helped me to sustain my recovery”, while a third respondent reported that “recovery through detox, rehab clinic, 12 step program with AA has completely changed my life and my attitude to life. I feel free and have choices and I am happy for the first time in years”

The overall conclusion by the majority of participants is that recovery is experienced as liberation and is an opportunity not just for a normal life but a meaningful and fulfilling one. That does not mean recovery is without regrets or without problems :

“My addiction was hell, my recovery has been amazing. I will be forever grateful for the second chance I was given. It took a long time to feel a part of the world when coming out of addiction. It was so hard to fit in with a world I felt so uncomfortable in. But now I love every day. I suffer with depression, and it has been harder than active addiction was but it is in remission and I have learned to live with it. My children are my greatest blessing and I have been able to break the cycle”.

 

Why Alcoholics Anonymous Works

Posted on by alcoholicsguide

A journalistic piece entitled,  “The Irrationality of Alcoholics Anonymous “, written by  Gabrielle Glaser, also harshly criticizes Alcoholics Anonymous. AA and similar 12-step programs.

I cite a blog on her criticisms here (1)

Why Alcoholics Anonymous Works

“Glaser’s central claim is that there’s no rigorous scientific evidence that AA and other 12-step programs work.

First, she writes that “Unlike Alcoholics Anonymous, [other methods for treating alcohol dependence] are based on modern science and have been proved, in randomized, controlled studies, to work.” In other words, “modern science” hasn’t shown AA to work.”

Glaser appears to lessen her argument by suggesting that AA is difficult to study (so how can she be so sure it is not effective then?).

” Alcoholics Anonymous is famously difficult to study. By necessity, it keeps no records of who attends meetings; members come and go and are, of course, anonymous. No conclusive data exist on how well it works.”

Equally there, in her world view, would also be no conclusive data to suggest if doesn’t work? So why make bold claims either way?

” In 2006, the Cochrane Collaboration, a health-care research group, reviewed studies going back to the 1960s and found that “no experimental studies unequivocally demonstrated the effectiveness of AA or [12-step] approaches for reducing alcohol dependence or problems.”

According to (1), Glaser is simply ignoring a decade’s worth of science, not only here but throughout the piece.

“No, that’s not true,” said Dr. John Kelly, a clinical psychologist and addiction specialist at Massachusetts General Hospital and Harvard Medical School. “There’s quite a bit of evidence now, actually, that’s shown that AA works.”

Kelly, alongside Dr. Marica Ferri and Dr. Keith Humphreys of Stanford, is currently at work updating the Cochrane Collaboration guidelines (he said they expect to publish their results in August).

” Kelly said that in recent years, researchers have begun ramping up rigorous research on what are known as “12-step facilitation” (TSF) programs, which are “clinical interventions designed to link people with AA.”

Dr. Lee Ann Kaskutas, a senior scientist at the Alcohol Research Group who has conducted TSF studies, suggest that TSF outperforms many alternatives.

“They show about a 10 to 20 percent advantage over more standard treatment like cognitive behavioral therapy in terms of days abstinent, and typically also what we find is that when people are engaged in a 12-step-oriented treatment and go to AA, they have about 30 percent to 50 percent higher rates of continuous abstinence,” said Kelly.”

The original Cochrane paper that Glaser cites came out before the latest round of studies did, so that research wasn’t factored into the conclusion that there’s a lack of evidence for AA’s efficacy. In a followup email, Kelly said he expects the next round of recommendations to be significantly different:

Although we cannot as yet say definitively what the final results will bring in the updated Cochrane Review, as it is still in progress, we are seeing positive results in favor of Twelve-Step Facilitation treatments that have emerged from the numerous NIH-sponsored randomized clinical trials completed since the original review published in 2006. We can confirm that TSF is an empirically-supported treatment, showing clinical efficacy, and is likely to result also in lowered health care costs relative to alternative treatments that do not link patients with these freely available recovery peer support services. Another emerging finding is that a central reason why TSF shows benefit is because it helps patients become actively involved with groups like AA and NA, which in turn, have been shown to enhance addiction recovery coping skills, confidence, and motivation, similar to professional interventions, but AA and NA are able to do this in the communities in which people live for free, and over the long-term.

In other words, the most comprehensive piece of research Glaser is using to support her argument will, once it takes into account the latest findings, likely reverse itself.”

In other words, it will also help contradict Glaser’s arguments.

“In an email and phone call, Glaser said that TSF programs are not the same thing as AA and the two can’t be compared. But this argument doesn’t quite hold up: For one thing, the Cochrane report she herself cites in her piece relied in part on a review of TSF studies, so it doesn’t make sense for TSF studies to be acceptable to her when they support her argument and unacceptable when they don’t.

For another, Kelly, Katsukas, and Humphreys, while acknowledging that TSF programs and AA are not exactly the same thing, all said that the available evidence suggests that it’s the 12-step programs themselves that are likely the primary cause of the effects being observed (the National Institutes of Health, given the many studies into TSF programs it has sponsored, would appear to agree).”

