“A Dent in the Universe” by Richard Jones

Pockets of Excellence

To paraphrase the institute for therapeutic change any service is better than no service but no service stands out as the best.

For the most part, this is true. There are outliers on either end.

Some programs/people/service providers are far superior to the rest of the field.

That is probably due to the exceptional skills of a few top performers who work there. The SUD field has always been full of these isolated pockets of excellence.

However, the approach or method or “level of excellence” has never been scaled or replicated.

Mainly because we haven’t found a way to clone the “masters” who run the show in these settings.

Remember, scaling a method or an approach doesn’t mean you open up a couple of more centers in your region or even a few scattered across the country.

Scaling means exponential growth and exponential reach. Millions; not thousands.

Walmart Providers

There are also outliers on the other end.

Horrible providers and therapists and programs and services.

People who should not even be in a room with another human being let alone being in a professional helping field.

Pop-up; Walmart providers are commonplace.

Miserable people burned out holding on way too long. Unfortunately, these programs/people exist.

I Am Amused

However, for the most part the majority of providers are adequate. Providing a variation of a service/program that has been around for 40 years.

If people engage they will probably start to get better. Not everyone. But many will improve.

As much as I hate slogans: these programs seem to ‘work if you work them’.

At least in terms of initial improvement and quality of life they will make an impact. Furthermore, in terms of keeping people alive, there are more options than ever.

I am amused as I see the latest “Recovery Coaching Certification” or “Family Recovery Certification” advertisement.

Or the announcement for the opening of the latest state of the art treatment center; this one will have acupuncture while you ride horses.

It’s called Equi-puncture.

Solutions Still Based On “Willingness”

All the hype and debate around MAT is foolish as well.

We know it works “if they work it”.

The latest “app” misses the mark as it only helps the person who inputs the data or enables the “tracking system”.

Because each and every “new solution” that is proposed assumes “willingness” on the part of the participant.

All of these “evidenced based programs” or “traditional tried and true approaches” are based on a participant who shows up and, for the most part, follows recommendations.

Debating the “best approach or best practices or evidenced based practices” may be entertaining and may make good content for this week’s task force meeting.

But it’s literally a red-herring. An inane exercise which makes us feel as if we are making progress.

But The Facts Remain:

• 90% of those in need never touch these “evidence based” programs. Hasn’t changed for decades. Probably won’t if we keep focusing on “evidenced based practices” to help the willing.
• The “system” that already can’t respond to 10% engagement (waiting lists exist for everything: including MAT) would literally implode if we reached even 25% engagement.

Therefore, the “hit bottom” and “you have to want it” foundations of our system, serve a purpose.

It goes to follow then that: the system which would be able to serve increased engagement doesn’t even exist yet. Furthermore, this new system will be unrecognizable by current standards.

It will be as different from the current treatment system as an iPhone is from a pay phone.

“Call Now” – What Are You Waiting For???

–The marketing practices and efforts at engaging the public and/or the person who may need help are laughable. The dude with the doctor scrubs on television.

The endless 12-step speaker meetings on facebook imploring us to “call now”.

You really think this is going to engage an ambivalent participant?

These approaches will SCARE some people into treatment.

But it’s actually going to increase stigma and make the rest of America run the other way.

FACT: The entire American economy is built on making people buy things they don’t actually need. Yet we can’t even make more than 10% in need come get something they desperately need.

There Is A Way

I spend less and less time with people in the recovery bubble.

I spend less and less time with people in the industry.

I spend more and more time with people from other industries and this is why I believe there is a way to change these outcomes.

The goal: 90% of those in need of SUD services engaged in professional support services.

This means at least another 20 million people.

Probably more as we will also engage the “risky” user who hasn’t even been identified.

QUESTION EVERYTHING

Question everything you have been told about treatment, recovery services, insurance, ect..

That system was put together by people who are less informed than we are and certainly no smarter.

Many act as if this “System” is “divinely inspired and comes from God!

They act as if we must do things this way.

We are much more knowledgeable than they were in 1970 when they cranked this thing up.

Stone Cold Truth – Really?

Over my 18 years in recovery and professional treatment/recovery services there have been countless times when I realized I was wrong about something.

Something that a year earlier I would have sworn on as dogma and stone cold truth.

Thank God my views evolve and I remain curious. I read. I read a lot.

I read on topics outside the bubble.

I’m not interested in addiction or recovery conferences or webinars. It’s all recycled information.

I ask questions. I change my mind.

More, More, More

It’s ironic that serving 20 million more people will not be based on more beds or more MAT or more insurance parity.

These areas are a very small part of the plan. Almost an afterthought.

These are ideas that are part of a vision. There is nothing threatening about ideas. Is there?

We will figure out how to get to that vision… by starting with identification of how NOT to get there.

We will figure it out.