UKDPC NON-CONSENSUS OF RECOVERY
The UK Drup Policy Commission charity was funded to draw up a consensus definition of "recovery". Addiction Today sees the definition publicly rolled out in May as divisive to the field, excluding those who seek alcohol- and drug-free lives for themselves and/or their clients. To ascertain if we are still continuing to identify the zeitgeist, we sent out a questionnaire to leaders in the treatment field.
DEFINITION OF RECOVERY: SURVEY RESULTS
Collated by Deirdre Boyd, CEO of the Addiction Recovery Foundation
UKDPC DEFINITION OF RECOVERY:
“Recovery is a process, characterised by voluntarily maintained control over substance use, leading towards health and well-being and participation in the responsibilities and benefits of society”
QUESTIONNAIRE EMAILED TO CEOs/Directors in the treatment field elicited the following consensus from over 20 heads of organisations.
Only 30% thought the UKDPC definition covered substance abuse
Only 25% thought it covered substance dependence
Only 15% thought it covered co-occurring disorders
70% said that all the above should be part of the definition of substance recovery.
“I like the thought of ‘well being’. It would seem that a complete sense of well being is hard to achieve without abstinence or receptor stability (ie with methadone). I’d like to think we have to include abstinence and perhaps add end notes about maintenance therapies.”
We thank the author of this statement: Dr Andrea Grubb-Barthwell, who was deputy drug czar of the US and is a trustee of the Addiction Recovery Foundation charity which publishes AddictionToday.
Maslow’s hierarchy of needs, Jung’s individuation, Assagioli’s transpersonal development all describe helping people to “become all that they can be”… is how you see recovery (for you/clients), and is not adequately covered in the definition.
0% of respondents said it was adequately covered.
Comment: “Very definitely – and no I don’t see it reflected in the statement”.
70% AGREED (15% disagreed):
A more accurate definition would start “Recovery is a process, the first step of which is characterised…”
60% AGREED (20% disagreed):
The 2 parts of the UKDPC definition can be likened to the 2 parts of Step 1 of the 12 Steps.
75% AGREED (10% disagreed):
The UKDPC definition ignores the other 11 of the 12 Steps.
We thank the dedicated professionals who responded – and those who are still sending their views in.
COMMENT FROM CEOs, DIRECTORS:
* Control? We know this doesn’t work, have these folks not been keeping up with the recent development in neuroscience? However, they could have been more liberal and really pushed the idea of “controlled use” or “reducing harm”, like the NTA. I like the process idea, ie: “Recovery is a process, where the first step is characterised by abstinence from the harmful use of mood-altering chemicals, followed by the engagement in a series of practical, emotional and psychological steps which enable the individual to lead a full an productive life, in order to reach their potential as a human being”.
* Recovery from addiction is a process, the first step is characterised by a total and honest personal acceptance of the condition, leading toward the opportunity for personal growth in turn allowing a full participation in the responsibilities and benefits of society. I think the UKDPC’s definition is very wrong, maintained control cannot be part of the process of recovery, but can sometimes be a valuable precondition. When the reality of the addiction is totally accepted, maintained control is merely an enabling tool.
* The word control in the definition suggests that an option of recovery is “controlled using”. Coming from a 12-step perspective, this is not a message I would want to send. However, this brings into question recovery from what, abuse or dependence? Although I maintain that abstinence is the best way forward from dependence for the wider meaning of recovery, measuring recovery in abstinence terms only is, I believe, limiting. Outcome measures that include people’s overall quality of life, relationships, employment, etc, from the treatment centres themselves would be a welcome contribution to a definition of recovery.
* Has anybody in UKDPC looked across the Atlantic? Why do the British have to bang their heads against a wall again and again to prove everybody else wrong? Americans completely accept that recovery is a therapy-led process. Our consultants cling to control like drowning men. The prob is that they are taking the patients down with them.
* I don’t think the UKDPC definition is a good place to start. I would look at it from some other definition – possibly from the US.
* I think of someone in recovery as being free from addiction, whereas someone on maintenance is still working towards recovery. If you ask, like I have done, people with illness such as diabetes, colitis, migraines and other illnesses that require regular medication – all of them 100% said they would not class themselves as being in recovery. Recovery to people not associated with this field is when their symptoms are no longer with them – abstinence. Therefore people taking methadone or other substitutes are not in recovery, by way of the millions of people not associated with the field !!!!!
* Something about choices, abstinence / maintenance, ongoing support, self care
* A better definition of who the client group is?
* Outcome measurements
* I don’t really see ho you can have any form of recovery without abstinence. The main challenge is encapsulating everything within a short statement.
* I think one of the most important characteristics of recovery is hope and would suggest something along the lines of “Recovery is a process, the first element of which is hope and is characterised by voluntarily…etc”
* Spirituality aspects could be included bearing in mind all the research. I don’t feel the words control and recovery go very well together and what about behavioural addictions which can be equally damaging?
* I find that the ‘treatment’ part of a person’s recovery is just the beginning of a long-term process, which is a baton we hope the client will pick up and run with after treatment. The government I suspect, is only looking for a definition of the part it is ‘responsible’ for and there has to ‘pay’ for. It is looking for the definition to include a link to clients getting back to work (paying taxes) asap. This I feel is very much in line with the new 10-year strategy, the governmental agenda can be heard loud and clear here. The problem is that you can read the statement to mean – get them on methadone, stabilised and working, as quick as poss – or a proper process or change – rehab – support – re-education and suitable employment. We shall see.
* Can’t agree with the leading towards comment – if I as an alcoholic suffer liver damage, or a heroin addict suffer hepatitis C, as well as bipolarity or other dual diagnosis, I am unlikely to be led towards ‘health’ or ‘wellbeing’ or the ‘participation’ in society simply from a characteristic of voluntary control… somewhat ridiculous in my eyes. My little stab: “Recovery is the process of structured physical, psychological and emotional rehabilitation of an individual from substance use or dependency, culminating in a healthy reintegration into society”.
* I am not sure it is worth the effort trying to go along with them at all when they are so patently out of touch. Nothing in what the UKDPC indicates to me that they have any understanding at all of either the 12-step programme or the therapeutic process.