Rebellion Dogs Radio Episode #48 – October 2019 View/Download as a PDF CLICK HERE
Recovery Capital Conference “chimes” in with the latest in recovery policy and practices
”Hello, from the New Westminster 2019 Recovery Capital Conference main-stage,” Pictured here are Dr. Ray Baker and Jessica Cooksey talking about Recovery Oriented Systems of Care to treatment professionals, policy makers and harm reduction care givers.
A warm shout-out to my NAADAC friends (American Association of Addiction Treatment Professionals) who met in Orlando for the 2019 annual conference. Sorry I couldn’t make it this year – I have been lurking at social media and presentation materials on the http://www.naadac.org site. It looked from We The North like another great year.
Last year, at Recovery Capital Conference in Canada, we talked with Giuseppe Ganci (Conference Chairperson) of Last Door Recovery Society about this conference. The feeling among organizers was that we get together to talk about addiction a lot; how about a conference to explore, study, brainstorm about recovery? That’s what the Recovery Capital brand is all about. Dr. Ray Baker will join me on Rebellion Dogs Radio for a recap of his Vancouver, Calgary, Regina, Halifax and Toronto stops for the tour. Jessica Cooksey and he were on the program at every stop.
But first, Step One: let’s talk about the state of addiction or more broadly substance use, today. Here’s some findings from the 2018 Substance Abuse and Mental Health Services Administration (SAMHSA) study of drug use and health[i].
Here’s some big numbers for context: This is just substance use, so it includes recreational use as well as addiction. 60% of people surveyed use alcohol, tobacco and prescription or street drugs. So, there is 109 million who didn’t use anything in the last month – 109 million sober people – so much for excuse #1: Everyone’s doing it. Of 165 million people who use mind/mood altering substances, alcohol is #1 with almost 140 million Americans drinking, 60 million smoke tobacco and 28 million smoke weed. The misuse of pain relief medicine make up 3 million and another 1.7 million misused prescribed stimulants. Two million’s drug of (no) choice was cocaine. Then the numbers go down for methamphetamine, hallucinogens and heroin at the bottom with 354,000 Americans who used in the last month.
News pegs are all about opioids and tobacco but booze is #1. Let’s get into our area of interest where alcohol is concerned and these numbers may play out for other substances, too. Of 140 million drinkers, 67 million are binge drinkers (48%). “Heavy alcohol users” are estimated at 16.6 million – that’s 25% of any of the binge drinkers and 11.8% of all users.
Here are some noteworthy findings:
The percentage of people with Alcohol Use Disorder in the past year has declined from 2002 to 2018.
18 to 25-year-olds are the most likely to have AUD than any other age group.
For people “aged 12 or older with a past year substance use disorder”, 15 million Americans have an alcohol disorder, 8 million are affected by illicit drugs, 4 million with marijuana, 1.7 million with pain reliever-misuse.
Total past-year Substance Use Disorder (SUD) cases adds up to 20.3 million people. “Double winners,” people with both alcohol and illicit drug use disorder are 2.7 million people.
My point here, before we turn to talk about recovery, is to identify the clear and present need for people who may be trying to transition from substance use disorder to recovery.
And recovery is working. Psychiatry.org reported that while we’re going to meetings, they are taking notes and compiling data:
A new meta-analysis examines 20 randomized controlled studies of spiritual or religious based programs for substance use problems. Previous research has identified spirituality and religiosity as having important roles as a protective factor against substance use and in recovery from substance use disorders. Spiritual/religious based interventions, such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), are commonly part of treatment for substance use problems. This study is the first systematic review and meta-analysis looking at the efficacy of spiritual/religious based interventions for substance use problems.
This report recognizes AA/NA, etc. as religious. That might not be your experience or my experience, especially if you mainly go to secular 12-Step meetings but as Joe Nowinski, author of If You Work It, It Works!: The Science Behind 12 Step Recovery report: studies show that, while atheist/agnostics are less likely to attend 12-Step meetings, those who do attend, respond and do as well as our more religious members.
The Psychiatry.org report from this fall[ii] goes on to say:
The researchers looked at two types of outcomes – substance use reduction/abstinence and improvements in psycho-social-spiritual outcomes (such as spiritual coping, depression, anxiety, employment, relationships).
Most of the studies in the meta-analysis involved Twelve Step Facilitation programs. These programs involve a series of counseling sessions with a professional counselor based on principles of 12-step fellowships such as AA and NA… Based on their analysis of these programs, the research authors conclude that … spiritual/religious based programs were more effective at reducing or eliminating substance use and equally as effective as other programs on broader measure of wellness and function.
