September is Recovery Month: Reinventing Recovery

 

Welcome to the September 2018 edition of Family Matters – Families Matter, our new blog authored and curated by FSDP’s Guest Blogger–pioneering harm reduction therapist, educator, advocate and author Dee-Dee Stout. To learn more about how your family can join our growing community of enlightened friends and advocates sign up here now.

In the first of a series of our Fall 2018 blogs, since September is Recovery Month for SAMHSA, this seemed the perfect time to write about the word, or concept of, “recovery” specifically as it’s typically applied in substance use disorder (or “addiction”) treatment.

September is also the traditional “back to school” month and many of us have kids who are returning to school or perhaps young adults transitioning to college. This is a good time to to review constructive ways to talk to our kids about alcohol and other drugs, and also to take a new look at treatment, drug policy, binge drinking. and how to negotiate the holidays  Therefore, for the remainder of 2018, our blogs will take a look at those topics and more. See you next month! #recoverywithoutabstinence #stopthestigma #familiesmatter

And now our 2018 “Recovery Month” edition:

Reinventing Recovery

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Photo by Toa Heftiba from unsplash.com

Usually when we hear (or often use) the term “recovery”, it has a very specific meaning: nearly always 12-Step oriented, abstinence-only based, and says to us this is a disease you’ll have forever. I want to definitively make the case for a new kind of recovery in the world of addiction(s): an “inclusive v exclusive” recovery that does not require the elements we’re used to – including abstinence – but whose definition can certainly contain it …and so much more. 

Recovery. It’s a truly loaded word (pun intended). Let’s go on a bit of a journey to see how and from where our concept(s) of recovery stems as it’s a word that comes with a lot of baggage, both positive and less than positive.

According to etymonline.com, the origin/first use of the word “recovery” comes in the mid-14th century and meant “return to health.” “Recovery” originates from the Anglo-French word “recoverie” meaning “remedy or cure.” The additional meaning of an “act of righting oneself after a blunder, mishap, etc.” is from the 1520’s. Could this also be at the root of the word having such moral implications?

In his July 2014 article for Psychology Today, well-known addiction expert, author and former Harvard Medical School professor, psychiatrist Dr. Lance Dodes discusses some of the problems we have with the word “recovery.”[1] In part, he sees the word as acceptable in the context of “recovering from a medical illness”, meaning that 1) relapse/lapse is normal, and that 2) one is headed toward a cure or an ending of the condition/illness. Quoting from the article, Dr. Dodes says, “In most of life, ‘being in recovery’ means a person is making progress even though s/he isn’t ‘cured.’” This is far different than how we too often hear the word used in addiction treatment circles or our greater culture. In both places, “recovery” typically means that one is abstinent and attending a 12-Step group – “working the program” to use the language of AA for example. This is meant to establish an “us vs. them” quality: you’re either attending meetings, working the Steps, and have a sponsor so you’re “in recovery” or you’re not and therefore you’re not in recovery. Black or white; right or wrong. Plus, the implication is that anything short of a 12-Step traditional recovery means you’re not doing recovery “right.” A lot of people – including many professionals – believe this is what the word means and ONLY what it means. I, too, believed this for a long time.

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photo by Danielle MacInnes for unsplash.com

I went to residential treatment here in Oakland, CA, in the late 1980’s. These were the “salad days” for residential treatment, coming on the heels of First Lady Betty Ford openly discussing her addiction to alcohol and pain medications.[2] No one of her stature had ever talked about their alcohol and other drug problems in the US and her “coming out” can’t be understated; it was also a huge step in reducing the stigma/shame for others to seek help for their substance misuse/problems. Finally, this event was also partly responsible for opening the doors of treatment to become the Big Business it is today (more on that in another piece).

In treatment, we were taught that addiction is a 3-fold disease: bio-psycho-social (some also added “spiritual”). It was like a, sleeping tiger, always waiting to pounce on you unless you were constantly vigilant in your recovery (meaning abstinence, attending meetings regularly, and “working a good program.”). We were taught phrases such as, “Your mind is like a dangerous neighborhood: don’t go in it alone” and “Avoid old people, places and things to stay sober.” In other words, 1) don’t trust your own thinking because you’re an addict/alcoholic and “your best thinking got you here”, 2) you’re never fully recovered, and 3) you must cut off all your old friends as they were only using friends and therefore not interested in your well-being; your relationships were only based on drug use. I remember someone saying that everything I had done up to the point of my entering treatment/recovery didn’t count – but now my life could really begin: “Today is the first day of the rest of your life”[3] was up on a wall somewhere. Scary stuff. And I was scared straight.

In what’s known in 12-Step circles as the Big Book (Alcoholics Anonymous 3rd edition), there are several references to the word “recovery” and “recovering” (somewhere around 15) but also references (about 10) to the word “recovered” which is akin to blasphemy today in most 12-Step circles.[4] This is another point of contention for many of us. Can we ever say we’re “recovered” or even “cured?” I say, “yes we can,” to borrow a phrase. And that we should. Why? Because to those outside of traditional treatment/recovery, I hear folks constantly say, “Apparently treatment doesn’t work because you people are never recovered!” I had never thought of the phrase “recovering” as potentially responsible for this perception. I personally say that after over 30 years of continuous abstinence, I am completely comfortable declaring that I’m “recovered;” the problems I have today have nothing to do with illicit drug and/or alcohol use (sometimes that would be simpler, frankly). The first paragraph in Chapter 2 of the 3rd edition of the Big Book titled, “There is a Solution,” also appears to see an end state to addiction. It states: “We, of Alcoholics Anonymous, (italics theirs) know thousands of men and women who were once just as hopeless as Bill. Nearly all have recovered (emphasis mine). They have solved the drink problem.”[5] This passage certainly seems to imply that one can indeed recover. But then what exactly does it mean to recover? And how do we achieve this state of being?

Mindfulness + Connectedness + Inner Growth

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Photo by Austin Chan for unsplash.com

 

A Phrase is Born. While working for the large American HMO Kaiser in the 1990’s, I was charged with developing and leading a relapse prevention track for patients in our Chemical Dependency Recovery Program (CDRP). These were folks for whom the course of treatment we offered (intensive outpatient program or IOP) didn’t work – or, as we phrased things back then, patients who didn’t try hard enough, were in denial of their “disease,” or simply relapsed back into drug/alcohol use due to inattention to “people, place, and things.” During one of our evening groups we were working on a definition for “recovery” and decided to see what we could come up ourselves. After all, we surmised, how can one relapse if you don’t have a clear idea of recovery?