“It’s worth pointing out that while critics of AA point it as a bit cultlike…to the researchers who believe in its efficacy, there’s actually very little mystery to the process. “We have been able to determine WHY these 12-step facilitation interventions work,” said Kaskutas in an email. “And we have also been able to determine WHY AA works.”

Simply put, “People who self-select to attend AA, or people who are randomized to a 12-step facilitation intervention, end up having people in their social network who are supportive of their abstinence,” she said.

Reams of research show that social networks…are powerful drivers of behavior, so to Kaskutas — who noted that she is an atheist — the focus on AA’s quirks and spiritual undertones misses the point.

“When you think about a mechanism like supportive social networks, or the psychological benefit of helping others… they have to do with the reality of what goes on in AA, with people meeting others in the same boat as they are in, and with helping other people (are but two examples of these mechanisms of action),” she said.”

At the heart of recovery via 12 step groups may be because it “works for a lot of people, simply by connecting them to others going through the same struggles.”

 

 

France - Alcoholic Anonymous celebrates its 75th year

 

 

 

Life in Recovery

Posted on by alcoholicsguide

The cost of addiction and the benefits of recovery are clearly illustrated in this survey from last year.

“Faces & Voices first-ever nationwide survey of persons in recovery from addiction to alcohol and other drugs was conducted by Alexandre Laudet, PhD.  The survey documented dramatic improvements in all areas of life for people in recovery from addiction and documents the heavy costs of addiction.

During their active addiction, 50 percent of respondents had been fired or suspended once or more from jobs, 50 percent had been arrested at least once and a third had been incarcerated at least once…

The dramatic improvements associated with recovery affected all areas of life including a 50 percent increase in participation in family activities and in paying taxes compared with their lives in active addiction.

Well the many costs of active addition are well documented, very little is known about the changes in key life areas as a function of entering and sustaining recovery, or when they occur. The survey measures and quantifies the recovery experience over time — less than 3 years; 3 to 10 years; and 10 years or more.

ADDICTION RECOVERY IS ASSOCIATED WITH DRAMATIC IMPROVEMENTS IN ALL AREAS OF LIFE

  • Involvement in illegal acts and involvement with the criminal justice system (e.g., arrests, incarceration ) decreases by about ten-fold
  • Steady employment in addiction recovery increases by over 50% greater relative to active addiction
  • Frequent use of costly Emergency Room departments decreases ten-fold
  • Paying bills on time and paying back personal debt doubles
  • Planning for the future (e.g., saving for retirement) increases nearly three-fold
  • Involvement in domestic violence (as victim or perpetrator) decreases dramatically
  • Participation in family activities increases by 50%
  • Volunteering in the community increases nearly three-fold compared to in active addiction
  • Voting increases significantly
  • Reports of untreated emotional/mental health problems decrease over four-fold
  • Twice as many participants further their education or training than in active addiction

 

THE BENEFITS OF ADDICTION RECOVERY OVER TIME

  • The percentage of people owing back taxes decreases as recovery gets longer while a greater number of people in longer recovery report paying taxes, having good credit, making financial plans for the future and paying back debts.
  • Civic involvement increases dramatically as recovery progresses in such areas as voting and volunteering in the community
  • People increasingly engage in healthy behaviors such as taking care of their health, having a healthy diet, getting regular exercise and dental checkups, as recovery progresses
  • As recovery duration increases, a greater number of people go back to school or get additional job training
  • Rates of steady employment increase gradually as recovery duration increases
  • More and more people start their own business as recovery duration increases
  • Participation in family activities increases from 68% to 95%.

ABOUT THE SURVEY

The online survey was developed, conducted and analyzed in collaboration with Alexandre Laudet, Ph.D., Director of the Center for the Study of Addictions and Recovery at the National Development and Research Institutes, Inc.  It was conducted between November 1 and December 31, 2012 and collected information on 3,228 participants’ sociodemographics, physical/mental health, substance use, and recovery history, and 44 items representing experiences and indices of functioning in work, finances, legal, family, social and citizenship domains…”

This survey help us see that recovery studies help us a societies to look beyond the illness to the recovery of the illness. It helps change our views.There is active addiction and recovery from addiction. We need to keep doing research into this wonderful new world of recovery.

It all helps de-stigmatise this condition so that many more can join us on the road to recovery.

I am not just the disease of addiction, I am the recovery from it.  

Reference

http://www.facesandvoicesofrecovery.org/resources/life-recovery-survey

 

 

Healing Communities via Recovery

Posted on by alcoholicsguide

Recovery is healing. From the personal to the communal. Here is a great example of recovering in recovery communities. It illustrates how recovery is a gradual move from isolation from,  to commune with other people.

We recover via communal contact and interaction with others. It is the new “secure attachment” with others which helps heal and also repair the neurobiology impaired by addictive behaviours.  It helps heal not only us but also our families and the communities we belong to. Love is the drug for me (and us).

