‘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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Behind the Pages with Bessel Van Der Kolk, MD

December 2, 2014 by

“The vast majority of drug abuse is associated with earlier trauma. It’s very rare to see somebody who becomes a drug addict who not also has a history of abuse and neglect.” Bessel Van Der Kolk, MD

Behind The Pages host Diane Goshgarian interviews author Bessel Van Der Kolk, MD about his new book The Body Keeps The Score: Brain, Mind, and Body in the Healing of Trauma. Interview recorded at 22-CityView Cambridge on October 08, 2014.

As I said last week, this book is essential reading if you are working in the mental health and addiction fields.

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‘The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma’ by Bessel van der Kolk MD

November 28, 2014 by

UnknownI have been saddened over the years by how little attention the addiction treatment field pays to the role of trauma in the development and maintenance of addiction. Tremendous efforts are made to argue that addiction is a disease or the person’s fault, but where are the arguments about the role of trauma (Gabor Mate being a notable exception)?

It is quite possible that the majority of people who develop an addiction to drugs and alcohol suffer from the impact of trauma. They use drugs (illicit and prescription) and alcohol as a coping mechanism. Many of these people will have been traumatised as children, and many will have been retraumatised through their experiences in the treatment system. 

I am just finishing an extraordinary book which is essential reading for anyone interested in trauma. I amazed by the advances that have been made in our understanding of trauma – in terms of its effects on our brain, mind and body – and how we can help people heal from its impact.

Bessel van der Kolk has written a classic. And the work that he and his colleagues – and a whole network of centers around the US – are doing is remarkable. As a scientist, it really excites me. As a person who cares, it really gives me hope.

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Classic Blog – ‘How do I know a treatment service is recovery-oriented?’ by Mark Ragins

November 12, 2014 by

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, a leading figure in the mental health recovery field, 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 of relevance to addiction recovery.

In summary, Mark emphasises three key features of recovery-based care:

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‘A Discussion of Labels, Part One: Disability’ by Melissa Bond

October 20, 2014 by

mbondI’m very wary of labels in health. Here’s a great blog and beautiful writing from Melissa Bond on the Mad in America website on labels.

‘When my son was born six years ago, the word “disabled” was suddenly all around me. It came from everywhere – the nurses, the doctors, the physical and occupational therapists, friends and family.

I remember looking into his ice blue eyes and so marveling at the lines of white that extended so symmetrically from his irises that I began calling him Star Boy. I felt a new mother’s sense of protection. The label surrounding my Star Boy was a smoke so thick I felt I could barely breathe.

Disabled. My boy with an extra chromosome was disabled. He wore a label that expressed negation, a subtraction. He was defined by the world at large by the Latin prefix denoting “apart,” “away,” or “having a privative and reversing force.”

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‘Stigma Reduction Through Recovery Contact’ by Bill White, Tom Hill and Greg Williams

October 15, 2014 by

Silence PosterMore insightful writing from Bill White and colleagues.

‘Debates continue on whether the stigma attached to persons experiencing alcohol and other drug (AOD)-related problems has a positive or negative social effect on the nature and magnitude of these problems.  Stigma promoters argue that public castigation of excessive AOD users prevents such use at a cultural level and exerts pressure for AOD deceleration/cessation among those with AOD problems.

Stigma detractors argue that such castigation inhibits help-seeking, forces excessive AOD users into subterranean drug cultures, promotes their sequestration through mass incarceration, poses barriers for the reentry of people seeking recovery into mainstream society, and places undue blame on individuals and groups while ignoring the ecology of addiction – the environmental conditions in which alcohol and other drug problems flourish.   

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‘Stigma and Service Integration’ by Bill White

September 21, 2014 by

Stigma and Service Integration ImageIn his latest blog, Bill White emphasises the importance of Recovery Stories and their value in tackling stigma.

‘One of the emerging trends of U.S. health care reform is the tri-directional integration of addiction treatment, mental health services, and primary health care.  This is evident in the growing integration of addiction and psychiatric treatment under the rubric of “behavioral health care,” efforts to integrate primary health care within addiction treatment settings, and increased delivery of addiction-related services within primary health care settings, e.g., physician offices, health clinics, and hospitals.