Mindfulness, connectedness, and inner growth was the phrase we all agreed described the basic ingredients for recovery. It wasn’t until later that someone noticed we neglected to include anything about abstinence/sobriety, 12-Step attendance, or the other usual things we associate(d) with recovery. I remember that night well because a gigantic light bulb didn’t just light up, it blew up in my head! This was the moment I began to wrap my head around the idea that perhaps alcohol and other drug use itself – and abstinence specifically – really had nothing to do with one’s healing or recovery; recovery wasn’t in fact begun with stopping drug use first (which is what we always told folks). What was at the core of the concept of true recovery of one’s life we decided were these 3 elements defined here – which may or may not include an end to one’s drug use:

Mindfulness: paying attention – to what you’re doing, who you’re with, what you’re putting in your mouth/arm/throat/etc., really everything that’s happening as well as you humanly can, plain and simple.

Connectedness: this means getting reacquainted with yourself, a vertical connection, we called it – your body, your mind, your spirit – and fully trusting them. This also spoke to the idea that your mind is connected to your body (yes, no matter what Descartes[6] said, they’re attached; it’s called a neck!). This vertical connection could also be to a higher power or great spirit of some kind. Connectedness includes a horizontal connection, too, or connection with others.[7]

Inner growth: this was a bit more difficult to flesh out at the time but we settled on it meaning whatever an individual does that leads to their seeking out new information and new ideas, being a part of the world at large. This could be going to school, walking in the park, dating, making new friends, a yoga practice, meditation, attending synagogue/mosque/church/temple/circle, or even reading. Or anything else that “feeds” a human’s curiosity and need for knowledge.

And that was it. Drug use, abstinence, continued using or something in between, wasn’t mentioned. Why? Because we realized that in any other bio-psycho-social illness (which nearly all are), one did not have to recover perfectly. In fact, in my definition humans cannot do this – at least not all the time. And we realized that it wasn’t the alcohol or other drugs that were at the core of the problems we had: they were but a symptom. [8]

Therefore, one could indeed be in recovery and use drugs. Not problematically because then you’re not connected or mindful or growing. But we agreed (again to our collective surprise) that yes, one could be using alcohol or other drugs – having a healthy relationship with them – and be mindful, connected, and growing internally: in recovery. And we also agreed that for some folks, to have these 3 elements in their lives could require abstinence: total, partial, forever or for a while, we made no comment on those notions. That would remain up to the individual (which also fits within AA/12-Step guidelines of no one being able to tell another that they are an “alcoholic or addict.”). In fact, we realized that having healthy relationships of all kinds could be achieved through these three elements. What a jolt to the brain this was to us all!

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Photo by Ron Smith for unsplash.com

YOU GOTTA GIVE THEM HOPE”, Harvey Milk[9]

These days, I have come to realize that it appears these elements or ingredients of recovery also build on one another: for example, you first need to improve or have some mindfulness about what you’re doing before you can truly connect with others and yourself, and that action can lead to growing internally. And again, we made the argument then which I’ll repeat here, drugs and drug use (including alcohol of course) don’t necessarily impede one’s ability to recover or regain health from having problems with them – or being “addicted.” The problem is in one’s relationship with substances or behaviors that have become problematic or compulsive, and that we continue to engage in despite negative consequences – what we call “addiction.” So here’s the Big Question: what if we as a collective culture decided to work on these 3 ingredients and the issues that get in one’s way of achieving them? What if we decided to help those in need to uncover why they – or collectively, why so many of us in the wealthiest nation in the galaxy – need to use substances in order to cope? Hmmm…

It’s time to reinvent the word recovery to mean this: “I have recovered my life and my health. with or without abstinence. I am mindful, connected, and growing.” Now that’s real recovery!

One of the ways to address these issues of the lack of mindfulness, connectedness, and inner growth is with what the Canadian author, physician, and addiction expert Dr. Gabor Mate calls “compassionate inquiry.”[10] Dr. Mate makes the case for needing people in our lives who can/will listen deeply, compassionately to those of us involved in using substances/behaviors that are causing pain in our lives. Another advocate of doing things differently in treatment is Stanton Peele, PhD, JD. In his newest book on addiction, Recover! Stop Thinking Like an Addict and Reclaim Your Life with The Perfect Program,[11] Dr. Peele discusses these issues at length, as he has for over 50 years. As an early adopter of harm reduction principles, he has tried to get us all – but especially we Americans – to see that the way we have come to view addiction is all wrong: 1) it’s not a disease, 2) most people quit on their own (so how can it be a disease), and 3) not all people are susceptible to becoming addicted. In fact, by viewing addiction as a disease, our society has actually increased the possibility of relapse[12]. It reminds me a bit of Charlton Heston’s famous line at the end of the film, The Planet of the Apes, when he realizes where he really is – back on Earth: “You finally really did it. You maniacs! …God damn you. God damn you all!” In looking for the reasons for addiction, we have to consider that perhaps, unintentionally, we have done much of the damage ourselves with our racist policies, unscientific treatments/interventions, and blaming of the people who use drugs (and often their families as well). It sure is easier to blame a drug(s). It’s much harder to look within, compassionately and deeply, for the reasons so many of us are in pain (of all kinds) and need relief to cope with living.

I see September’s Recovery Month as a great time to take a look at what we’ve done with addiction treatment and recovery. And to take a hard look in the Mirror of Truth about our society and its complicity in addiction(s). It’s time to stop the unscientifically-tested treatment of this “medical-and-more” complicated condition. It’s time to demand professionals who are highly trained and compassionate – always. It’s time to radically change how we view people with substance problems – and their loved ones – regardless of whether you believe this is a condition of their making or not.

It’s time to reinvent the word recovery to mean this: “I have recovered my life and my health. with or without abstinence. I am mindful, connected, and growing.” Now that’s real recovery!

DON’T MISS NEXT MONTH’s EDITION: 

COMMUNICATING WITH LOVE ABOUT DRUGS WITH SOMEONE YOU LOVE. 

[1] https://www.psychologytoday.com/us/blog/the-heart-addiction/201407/what-does-it-mean-be-in-recovery

[2] A Johnson Institute-style intervention was held in 1978 for Mrs. Ford leading her to seek treatment for her substance use. In 1982, she founded The Betty Ford Center which is now part of the Hazelden family of programs.

[3] As discussed in our last piece on “tough love,” the originator of this phrase is the founder of Synanon, Chuck Dederich.

[4] “A Reference Guide to the Big Book of Alcoholics Anonymous” by Stewart C.; (1986). Recovery Press, Seattle, WA.

[5] p17. Note: The “Bill” that is referenced here refers to the co-founder of AA, Bill Wilson.