The Healing Power of Recovery – Connecticut  Community of Recovery – how community recovery also helps individuals overcome feeling stigmatised by their condition and can feel more encouraged to seek treatment for their addictive behaviours.  So in a sense we can see recovery communities are passing the message of recovery on to others by putting a “face on recovery” acting as role models of recovery. Attraction and promotion.

For me this recovery community is showing the world “how it works” in a sense, the collective wisdom of recovery we often share among ourselves in recovery meetings but now share this with the wider society; this is what we got and what you can have.   We will help you get it too if you want it. This is how we all get better, recovering together.

 

Recovery is Contagious

Posted on by alcoholicsguide

In our final blogs on the invaluable insights into the Recovery process given by the research and experience of William White we finish by looking at the rise of recovery communities in the US in particular and discuss whether this “New Recovery Advocacy Movement” is the future of recovery (treatment) which is much more long term recovery orientated rather than simply treating this chronic condition of addiction as an acute disorder which is generally what treatment centres do.

We may have to move away from a narrow neurobiology of addiction (disease model) to a wider neurobiology of recovery (recovery model). We may have to make it more plain to the world that recovery happens all the time and that millions upon millions around the world are in long term recovery, and have a very high chance of remaining so.

That is not to say we should not continue to look within the brains of addicts to learn which neural and affective mechanisms propel this disorder forward but that research into addiction needs to be much less lopsided and negative. It needs to look at vulnerability and the progression of this condition but it also needs to more fully address the recovery stage too. It is like reading a page turning novel only to find the riveting denouncement has pretty much been omitted. Research needs to move from diagnosis of the problem to prognosis of the solution, i.e. recovery.

The shares of a 12 step meeting are some of the greatest stories of redemption you are likely to hear. The outside world needs to know how these stories are created, yes, but also how they are resolved via recovery. The outside world needs to hear the story does not end with recovery, in some ways this is where the story really gets interesting. The spiritual voyage of recovery is a story those suffering from addictive behaviour need to hear. Otherwise, research demoralises, rather than encourages. It perpetuates a unnecessarily negative view and a false picture about the reality of long term recovery for many millions of people, their families and communities.

Clinical neuroscience, in particular, needs to show the images to go with these stories otherwise it is falling down on it’s obligations to society and the greater world.

Science has not sufficiently shown us how the brain is altered in a positive, adaptive, healthy manner by behavioural changes associated with long term recovery. The major role of science is to predict behaviour. It needs to start demonstrating and confirming that if an addict starts doing certain behaviours, certain positive outcomes will follow. It needs to illustrate the neuroplasticity so that suffering people can clearly chart, in a rational manner, the course of wellness ahead.

I remember seeing the Jellinek Curve in treatment and was re-assured that this was a disease that one could clearly recover from and within a defined trajectory. It showed me rationally how others had done this recovery thing and how I could and would if I wanted to achieve what they had achieved.

Rather than the constant search for a “magic pill” should we not be celebrating in research this wonderful success story called long term recovery. Isn’t this one of the greatest stories out there?

Anyway, back to William White and his powerful advocacy of recovery communities which as he suggests may make students of us all when some of use thought we were teachers.

The story moves on, becoming more enriching and inspiring.

There is a movement towards the management of long term recovery from an acute treatment model. There have been new developments like recovery coaches which show an increasing focus on long term recovery.

There is also an emergence of a recovery movement that has not historically existed before. “Recovery is everywhere” campaigns organised not by treatment centres but by local, grass-root, recovery community organisations. They are not mutual aid or treatment based. They have never had a category to put them in until now.

We are seeing the mobilisation of people in recovery. We are seeing a number of New Recovery Support Institutions such as Recovery Community Centres, offering non clinical recovery support services for individuals and families in long term recovery, Recovery Homes, Recovery Schools movement, Collegiate recovery programs, recovery industries who realise that people in recovery make the best and most hard working employees, recovery ministries, religious base recovery communities like including Celebrate Recovery which is attached to over 10,000 churches throughout the US, Recovery Cafes, and an ever increasingly elaborate interconnection of recovery resources.

William White ends with an intriguing suggestion that we may, via these increase recovery support organisation and via our own long term recovery be able to break the chain of dependence in our own children.

This way seem somewhat far fetched to some but equally it may be possible to identify the ways genes are expressed by certain behaviours in certain environments and for these to be altered by a change in these behaviours as the result of recovery and for environments to be changed too.

If, as we have suggested, addiction is at heart an emotion processing and regulation disorder, we could intervene to shore up these skills in those vulnerable to alter addiction by teaching sharing emotions, identifying and labeling of emotions, verbalisng of emotions etc, because we are attacking the pathomechanism of addiction, the mechanism by which addiction is propelled.

In doing so we may have a fighting chance of altering the course of possible addiction. So what has always been seen as inevitable (drunks beget drunkards) may for the first time in history not be so straight forward, so inevitable. This pathomechanism may be malleable and be susceptible to us changing the course of a likely disorder. In doing so, it will affect the chain of genetic inheritance from one generation to the next?

Fanciful or possible?

We discuss our ideas and William White’s ideas on this in another blog.