Considerable resources have been invested in creating policy frameworks for such integration (e.g., provisions for office-based treatment of opioid dependence) and developing technological innovations (e.g., screening, assessment, and treatment protocol) to facilitate such integration, but history would suggest a far greater obstacle to service integration:  social and professional stigma.

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Human Healing in the Age of Science – The Art of the Healing Shift: Dr David Reilly

September 1, 2014 by

I believe passionately that our systems of care for mental health and addiction are broken and need transformation. Sadly, the same systems of care are generally resistant to change.

The situation continues to get worse for two primary reasons. Firstly, the negative consequences of modernity include an increase in emotional distress, disconnectedness, social isolation and addictions of various kinds. Ever increasing numbers of people are looking for help.

Secondly, the poor outcomes of our mental health and addiction care systems are leading to disempowerment and lack of hope, which in turn further increase the problems described above. Moreover, people seeking help are often blamed for not getting better, rather than the system accept its own shortcomings.

We have the knowledge to do so very much better. Sadly, those of us who are trying to transform these systems so that more people get better often bang our head against a brick wall. Vested interests play an important role in underlying this resistance to change.

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Open Paradigm Project – Matt Samet

August 26, 2014 by

Rock climber, author, and Mad in America Blogger Matt Samet discusses his experience becoming addicted to, and subsequently coming off of, benzodiazepines. Check out Matt’s book Death Grip: A Climber’s Escape from Benzo Madness.

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Essential reading: ‘Speed’ by Stephanie Brown, Ph.D

August 20, 2014 by

I’m reading the excellent book, Speed: Facing Our Addiction to Fast and Faster – And Overcoming Our Fear of Slowing Down, by one of my favourite recovery thinkers/writers, Stephanie Brown. It’s well worth reading. Here is what is written on YouTube.

‘MORE, BETTER… SLOWER.

Feeling rushed, out of control, and overwhelmed?
Feeling like you can’t keep up…and can’t stop?
It’s not just you.

From the need to be constantly connected and the changing definition of “work hours,” to unrealistic expectations of instant gratification, our bodies and brains are being harmed by habits that, as with any kind of addiction, promise short-term satisfaction while doing long-term damage.

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‘From the Rooms to the Streets’ by Bill White

August 12, 2014 by

Unknown-1‘Until recently, recovery from addiction was shrouded in public secrecy in the United States and in most other countries. Addiction has long been viewed as a personally and culturally intractable problem, and pessimism has reigned about the prospects of long-term addiction recovery.

These perceptions have been fed by the unrelenting public visibility of addiction-related problems, but the comparable invisibility of stable, long-term addiction recovery.

Historically, most people in recovery either completely eschewed recovery status (refused the addiction and recovery labels and culturally “passed”) or regularly cloistered themselves in “the rooms” of recovery mutual aid meetings before repeatedly and invisibly re-entering their civilian roles without acknowledgement of their recovery status.

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‘Recovery for a Higher Purpose’ by Bill White

July 31, 2014 by

Recovery for a higher purpose“The greatest danger for most of us is not that our aim is too high and we miss it, but that it is too low and we reach it.” Michelangelo

It is one of the most beguiling qualities of the experience of addiction:  it sucks up everything of importance in your life and casts those cherished assets into the remotest reaches of one’s heart, leaving nothing but itself. This all occurs an inch at a time and second by second – increments so small they escape the category of decisions.

It is at the end of such a process that one cluster of fears stands greater than the full awareness of what has been lost.  That is the terror of one’s own emptiness and the gaping nothingness of one’s future.  Those latter breakthroughs of consciousness can fuel unending cycles of oblivion and sickness and take damaged souls to, or beyond, the brink of suicide.

These same fears pose a significant obstacle to recovery initiation.  That’s why the promise of recovery must offer more than the removal of alcohol and other drugs from one’s life.  For the person staring into the abyss, the promise of recovery to a life of meaning and purpose may be far more potent than the promise of recovery from addiction.

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Overcoming Drug Addiction: Darren’s Recovery Story

July 30, 2014 by

Here’s one of a number of short films abut recovery that is worth checking out.

‘The Alcohol & Drug Service (ADS) has been transforming lives for more than 25 years. Here is one true story about Darren, a young man from Grimsby, who has battled back from addictions to drugs to reclaim his life and rebuild relationships with family.