[6] Rene Descartes was a 16th c. French philosophermathematician, and scientist; dubbed the father of modern Western philosophy who famously argued that the human body and mind were separate. Wikipedia.com

[7] Remember that church I mentioned in my first blog, the United Church of Christ or UCC? There we were taught that God was within each person and living thing on Earth and that we were all connected. Very Deepak Chopra. Hmmm…

[8] Interestingly enough, a similar idea can be found in AA’s Big Book on p85, in this line: “What we really have is a daily reprieve contingent on the maintenance of our spiritual condition.” And I was taught that “spiritual” merely meant connected.

[9] Quote from slain San Francisco Supervisor Harvey Milk, one of the country’s first openly gay politicians. This is from a tape recording (1977-11-18) to be played in the event of his assassination, quoted in Randy Shilts book, The Mayor of Castro Street: The Life and Times of Harvey Milk. (1982), p. 277. Wikipedia.com; personal communications.

[10] From Dr. Mate’s website, drgabormate.com: “Through Compassionate Inquiry, the client can recognize the unconscious dynamics that run their lives and how to liberate themselves from them.”

[11] For more information, view the results of the NESARC study and more, discussed in Dr. Peele’s book, p36-42. (2014), Da Capo Press.

[12] Miller et al; “What predicts relapse? Prospective testing of antecedent models.” https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1360-0443.91.12s1.7.x

“Love Has No Labels: The Rise and (hopeful) Fall of Tough Love in America?” — Part 2

Welcome to the August 2018 edition of Family Matters – Families Matter, our new blog authored and curated by FSDP’s Guest Blogger–pioneering harm reduction therapist, educator, advocate and author Dee-Dee Stout. To learn more about how your family can join our growing community of enlightened friends and advocates sign up here now.tyler-nix-525388-unsplash

Last month we started our discussion of “tough love” and its origins. This month we’ll continue this look at this well-known and used concept to see if it really works and is the most effective strategy for families who love someone who misuses drugs.

We’ve discussed Synanon and its use of harsh confrontation and “tough love” in treating drug use problems. We’ve looked at Al-Anon and its concept of “letting go with love” and seen that what that often looks like is anything but love – though setting limits is important, too. Also, we’ve discussed how this concept of “tough love” isn’t just bad for helping drug users make changes but also bad for loving family members. We also talked about the difference between gaining or giving approval versus love. Finally, we looked at what more pain does for drug users: encourages them to use more, not less. So, let’s pick up the conversation here, starting with more on harsh confrontation.

You may have questions by now and I’m going to try to guess what some of them are and provide answers here. 1) Is tough love the same as harsh confrontation? The answer is yes! 2) I thought treatment is supposed to break through the denial of a person addicted to substances? The answer is no, that’s actually more likely to harm clients especially those with other underlying mental illnesses including trauma. 3) Don’t people who use drugs problematically need to be shown what a mess their lives are and how they’ve hurt others, such as their families? Again, the answer is no, they’re fully aware already and are usually extremely ashamed of their lives and behaviors even though families may not see this.

By the way, these are all reasonable questions to ask. Let me suggest, as many experts in the field do, that we look at how we treat other chronic medical conditions. Let’s take diabetes for example: when one has diabetes and is reliant on medication, do we complain that they are “addicted” to insulin? Of course not. We’re happy that there is a medication that can help them live a more full and healthy life. But with medication-assisted treatments (MAT) we hear negative comments (Narcotics Anonymous (NA) has made their views clear in their official pamphlet on MAT) such as how folks are just trading one drug for another; that they aren’t really “clean”. Here in California, our Department of Health Care Services has informed treatment providers that they expect us not to ask clients to engage in activities that we wouldn’t ask of those with other chronic health conditions such as diabetes. So, for instance, would we ask someone with diabetes to list their character defects that may have led to their illness? Of course not. Would we ask them to hold hands in prayer around a circle? No again (while any individual may find this helpful, we wouldn’t consider this professional treatment). We certainly wouldn’t put a toilet seat around their necks and tell loved ones to throw them out of the house for eating less healthy foods! But these are all deemed reasonable treatment approaches to addiction to many in our profession even today. (This calls for a lengthier discussion on addiction that I’ll do in another installment)

As I often do, I got out the dictionary to view some definitions of these 2 words as I prepared to write. Using the online version of Merriam-Webster’s (M-W) dictionary, I found “tough” means durable, strong, resilient, sturdy, rugged, solid, stout (I couldn’t resist!), long-lasting, heavy-duty, industrial-strength, well built, made to last. And what of love? “Love” is defined by M-W as “unselfish, loyal and benevolent; concern for the good of another.” Love is further defined as “an assurance of affection.” An assurance of affection. Wow. In my experience with “tough love”, there was absolutely none of that. In fact, withholding affection/love is at the crux of “tough love.”

So if these 2 words are polar opposites, how did they come to occupy the same space in our heads and in our common lexicon? As stated previously,    the phrase “tough love” was originally used by therapeutic community programs such as the former Walden House in San Francisco and DayTop Village and Phoenix House in NYC and continues to be used frequently today (just Google it to see for yourself). Using this concept of tough love, parents were encouraged to check their troubled teens into wilderness camps and behavior modification programs to deal with their kids increasingly frustrating and sometimes dangerous behaviors. And parents absolutely mean/t well; they were at a loss as to how to control their “out of control” teens. Plus they were listening to the so-called experts tell them, “you have to stop coddling your kids; you need to get tough with them – show them who’s boss.”

My own parents tried to do this with me when I was 15 or 16 (It backfired. I filed for legal emancipation and won. However, my relationship with my parents and siblings was forever damaged, as was I). It would seem that the concept of tough love is really about control. And when did control become synonymous with loving?

“Tough love” is also often associated with criminal activity or with children. In other words, if you’re a person who uses drugs problematically – or a criminal or a child – our society says using tough love is acceptable. The thinking is that in any of these three instances the person you’re using “tough love” with is incapable of learning any other way; their behavior must be controlled for their own good. In fact, the definition according to an old book we used to use in addiction treatment and studies called “Addictionary” (by Judy and Jan Wilson, 1992; Hazelden) “tough love is a phrase that describes behavior to stop enabling addiction. When you refuse to cover up for an addict, to rescue them, or to prevent them from experiencing consequences of their addiction, that is tough love. It is loving of the person but tough on the disease.” But is this true? And is this the most effective treatment modality? Perhaps the best question is who does the concept of tough love harm? I’d argue that tough love harms everyone involved – and that often once used, it damages relationships beyond repair.