Separate studies compare 12-Step approaches to SMART, Women for Recovery and Life Ring and these studies find that a “group of drunks” by any other name, gleans the same positive outcomes.
Episode # 48 includes Dr. Ray Baker, chatting with you about this year’s conference. Ray is a retired addiction medicine doctor and soon-to-be author. Ray (doing most of the work) and me (coaching and publishing) are working on a book together that will be new for 2020 about Recovery Capital. Along with Jessica Cooksey, he was speaking to people about “What is Recovery Capital and what is a Recovery Oriented System of Care?”
I joined Ray and the whole New Westminster BC (Vancouver if you don’t know the Lower Mainland of British Columbia) for the 2019 kick off two-day event. A highlight was the presentation of recent research by David Best, Professor of Criminology in the Department of Law and Criminology at Sheffield Hallam University and global expert relating to the addiction recovery field and for the Recovery Movements in the UK and Australia. David Best is the author of nearly 200 peer-reviewed academic papers and another 70 technical reports. This Fall, his new book comes out: Pathways to Desistance and Recovery: The Social Contagion of Hope. I can’t wait.
David Best argues—based largely from his findings—that recovery includes identity change, and four other factors. Research shows that for people emerging from rehab and/or detox, if they know just one person in recovery, this significantly improves outcome rates. From a 2011 British Journal of Psychiatry, David Best reveals the five CHIME “charms” that enable recovery: Connectedness, Hope, Identity, Meaning and Empowerment.
David Best aims to advance a social identity model as a mechanism for understanding the journey to recovery or desistance and the centrality of reintegration into communities for a coherent model and public policy around addiction recovery,[iii] to quote him directly.
I’ll get the exact details that follow wrong and I am undertaking to arrange an interview with this guy to assure I get the facts straight, but I am confident I’m in the ballpark. A study was done—Maybe the UK, USA and Australia—as an extensive longitudinal study that identifies, of persons with substance use disorder who reach out for help, what percentage will be living in recovery five years later—or was it attained five consecutive years—that’s why I need this book, and Dr. Best, if you’re out there—call me; let’s talk. But the percent that met this standard of this study was 58% making it. So, you have a problem with alcohol or other drugs and want help? Chances are it will work; you have better than a 50-50 odds at recovery over addiction.
These same researchers went to, or back to, treatment professionals who helped facilitate these findings. People who treat us were asked, “What percent of people transitioning from addiction to recovery will make it five years?”
Frontline workers were asked how they thought we’d do, and their answer was—on average—7%.
That’s pessimistic. Professionals have a negative bias when they start their day at our detoxes and treatment centers each day. Now in part, this is forgivable; they deal with the chronic recidivism, the retreads that keep cycling through the system. Addiction counselors don’t work with people who are quickly transformed to high scores of recovery capital. These people don’t need ongoing or recurring care.
Best sees optimum care as being three stages: Measure, plan and engage. The presentation was a dose of sober second thought and I will endeavor to have David Best as a guest soon.
But we have Dr. Ray Baker on Rebellion Dogs Radio this show; so “One day at a time!” From beautiful downtown Toronto, Ray will give us a city by city comparison of the problems each area is facing and the audience that attended, plus we’ll talk a bit about his presentation, our upcoming book and where to search the web for resources—and how to guard against mis-information.
Being a do-it-yourself independent publisher, we try to draw attention to indie musical artists, too. Episode 48 ends with a tune from Toronto songstress, Lily Frost with here song, “Red Flag,” a sort of codependent’s anthem about what to do with cheats and addicts like us. This his from her 2017 recording, Rebound.
Up next; William Shaberg has written The Writing of the Big Book: The Birth of Alcoholics Anonymous. It was 11 years of research about what early AA was like, from 1937 when the book was floated as an idea until April 1929 when it was printed. There will be some folklore challenging and myth-busting as Bill goes through with us, his process of testing all those stories we’ve heard and told – and sometimes told from the source – and how these “stories” measure up to contemporaneous data by way of letters in archives, Lois’s diary, etc. It’s a scholarly look, something that hasn’t been done about early AA since Ernie Kurtz gave us Not God: The History of Alcoholics Anonymous in 1979. After listening to this week’s Rebellion Dogs Radio, click on the hyperlink above to sample a chapter of Writing of the Big Book.
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