As a person in long-term recovery – and as an addiction treatment professional – I sometimes find myself getting burned out on recovery culture in the U.S. In the mental health field, burnout is understood as a kind of emotional, physical, and mental exhaustion that results from work overload or a lack of self-care. Today, I’m not talking about that kind of burnout. Instead, I’m referring to the weariness that occurs as a result of watching people die preventable deaths. What do these deaths have to do with our recovery culture? Doesn’t recovery culture save lives? It depends on how you look at it.
We’ve talked about how the recovery community itself can contribute to addiction stigma, as well as the ineffectiveness of widely embraced “prevention” models; but even with irrefutable science to back up the need for recovery culture reform, nothing changes. It would be a gross overgeneralization to say that everyone is resistant to change… but the majority rules. Other countries, i.e. Canada and Portugal, have implemented strategies that drastically lower death rates and we have yet to adopt any of their successful programs.
For example, Insite, a medically supervised injection site for street drug users in Vancouver, Canada, has saved thousands of lives. Not only do safe injection sites keep drug users alive, they also provide a non-judgmental space in which people can build relationships with healthcare providers. These relationships may facilitate treatment or other positive outcomes. Vancouver Coastal Health states: “More than 3.6 million clients have injected illicit drugs under supervision by nurses at Insite since 2003. There have been 48,798 clinical treatment visits and 6,440 overdose interventions without any deaths”.
The Elephant in the Room
One of the most important things I’ve learned in almost ten years of personal and professional experience is that I don’t have to adopt – or even like – an addiction treatment strategy to acknowledge and advocate that it works for someone else.
The recovery process has also taught me to approach the world from a compassionate and gentle stance – which I’ve learned is a way of being that is in alignment with my true spirit – but the problem is that gentle doesn’t always work. According to the CDC, “on average, 130 Americans die every day from an opioid overdose”. This statistic does not even take alcohol and other drugs into account. The death toll from opioid overdose alone reaches the 9/11 fatality mark every 23 days.
Our reaction to these numbers should not be gentle. Our reaction should be loud and proactive. We should be like a herd of organized elephants stampeding through the streets in our eagerness to abolish antiquated ideologies and implement new models.
When we are silent, apathetic, or ego-driven, what we’re really saying is that people with substance use disorder don’t matter. We’re saying that some lives have more value than others.
I have been told on multiple occasions that I should “stop focusing on the problem and focus on the solution”. Okay – fair enough. But before we can discuss a solution, we must first acknowledge a problem exists. And what we like to ignore is how we cling with feverish desperation to a recovery culture that is in need of reform. “If an addiction treatment method works for some people,” we argue, “it should work for everyone”.
Reforming Recovery Culture Starts With You
I often teach about the impossibility of forcing people to change, and I’ve mentioned it numerous times within the scope of the Process blog. I have to follow my own advice and ask, “What can I do differently?” The first thing I can do is stop mincing words to make people feel comfortable. Recovery, after all, means honestly living your truth. I can continue to exercise compassion toward all human beings even when I would rather not. I know I will never love perfectly – but I can try. I can examine how I might be closed off to ideas that have the potential to keep people alive. I can refuse to participate in events that continue to saturate our culture with outdated information – such as those that push a War on Drugs or “just say no” agenda” – or those marked by back patting and self-congratulation. We have not even started to address the crisis of substance use disorder – but it’s more comfortable to pretend we’ve done everything we can.
Although I can’t force change, I can attempt to inspire recovery culture reform by creating calls to action:
If you are a prevention organization, I challenge you to phase out campaigns based on “just say no,” or the idea that education alone is enough. Children and teens need intervention. They need access to trauma treatment and mental health services. They need transparency and positive community connection. They need adults who understand how early childhood development and brain wiring can create a predisposition to seek chemicals that are naturally lacking. These needs are backed by science. This may sound harsh, but every time I see an anti-smoking campaign, I wince. None of these campaigns address the issues at the root of substance misuse, such as untreated mental health symptoms, and unhealthy or abusive home environments. In fact, campaigns that demonize substances may contribute to a child’s shame. Substances are merely survival mechanisms of the suffering. Rich Walters said, “The real gateway drug is trauma”.
If you are interested in learning more about the link between trauma and substance use, Dr. Gabor Mate’s book, In the Realm of Hungry Ghosts, is an excellent resource.
If you are a person in recovery, I challenge you to accept that what works for you may not work for someone else. Too often, we greet foreign recovery pathways with judgement rather than love. While our pathways may differ, people universally need love and acceptance to recover.
I also challenge you to be loud and proud. Sharing your story will save lives. Be wary of self-stigmatizing language. Speak gently about yourself and others. The world is listening.
If you are an addiction treatment professional, I challenge you to evaluate your biases. Not unlike a doctor who takes the Hippocratic Oath, we are required to abide certain ethical standards. Not only are we required to provide non-judgmental addiction treatment, we also have a duty to advocate for people with substance use disorder in the public arena. The National Association for Addiction Professionals includes ‘advocacy’ in our code of ethics: “Addiction Professionals shall advocate for changes in public policy and legislation to improve opportunities and choices for all persons whose lives are impaired by substance use disorders”.
The two most important words in that sentence are “improve choices”. It is not our place to determine which choices a person makes in respect to his or her treatment. It is our responsibility to make sure a person has access to choices.
As addiction treatment professionals, we are not omnipotent. Our favored way is not the only way. If you cannot non-judgmentally support a person’s right to choose – or advocate for new opportunities – you cannot be a competent practitioner in the addiction treatment field. This isn’t my personal opinion – it’s the code of our profession!
If you are a law enforcement officer or first responder, I challenge you to become willing to engage in self-evaluation. First responders are exposed to traumatic incidents on a regular basis. Unfortunately, substance misuse is a widely embraced coping mechanism in first response professions. I challenge you to lead by example and model the utilization of healthy coping skills. How can you expect someone else to change if you are unwilling to evaluate your own behaviors or attitudes around substance use? Asking for help is not a weakness, and we need professionals in leadership positions to light the way.
I further challenge you to ask if you really understand how substance use disorder works in the brain. If you are under the impression that addiction is a failure of willpower, you do not possess an accurate understanding. Until you are willing to investigate the true roots of drug addiction, you will fail to know why it is impossible to arrest or incarcerate our way out of this crisis. While police officers hesitate to consider themselves social workers, it’s important to remember that law enforcement agencies engage the most traumatized and vulnerable members of society. Mental health awareness and an emphasis on compassionate communication will go a long way toward improving outcomes and building bridges.
If you are a concerned member of the public, I challenge you to consider these words by yung pueblo:
They asked her,
“What is the key to saving the world?”
“You. You are the key. Heal yourself, know yourself, make yourself whole and free. Release all limits so that your love can flow unconditionally for yourself and the world, this will open the heaven of your heart completely and it will guide you without fail”.
Autumn Khavari is the Process Recovery Center’s in-house writer. She received an education in Substance Use Counseling from Beal College in Bangor, Maine.