But it works sometimes, right? I guess that depends on your definition of “works.” Can you get your loved one to behave or not behave in a way that’s acceptable to you? Probably, with enough threatening and coercion. But again, that’s not love. And it usually isn’t helpful for those of us diagnosed with a mental illness or substance use disorder (or chronic pain condition). In fact, Johann Hari, in his book “Lost Connections” argues that disconnecting from loved ones (as parents and partners are often told to do) who are “misbehaving” is typically the worst thing a parent or partner can do; losing connections to love – friendships, enjoyable activities such as sports, pets, and more — is often the exact scenario that is ripe for addictive behavior and other mental illnesses to thrive in, to fill the void left by the withholding of love and affectional bonds. I know I can definitely relate to this.

Now let’s be clear here: I’m not saying that limit setting is unnecessary. Of course, it’s necessary. Limit setting is part of being a responsible parent and, sometimes, a loving partner. But the most important piece is that when you set limits with someone, you do so with unconditional love and appreciation for the other person.

You listen to their ideas, negotiate, and you have this conversation–this is crucial–when you’re not emotional. Once again, the time for limit setting is BEFORE the undesired behavior occurs, not afterwards (when limit setting is done after the behavior occurs, it’s called ‘punishment’). There are exceptions, which again each family must work out for themselves (this is the work of family or couples treatment/therapy). Bottom line, when dealing with the problematic drug-use of a loved one, yelling, screaming, throwing out their alcohol or other drugs, etc, isn’t helpful to anyone.   And it certainly isn’t loving behavior.

Now let’s be clear here: I’m not saying that limit setting is unnecessary. Of course, it’s necessary. Limit setting is part of being a responsible parent and, sometimes, a loving partner. But the most important piece is that when you set limits with someone, you do so with unconditional love and appreciation for the other person.

OK so what about the idea that “addicts” must be shown what a mess their lives are and take responsibility? Well, I can tell you that I was aware every moment that my life was a mess when I had a substance use disorder as we now term the condition. There was no need to show me how bad things were. In fact, whenever I got a glimpse of the mess that was my life, I wound up using more to cover the pain and the shame. This is a typical response we see in many problem drug users. Lastly, let’s look at how tough love confronts personal responsibility. The tough love that my family of origin gave me did two things: 1) made me more ashamed and reluctant to try to change (if it’s my fault and I’m such a fuck up, why bother trying to change?); and 2) ruined any chance of a healthy family system because my family couldn’t look at what they may have contributed to my life of addiction (no I don’t blame them). Most of the “mess” or “unmanageability” as 12-Step would describe it, are problem behaviors of illicit drug users due to the illegality of most drugs of misuse. When drugs are illegal, drug users must go to places to get drugs where they are likely to be put in danger, risking rape and other physical harms, as well as jeopardizing their freedom by being caught by police with the results often being arrest/jail/prison, especially if you happen to be black or brown. Plus, drug users tend to use more in these circumstances than they would in safer locations, and they overdose more often. More on this in future segments.

So here we are at the end of this discussion on “tough love”. And I hope I’ve shown that tough love doesn’t look much like love at all. Instead the concept appears to be all “tough” with “control” at its core. Think of it this way: with positive reinforcement (think B.F. Skinner and others), I reward you for positive behavior (coming home on time) by giving you something you want (perhaps an extended curfew on one night) and set limits regarding less positive behaviors (think staying out after curfew) but I do this BEFORE you are late. And I do this when I’m not emotionally raw. If I wait and give you “consequences” for your undesired behavior, then I’ve punished you. That does not lead to positive behavior change. It leads to controlling with fear. Also, too often we fail to couple “consequences” with any kind of reward for the positive behavior. And when that consequence is withholding love and affection, well, can you see where this could lead to increased drug use? Not what anyone wants. But now we’re “woke” and can see while it isn’t what I wanted, it is expected. This denial of love and affection leads more people to have a (another?) traumatic experience and we know trauma and addiction – and other mental illnesses – tend to feed off each other. I am sure that this is not the outcome that any parent – or partner or loved one – wants for their child/partner/loved one.

So what have I learned – and what do I hope I’ve shared with you all here on this topic of “tough love?” Here are my Top Four “Take Aways” from this discussion:

1) Perhaps the most important take away is this: I hope I’ve made the case that we as a culture need to stop treating the concept of “tough love” as something positive and healthy. I’m optimistic that I’ve shown how inaccurate and horribly damaging to individuals and families tough love actually is, too;

2) That the concept of tough love really means that this concept is tough on all of us: drug users and loved ones/families alike. Like my own unrepaired family of origin, I have seen so many that will never recover from this so called “treatment intervention/sign of love.” Nothing could be further from the truth;

3) That what we really need instead is a concept let’s call “love AND limits,” meaning there is no limit on our love – ever – and (not “but”) we human beings have limits, too: on our time, our resources, our finances, and more. That’s called life and should always be negotiable and honest.

4) We can no longer afford to use a tired, inaccurate, corrosive concept such as “tough love” to (hang in here with me ok?) “excuse” us from the task having difficult conversations about hard topics with people that we love, what I’m calling “Compassionate Conversations.” What do I mean by this? I mean we must begin the work of having conversations that are about deep, profound, empathetic listening to one another, conversations that seek to really understand.

Today it seems that the conversations we typically have with loved ones – especially with drug users – are ones with agendas to get them to stop using. So, what’s the worst that could happen if we could truly let go of our old agendas and just listened? And just for the record, I’m not suggesting that we should agree with how our loved ones view something or how they behave right now, but rather I’m suggesting that our conversational goals change from getting-them-to-do-something-I/we-want to one of astonishing appreciation: of their views, their perspectives, their reasons for using/behaving in less than healthy ways. Let us decide that gaining compassion will be our attending agendas in these conversations.

Our world today is filled with rhetoric (with few real conversations) that is siloed and dishonest, cut off from reality, and full of prejudgments and predetermined agendas. Sadly, when we act from these values, we do so from fear–fear of losing power, fear of not being accepted, fear of losing our place in the world, fear of losing our loved ones to drug use and more. But when we push forward incorporating these fears rather than fighting them and force ourselves to see what is and become “woke” as the modern vernacular states, we have opportunities galore to change our relationships to ourselves, to our loved ones, and to the world. We learn how to say things like, “I love you more than anything AND I’m uncomfortable/unhappy/it’s difficult being around you when you’re loaded/high/under the influence. But when you’ve come down/sobered up/are able to moderate, let’s have lunch/dinner/go to that movie we’ve talked about.” Or how about, “I really love spending time with you when you’re emotionally available to me/us/the family/yourself.” I realize these “compassionate conversations” aren’t dramatic so they won’t make for good “reality” television, however they do make for good, healthy, strong relationships in real life. Plus research shows us these types of conversations are also more likely to help encourage positive changes toward healthier behaviors for everyone.

So, let’s tip “tough love” into the collective trashcan and from our collective vocabulary. Instead let’s work towards an agenda/belief of “love and limits” through “compassionate conversations.” Frankly, after all the pain caused to us all from using “tough love”, just how much harder can this new way of being really be?

