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I'm also a professional in the field of drug addiction. I've been tempted to write a diary about it for a long time, but haven't. Today, I went to a conference about Promoting Recovery with Recovery Support Services. Recovery Support Services?? Code for something? Yup.

It means, no one can help an addict (alcoholic, mentally ill person, traumatic brain injured person, etc) like another addict (etc). There is just some power, some power of example, in having been there, suffered through it, gotten the message, gotten better, recovering... and getting on with your life.

And on the other hand, there is a stigma associated with being or having been an addict or mentally ill. There is some danger in coming out of the closet, as it were. I know that phrase has real charge in the gay/lesbian community, and even in the largely anonymous world of the blogosphere, but I've gotta admit: I've been sober since 1979. And back in the day, addiction professionals were more often than not recovering persons. The counselors were part of the recovering community. Then, the profession started becoming professionalized, with degrees, certificates, core functions, training, education... I'm not saying these are not valuable and needed, but where are the recoverees?

So now there is a movement to remerge, rejoin the two. Do we, do I, as a professional, have to let my prospective client hit bottom before I can work with him? As in, nothing motivates like pain. Which may be true, but people are so diverse in their addictions and afflictions, that this may not be true all the time - or even most of the time. Perhaps hope is also a strong motivator. I can point to myself and say, I've been there, done that, got the tee shirt, and gotten over it. And I can tell you, I like it lots better where I am than where I've been. And that is a powerful message.

But that is only the start. There are cultural issues. The stigma of mental illness and addiction is still powerful. Even the separation of the two is not very healthy. And even the separation between physical health and mental health is not a good thing.

I know that getting insurance to pay for physical illness and trauma is a battle, in this age of death by spreadsheet, but try getting coverage and payment for mental illness or addiction. You'll notice the difference. In 2008 America, the Treatment of Choice for Mental Illness and Drug Addiction is incarceration. The insurance companies say treatment is not effective, they keep coming back time after time after time. As if treatment for physical maladies has a 100% money back guarantee! My state has a Dept of Mental Health and Addiction Services. It should have a Dept of Health with includes mental health, physical health, addiction disorders, TBI, all human maladies. Why is there a double standard?

There was also a lot of talk about which mode of treatment is the best? The answer seems to be, it depends on the client/patient, just like in real medicine. Medication-assisted treatment, such as methadone and buprenorphine, works well for some. 12 Step Fellowship works well for others. Some need detox, followed by weeks or months of counseling. Some need several detoxes. We need to change the culture to reflect this. There should be no wrong door when an mentally ill person or addict shows up wanting help. We should explore what they need, rather than sell what we got. This is a pragmatic view, more or less a new idea. The reduction of harm model. And who better to know this than those that have been there and gotten better?

I intend to ask my candidates and politicians some questions: 1; If elected, will you support an increase in funding to ensure that treatment and recovery services are available to all who need them? 2; Will you vote for or introduce bills to end insurance discrimination by offering the same coverage (parity) for addictions and mental health issues as for physical health issues? 3; Do you agree that the War on Drugs is lost, that the money is better spent on treatment and prevention? 4; Will you support repeal of discriminatory laws that basically prevent people who have paid their debt to society and overcome their drug and mental health issues from getting jobs, education, housing? and 5; Do you support restoring and even extending funding for long term recovery support services, which the Bush Administration has cut from the 2009 budget?

And then, I'll vote for 'em. And then, I'll hold their feet to the fire.

Originally posted to JohnMac on Fri May 23, 2008 at 07:15 PM PDT.


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