Darren was supported in his recovery by The Junction, a service which The Alcohol & Drug Service delivers in partnership with Rotherham Doncaster & South Humber NHS Foundation Trust.’

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‘Benzodiazepine Guidance’ by djmac

July 29, 2014 by

Diazepam-3‘SMMGP has published guidance for using benzodiazepines and benzo-like drugs in primary care. It’s a comprehensive 60+ page document which covers most (but not all) of the bases and reinforces the need for caution when prescribing the drugs.

The guidance is so long in coming because consensus could not be reached. Benzo prescribing is an issue where people have strong views.

The guidance sets out a major problem: that current prescribing guidance is that these drugs should not be used for more than 2-4 weeks, but in practice this is widely flouted with over one million people on these in the long term.

As I say the document is comprehensive, so I’ve just picked out a few nuggets here.

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Climbing out of addiction and depression: Margo Talbot at TEDxCanmore

July 27, 2014 by

Great talk and pics and one hell of a recovery!

‘Current research suggests that addiction and depression are symptoms of emotional distress, not causes of it, forging the link between childhood trauma and mental illness. Margo Talbot’s journey supports these studies.

Diagnosed Bi Polar at age twenty-two, Margo spent the next fifteen years in suicidal depression before discovering the healing power of presence as the antidote to emotional trauma. Being present to our thoughts and emotions, not running the other way or masking them. Where best to practice the art of presence than the frozen world of ice climbing…

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I Am Not Anonymous: Faith’s Story, “One More Chance’

July 23, 2014 by

Faith-Text-1024x681(pp_w1000_h665)Another wonderful story from I Am Not Anonymous, which helps us feel what addiction is like and experience the personal joys of recovery. Thank you, Faith.

‘Until I got clean and sober, I never knew that other people experienced the same pain and emptiness that I used drugs and alcohol to escape from. Even when I was a little girl I felt like a part of me was missing – I felt alone, afraid, uncomfortable, and incomplete.

I remember looking up in the sky at airplanes and wishing I could trade places with someone on them. It didn’t matter who it was or what the destination was, I just wanted to be anyone else and anywhere else… and I didn’t know why.

I started using drugs and alcohol in my early teens and they took me very temporarily to the place I thought I always wanted to be. They gave me relief from myself, my insecurities, my fears, and my loneliness. They made me feel “okay” with who I was, where I was, and who I was with, but they came with a price. At the time they seemed worth it.

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

July 17, 2014 by

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.

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I Am Not Anonymous: Adam’s Story, ‘An Open Book’

July 15, 2014 by

Adam-Text-1024x681(pp_w1000_h665)‘For the entirety of my addiction – many sad, painful years of car accidents, overdoses, barroom brawls and street fights, failed relationships, small-time legal skirmishes and stints at rehabs – everyone wanted me to admit I had a problem, to talk about it.

Then, after I got clean and sober and became a husband, father, hockey dad and a union president that negotiated my co-workers salaries and medical benefits, many people wanted me to put it behind me, to shut up about it.

The planet witnessed the train wreck, yet I was supposed to cover it up after I got that bad boy back on the rails, which was no small feat.

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I Am Not Anonymous: Mariel’s Story, ‘Together We Can’

July 14, 2014 by

Mariel-Text-1024x681(pp_w1000_h665)I’ll be finishing off Bill White’s talk this week, as well as highlighting some stories from the excellent website I Am Not Anonymous. Here’s the first of these stories.

‘My name is Mariel Harrison. I am 28 years old. I live in Point Pleasant, NJ. I am a daughter, sister, aunt, girlfriend and friend. I am also a consumer, a voter, a tax-payer, a home-renter, and a licensed/registered/insured driver.

I am a responsible, productive and valued employee. I am a diligent full-time student with a 3.9 GPA. I believe wholeheartedly in the healing properties of yoga and meditation, am a certified yoga teacher, lived in an ashram for 9-months, and hold nothing more sacred then my personal practice both on and off the mat.

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‘Experiencing Recovery – Part 6′ by William L. White: Recovery Durability Set Point

July 10, 2014 by

When does recovery become durable? When does sobriety today predict sobriety for a lifetime? When does my risk of resuming alcohol and drug use and having a recurrence of a substance use disorder plummet?

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