#stopthestigma #recoverywithoutabstinence

In honor of September being Recovery Month, don’t miss next month’s edition: Reinventing Recovery

 

“Love Has No Labels: The Rise and (hopeful) Fall of Tough Love in America?” — Part 1

 

Welcome to the second installment of Family Matters – Families Matter, our new blog authored and curated by FSDP’s Guest Blogger–pioneering harm reduction therapist, educator, advocate and author Dee-Dee Stout. To learn more about how your family can join our growing community of enlightened friends and advocates sign up here now

tyler-nix-525388-unsplash
(photo by Tyler Nix @unsplash)

Hello again!

Before we get into the meat of this topic, I need to say a couple of things: First, I apologize for not finding a way to present this in my usual more light-hearted way. This just seemed too serious of a topic for that. I just finished reading Maia Szalavitz’ 2006 book Help at Any Cost which deeply disturbed me. Although I was certainly aware in a general way about a lot of the material about teen “treatment” programs, I was both obsessive to finish the book (reading until 2AM) and distressed that these programs are still around. Here in the Bay Area, our local newspaper, The San Francisco Chronicle just did an expose on teen “leadership” schools. As a result of the excellent journalistic work, many supporters and contributors to these programs have now removed their support, both financial and verbal. But there are some who insist these programs are meaningful.

This is also true in Ms. Szalavitz’ book. I’ve seen this in my classrooms over the years of teaching folks to become certified alcohol and other drug counselors. Many of my former students came from Synanon-influenced programs (often ones they attended as clients and then became workers, which I did, too) such as the former Walden House and Delancey Street (which is the only true therapeutic community (TC) left as they do not employ any professionals, the definition of a TC) and some have insisted that they were helped by such “tough love.”

I had the opportunity to ask the world-renowned researcher, Emeritus Professor William R. Miller (author/developer of Motivational Interviewing (MI) about this once. “is it possible that these folks were actually helped by these abusive tactics?” He responded, “I believe that these are people that are so motivated to make a change in their lives that you could have put them anywhere and they would’ve found a way to get better. So, their lives improved not because of the treatment they received but in spite of it.” That response has stuck in my mind and did so while writing this blog installment.

Finally, I was allowed to view the new film Fix My Kid, a documentary on the organization Straight, Inc, a popular behavior modification program for teens from the 1970’s (it was closed in the 1990’s but really just redesigned and opened under new names).  I can’t begin to tell you how upset I became watching this.  Some of this is certainly due to my own experiences with “tough love” but as a human being, I don’t see how anyone could view this without teetering between anger, outrage, and incredible sadness.  I highly recommend a viewing when it becomes available – but be prepared.

And two more blog housekeeping things:  1) As this topic is both so important and large, I’m doing two installments this time.  Today we present Part 1, covering some of the basics of “tough love” and approximately one month later you can expect to see Part 2, which will go into more detail especially as to how the culture came to embrace this concept.  Please let me know at info@fsdp.org what you think about this two-part format.  2) Since September is National Recovery Month, I’ll be doing an installment on the word “recovery” then which I promise will not be your typical take on the word!

And so…here we go again!

“Love means never having to say you’re sorry.” If you remember that phrase, you were around in 1970 when the film, Love Story, came out (starring Ali MacGraw and Ryan O’Neal) and this phrase about love was the tagline in the studio’s advertising that, using today’s language, went viral. Even then I wasn’t very fond of the phrase. To me, love was quite the opposite: it meant I could make mistakes and saying you’re sorry was part of the healing process – and love would always still be there; it was a given; it had no limits – even if I do. We’ll return to setting limits later.

I’ve been reading a lot of things about love/tough love/etc, preparing for this blog. In a piece from the HuffPost from 2012, writer Sheryl Paul states that if there are conditions on love, then it’s not love but approval – either trying to get it or give it. I hadn’t thought of it in quite that way but she’s absolutely right. And love is NOT the same as approval. In fact, the challenge of love is to love. Full stop. Anything else is based on approval and doesn’t feel like love to the person on the receiving end – because it’s not. Real love isn’t conditional.

A popular phrase in 12-Step/AlaAnon is “you have to let them hit bottom.” We are told as family members that this is “letting go with love.”  However, what if “their bottom” is death? Or jail/prison? Or something else traumatic? How is letting someone “hit their bottom” showing love and not simply trying to control or give approval for “doing the right thing” and not “enabling”? And what evidence do we really have that hitting bottom works? None, save some individual stories of such (side note: I just googled the phrase “hitting bottom” and found a disturbing number of articles and treatment centers advocating this approach). Back to Dr. William Miller: MI has shown us, as has CRAFT (Community Reinforcement Approach and Family Training; developed by Dr. Robert Meyers), that standing by and letting a problem drug user get to the absolute worst place they can does little to actually help them seek treatment/change. In fact, it typically makes things worse (the late Dr. G. Alan Marlatt showed this in several studies and discusses this in his seminal books, Harm Reduction and Relapse Prevention).

Anecdotally, when I was in more pain (of all kinds) and things got even worse, that made drug use even more attractive, no matter the negative consequences. And this is typical. This doesn’t mean family shouldn’t allow for some natural consequences. What those are and how one decides when enough is enough must be decided by each individual family and needs to be discussed with the problem drug user beforehand so there are no surprises

So, where did we get this idea of “tough love” especially if it’s harmful? And why is it still such a popular approach? Although tough love is a concept used on adults as well as teens, according to Szalavitz’ book, Help at Any Cost, the phrase “tough love” was first coined by Bill Milliken in his book of the same name in 1968 that discussed parenting approaches. There is also another book of nearly the same name, ToughLove by Phyllis and David York from 1985. Either way, the phrase started out as a term for parents to describe interventions to be used as their teenagers began to act out – perhaps using/misusing alcohol and other drugs – and engage in other less-healthy/desirable behaviors. Unfortunately, typical adolescent separation/developmental behaviors became pathologized (still often are….more on that perhaps at another time). Before the phrase “tough love” caught on in parenting circles, the concept was used here in California by a group long gone but whose long reach can still be felt in drug treatment facilities here and across the country: Synanon.

Synanon was a California institution. It was founded in 1958 in the then sleepy beach town of Santa Monica, by Charles (Chuck) Dederich. According to journalist Matt Novack, Synanon “was one of most dangerous and violent cults America had ever seen…” I have seen the outcomes of Synanon up close and personal through my work in treatment facilities, many founded by former Synanon members. Several ideas of these persuasive and talented people were sensible. Sadly, though I believe all meant well, many of their ideas were still too infused with the highly confrontational concepts of Synanon. Having worked and been trained in some of these treatment centers, I am saddened to know that while I helped many people in the dozen or so years I worked in this confrontational style, I am aware that I harmed many others. But Synanon was more than highly confrontational. It was far worse and caused far greater harm.

Synanon was the developer of something they called “The Game.”

“They played the “game” in which anyone was allowed to say anything, true or not, to someone to cause an effect. Only the threat of violence was prohibited. It was a game because one being gamed could turn the game on another.

Addicts’ behaviors and past lives were attacked viciously in games, members were told their lives depended on staying, contacts with family were prohibited, and a system of rewards and punishments was applied. Publicly one was berated ({given a] “haircut”) for misdeeds…Dederich and Yablonsky acknowledged that the system was brainwashing…”

And brainwashing was what Synanon leaders believed drug users needed. According to Paul Morantz (an attorney Dederich attempted to murder for suing Synanon) is credited with coining the phrase “Today is the First Day of the Rest of Your Life.” He also “preached “Act as If” which meant do not try to reason as to what Synanon asks they do; as thinking got them there, just trust what they were told and act as if it is right.” Alcoholic Anonymous (AA) uses similar slogans today. In fact, Dederich was a longtime AA member and popular speaker before his transformation to cult leader (Dederich later became mentally unraveled, extremely paranoid, and preached of a new religion he called Synanon III.

Synanon was heralded as a drug addict-saving program and even had the blessings of Governor Edmund “Pat” Brown, who exempted them from health licensing laws. They also started seeing monetary gains as Hollywood superstars such as Robert Wagner, Leonard Nimoy, and Ben Gazzara came to play “the game.” Life magazine did a 14 page in-depth article in which they quoted a Congressman calling Synanon the “Miracle on the Beach.” Columbia Pictures even made a film on it. By the mid-1960’s, Synanon was known as a alternative community which attracted its members through a focus on living a “self-examined life” using “the Game” to uncover hidden truths in group sessions. Even non-drug using professionals were invited to join as long as they “gifted” their assets. Like other cults, Synanon worked by controlling its members. In Synanon the main source of control was by use of “the ‘Synanon Game.’ The “Game” could be considered a therapeutic tool, likened to group therapy; or a social control, in which members humiliated one another and encouraged the exposure of one’s innermost weaknesses, or both.” This was truly tough love at its “finest.”

Today we may not see toilet seats around clients’ necks (I heard reputable reports that this was done in some drug treatment facilities up to the late 1990’s, to demonstrate that a client had behaved like a ‘piece of shit’) but we certainly continue to have the ethos of stigma, shaming, and harsh confrontation we inherited from Synanon. The threads of Synanon are woven throughout drug treatment programs everywhere in the US (and further in a few cases) today.

PART 2 “Love Has No Labels: The Rise and (hopeful) Fall of Tough Love in America?” coming August 2018

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IMG_6574Dee-Dee has worked in the addictions/mental health worlds for more than 30 years and continues to maintain a busy clinical practice where she works with a variety of clients whose behavioral goals include abstinence, moderation, and “anything they want and in any way they want” to achieve their goals. Her book, Coming to Harm Reduction Kicking and Screaming: Looking for Harm Reduction in a 12-Step World is widely available and has received positive reviews.

 

 

FSDP Celebrating Life: A Town Hall with New Solutions for the Opioid Crisis

Please join FSDP co-founders Carol Katz Beyer and Barry Lessin, Team FSDP and our partners–The Center for Optimal Living, Harm Reduction Coalition, The New School, International Network of People Who Use Drugs (INPUD), New York City Department of Health and Mental Hygiene, New York State Psychological Association’s Division on Addictions, and VOCAL-NY—who are representing our families to demand solutions based on a new paradigm of healthcare that provides a comprehensive continuum of care with multi-tiered strategies that empower families with reality-based solutions.

celebratelife_townhall (FINAL)We are privileged to be represented on the panel of representatives from the fields of public health, psychotherapy, community engagement, public policy, and The New School’s Student Health Services who will present their perspectives on the impact of opioid use, the opioid crisis, and how to reduce the number of overdoses.

We will also be training attendees in overdose prevention strategies and naloxone kits will be provided to those who wish to receive them.

Following an overview of the current opioid use patterns and overdose rates in New York, we’ll discuss the programmatic work that is being done to address the multiple challenges associated with this issue. We’ll hear from people who work with active drug users as well as current and former people using drugs contributing to the panel discussion. In addition, treatment professionals will describe an integrative harm reduction approach to working with people using drugs.

Overdose deaths are preventable and we shouldn’t be punished for making progress in our in our path to optimal health and well-being! Lives will be saved when we shift our thinking about treatment to complement and support public health overdose prevention strategies. A harm reduction-informed continuum of care linking harm reduction strategies to the full array of effective substance use disorder treatments needs to be integrated with overdose prevention efforts.

Families impacted by substance use deserve the best care available. Every other medical condition is guided by best practices and we expect nothing less. We are in the best position to help our loved ones and we demand the information and services required to give us the best chance for successful outcomes.

This event is open to the public and is free of charge.

Reflections on Stigma’s Insidiousness in the Addiction Treatment Community

A therapist colleague of mine who doesn’t work within a harm reduction framework has a nephew who is struggling with problematic substance use and she shared with me last week that she finds herself being more sympathetic to her clients than her nephew about their drug use.

fsdp-our-missionI had the same reaction as her when I was involved as a family member in my own family’s therapy experience when my nephew was working on his substance misuse issues. It was before I was a harm reduction therapist and my incongruent reaction to this opened my eyes to my own perceptions of my substance using clients and I realized just how pervasive the judgments about people using substances are in our culture.

fsdp-donateThe judgments were so ingrained for me, it took me several years to shed these stereotypes, but as family members we don’t have the luxury of time and such an opportunity for this awareness. These judgments are damaging to individuals and families in treatment–damage that makes healing that much more difficult. It reinforces, and sometimes adds to, the trauma that many people enter treatment wanting to address.I’ll be exploring the effects of stigma on our families in future posts and would love to include your reactions on how it has affected you and your relationhip with your loved one, and what have you done, or do, to adjust…

I’m curious about people’s reactions to this from the perspective of a family member, a person using substances, or a treatment provider?

Any suggestions for reducing the treatment-inducing stigma that can can be such a barrier to good care? Email me at barry@fsdp.org with your experiences and I’ll share them in future blog posts.

FSPD brings a Weekend of Family Empowerment to the United States

TFDS NYC Workshphe inspirational and motivational moments shared with internationally acclaimed Family Drug Support founder, Tony Trimingham at the International Harm Reduction Conference in Montreal, Canada #HR17 will continue with a dynamic and thought provoking celebration of family empowerment next week in New York City with an extraordinary weekend filled with enlightenment and hope. 

When: May 20, 2017, 10am to 4pm

Where: Center for Optimal Living, 370 Lexington Ave, Suite 500, New York, NY.

FREE Sign up herehttp://support.bpt.me/

Our families have a vital role in the development and resolution of how substance use impacts their home—for far too long our families have not been afforded the opportunity to engage as active participants and problem-solvers.

We remain humbled and honored to serve our growing network of families who are asking for non judgmental alternatives to support optimal health and well-being for their loved ones impacted by substance use while managing their own needs and self care in the process. Attendees will learn how to become ambassadors for your community by implementing a new paradigm of support for families impacted by substance use by becoming a Family Drug Support meeting facilitator.

The FDS model has enjoyed much success over the last 20 years because it presents viable alternatives for families to explore potential solutions and coping strategies. It introduces reality-based concepts and tools based on what families need, expect and experience.

The concepts are based in harm reduction approaches of meeting families where they are, listening and understanding, changing language, dropping labels, stages of change for drug users and their families. coping with positive changes and challenges, while challenging your triggers and assumptions.

This workshop, co-hosted by FSDP, Family Drug Support, Center for Optimal Living, New York Harm Reduction Educators (NYHRE), and Washington Heights CORNER Project.

We are energized and privileged to bring the FDS model of family support to our cherished friends here in the United States and are busy working behind the scenes in preparation to launch our inaugural family support meeting!

Weekend Part 2

FDS SIF event rev

Last year almost 54,000 lives were lost as a consequence of accidental overdose. Many of these deaths could have been prevented by ensuring that our loved ones had access to a full continuum of care that is rooted in science and compassion. Our families deserve person-centered screenings and alternative solutions that meet them where they are with the goal of optimal health and wellness based on individual needs and unique circumstance

Co-sponsored by FSDP, Family Drug Support, Center for Optimal Living, New York Harm Reduction Educators (NYHRE), Washington Heights CORNER Project, Students for Sensible Drug Policy and Community Insite, join us at a FREE panel including International harm reduction pioneers Tony Trimingham and Liz Evans and others, presenting life-saving alternatives to public injection and overdose from other countries

When: Sunday, May 21, 2017, 11:30am

Where: Malcom X and Dr. Betty Shabazz Center, 3940 Broadway, at 165th St, NYC

FREE Sign up here: http://opioidresponse.bpt.me

Evidence from years of research is conclusive that Supervised Injection Facilities (#SIFs) reduce HIV and hepatitis transmission risks, prevent overdose deaths, reduce public injections, reduce discarded syringes, and increase the number of people who enter drug treatment. Across the globe, there have been no reported fatalities from an overdose in an SIF.

A preponderance of evidence also shows that clients of SIFs are more likely to go to detox and quit injection drug use over time. SIFs increase access to lifesaving services and restore some of the humanity and dignity that drug users deserve by offering them a safe place to access medically supervised care and other related services.

“If synthetic opioids are in fact becoming the new norm in terms of distribution and consumption, then drug checking and supervised injection sites ought to become the new public health norms too.” — Rick Lines, Executive Director of Harm Reduction International #HR17.

FSDP embraces enlightened drug policies to empower families, restore health, and save lives..

#FSDPSaysOurFamiliesDeserveSIF’s

 

Special Evening for Families with Dr. Robert Meyers, Developer of CRAFT

FSDP’s latest collaboration with Dr. Bob Meyers, the developer of Community Reinforcement and Family Training (CRAFT), and Andrew Tatarsky and his Center for Optimal Living will give attendees a unique opportunity to meet Drs. Meyers and Tatarsky, hear an overview of the CRAFT treatment model and be part of a Q & A to follow.

FAMILY CRAFT

This special evening will be hosted by FSDP Cofounders Carol Katz Beyer and Barry Lessin.

WHEN AND WHERE:

Friday March 10, 2017, 6:30- 8pm.

The Center for Optimal Living, 370 Lexington Ave, Suite 500, NYC 10017

Tickets are still available but space is LIMITED, so SIGN-UP NOW!

For additional information, please email barry@fsdp.org.

CRAFT fosters a different journey toward treatment and recovery for families. It is love-based and empowers families to stay TOGETHER rather than “detaching” or using harsh, punishing methods with loved ones.

Supported by 20 years of peer-reviewed research, CRAFT is a comprehensive behavioral program that teaches families to optimize their impact while avoiding confrontation or detachment. Most programs developed to promote or encourage positive lifestyle changes are not always built upon the level of long-term research and analysis that supports CRAFT as a successful model for engaging substance users toward treatment.

CRAFT methods are evidence-based and provide families with a hopeful, positive, and more effective alternative to addressing substance problems than other intervention programs. CRAFT works to change the loved one’s environment to make a non-substance using lifestyle more rewarding than one focused on using alcohol or other drugs. In the CRAFT model, concerned significant others (CSOs) are the focus of the therapy instead of the substance abuser. Randomized clinical trials have shown CRAFT 3 to 5 time better at engaging resistant substance users than Alanon or the Johnson Institute style.

For more information on CRAFT, click HERE:

WE LOOK FORWARD TO SEEING YOU THERE!

FSDP Brings the Voice of our Families to Aspiring Medical Professionals

IMG_1960One of FSDP’s missions is to bring the family voice to the various segments of our society that directly impact our health. So I was excited to be joined by FSDP members Brooke Feldman and Kenneth Anderson, as well as Fred Goldstein, Ph.D., Professor of Clinical Pharmacology at Philadelphia College of Osteopathic Medicine (PCOM) to share our perspectives on a panel discussion for medical students, “The Culture and Misperceptions of Addiction”, held at PCOM on Thursday, January 5, 2017.

The panel allowed us to reach healthcare providers at the beginning of their careers with a message about harm reduction, drug policy reform, progressive treatment and recovery, and substance use as public health and human rights issues. IMG_7851The audience of medical students were actively engaged and their questions prompted discussion about the nature of addiction, co-morbidity (dual diagnosis), engaging people in treatment, stigma, policy, epidemiology of substance use, impediments to effective care, conflicts of doctors…

Ken Anderson, founder of Harm Reduction, Abstinence and Moderation Support (HAMS) shared his expertise about the epidemiology and myths of substance use, addictIMG_7845ion, and recovery. Recovery advocate Brooke Feldman shared her unique perspectives on the lived experience of substance users, stigma, and the unique paths taken by people in recovery. I addressed some of the issues around the influences of culture and policy on substance users and families, and strategies for engaging young people and families in treatment.IMG_7846

Many thanks to our gracious hosts at PCOM, especially Maggie Gergen for coordinating the event, and FSDP Harm Reduction Epidemiologist April Wilson Smith for developing this event, and Co-Founder Carol Katz Beyer for her guidance.

FSDP to Address Aspiring Medical Professionals in Philadelphia, PA

14731154_10154153120499195_2687285408442853763_n - Version 2Families for Sensible Drug Policy (FSDP) Co-Founder Barry Lessin and FSDP members Brooke Feldman and Kenneth Anderson will be on a panel to discuss “The Culture and Misperceptions of Addiction” with medical students at the Philadelphia College of Osteopathic Medicine on Thursday, January 5, 2017, 5:30 to 7:30pm this Thursday.   This is an amazing opportunity to reach healthcare providers at the beginning of their careers with a message about harm reduction and compassionate, evidence-based care for substance use problems.  

Said Barry, “I spent most of my career as an abstinence-only, one-size-fits-all psychologist until I became aware of the War on Drugs five years ago and began viewing drug use and people who use them through a human rights and public health lens. I realize now that using this model was doing more harm than good by reinforcing stigma and shame by blaming my clients for the lack of success in treatment. I now embrace a harm reduction, client-centric approach and feel it’s important to share my harm reduction knowledge and experience with people who will have an important impact in providing care.”

Brooke Feldman, an outspoken recovery advocate and Huffington Post columnist [link], as well as FSDP member, said, “It is imperative that all medical professionals understand substance use and its related impact on whole health and wellness.  Only through truly understanding the delicate interplay between mental and physical health, including alcohol and other drug use, medical professionals can be best positioned to practice the holistic, integrated care that is the future of quality healthcare in this country.”

Kenneth Anderson, Executive Director and Founder of Harm Reduction, Abstinence and Moderation Support (HAMS) and long time FSDP member, broke down the myths and facts he plans to address at the session:

Myths and facts about substance use disorders

Myth: Everyone with an addiction dies from it unless they get addiction treatment.

Fact: 90% of people with alcohol dependence recover whether they get treatment or not. For drug dependence the rates are even higher; 98-99%.

Myth: Lifetime abstinence from all mood altering substances except caffeine and nicotine is necessary for recovery from addiction. 

Fact: Half of all people with alcohol dependence recover via controlled drinking. Marijuana is frequently an exit drug from more harmful substances.

Myth: Addiction treatment is effective.

Fact: Most treatment centers do not use evidence based treatment even if they claim to do so for the sake of collecting insurance payments. The odds of dying of heroin overdose after graduating from a 28 day inpatient program are 3,000% higher than if one continues to use heroin with no treatment.

Myth: Patients must be confronted and forced against their will into AA because they are in denial and only the 12 step program is effective.

Fact: The more people are confronted the more they will drink. Actually listening to what the client wants is the most effective approach here as it is everywhere else. Although some people benefit from the AA fellowship, others, including myself, are greatly harmed by it. I nearly drank myself to death before I left AA.

FSDP continues to be the voice of families affected by the cruel and ineffective drug war, everywhere from the meetings where policy is made to the institutions where new healthcare professionals are trained.  Stay tuned for an update after the event!  

 

FSDP at the Southern Opioid Epidemic Symposium

FSDP’s Co-Founders Barry Lessin and Carol Katz Beyer, and our Harm Reduction Coordinator Jeremy Galloway represented us at the Southern Opioid Epidemic Symposium held at Emory University’s Rollins School of Public Health this past week.

The symposium convened academic, medical, research, policy, and government stakeholders to identify and develop strategies to advance a comprehensive response to the opioid epidemic in the South and beyond.

Barry Lessin was invited to speak, and here’s the text of of his talk “The Significance of the Family in Developing Harm Reduction Strategies and Practices in the Southeast and Beyond:

15541250_1393299694023257_4760824146094682188_n“I’m an aging hippie from the VietNam war protest days when I came of age, during the drugs, sex, and rock and roll era and as a result developed an ingrained distrust of the federal government.

When FSDP was invited to join the Southern Collaborative on Opioid Harm Reduction , my initial thought was ‘Oh my God, I’m going to meet with the government to talk about drug use. I hope they don’t ask me too many questions about my past’. My worry and disbelief quickly dissolved when we got to the meeting and saw how serious the government is about attacking the opioid problem with comprehensive harm reduction …

We’re again a very divided nation, even more so in some ways, but I have optimism because of our ability to convene forums like this to tap into the brilliant minds gathered here to identify life-saving solutions to this public health epidemic.

So being here is an exciting and encouraging moment for myself, co-founder Carol Beyer, Jeremy Galloway and the 1000s of families and diverse stakeholders we represent because it’s an opportunity to be a part of process of an ongoing collaboration with this esteemed community to address the needs of the millions of families who have suffered the direct consequences and collateral damage of substance use and the existing harmful drug policies.

FSDP is a global coalition of families, professionals, organizations and drug policy reform advocates who view substance use through a human rights and public health lens. Viewed this way, Harm reduction interventions, are a natural fit for managing substance use, but have rarely found their way into family settings.

We have listened to our families, parents and users alike, sharing their lived experiences of being harmed by a broken treatment system that uses ineffective, often unregulated treatment methods, that treat people more like commodities to fill beds than patients being provided effective care.

When people relapse with other complex problems similar to addiction that require lifestyle changes like cancer, heart disease, and diabetes, we don’t blame the person for treatment failures, we don’t tell them they’re in denial, or they ‘need to ready’ or they must ‘hit bottom, we don’t throw them in jail, or kick them out of schools.

With other conditions, we respond with scientific, commonsense, and compassionate approaches and we look at the treatment methods that are failing them and do more research to provide better treatments.

Families are in a unique position to directly influence the development or resolution of substance use problems because substance use doesn’t take place in a vacuum but in the normal context of family life and relationships as well as the wider culture that the family resides in.

We know that problematic substance use is a complex interaction of psychological, biological and socio-cultural variables. Prohibition-based drug policies directly contribute to a cultural narrative that views the substance as the primary problem, ignoring the uniqueness of each family, the culture it exists in, as well as the family’s strengths and resources.

We don’t have to reinvent the wheel–harm reduction approaches are already in place for other conditions. We can use this knowledge to extend these benefits to implement family-friendly strategies and practices in combatting the opioid problem.

FSDP bring diverse communities together to embrace enlightened drug policies—empowering families, restoring health, saving lives. We are dedicated to identify a vision and approach that will provide solutions and pathways forward…

Our meeting here offers us an opportunity for us to engage with the communities brought together here who share the public health lens of substance use, to be catalysts for change by tapping into your knowledge as scientists, educators, and healthcare providers to eventually develop the necessary strategies and practices and the hands-on tools to offer our families to restore our health to the level we deserve.”