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Peer Support Is Evolving!!!

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Peer support is an evolving discipline. It’s a relatively new discipline. Standards are still being defined.

Like any other profession: there is great variability in terms of quality.

Completion of a training doesn’t equal effectiveness as a coach. We need time, supervision, and structure to hone our craft. It takes time to get good at coaching.

💥💥💥 “If you hone something, for example a skill, technique, idea, or product, you carefully develop it over a long period of time so that it is exactly right for your purpose”.

Our goals are:

✅ help advance the evolution of peer support. Specifically, develop assertive engagement specialists. Refine that specialty.
✅ enhance the experience with technology
✅ redefine “family recovery coaching”
✅ establish ourselves as the nation’s premier provider of peer support services.

ABOUT RICH JONES MA, MBA, LCAS, SAP
EVP & EXECUTIVE DIRECTOR, HERITAGE CARES

Richard Jones

Executive Vice President (EVP) at Heritage Health Solutions, Inc.
Chief Strategy Officer Co-Founder at Youturn,
CEO at Wellness Partners Group
CEO/President at Jones Solutions Group
Former CEO at FAVOR Greenville

Visit Heritage Health at – Click Here

For Addiction Support Info – Click Here

Please Subscribe to the Recovery Cartel – Click Here

Recovery Cartel Blog 07262021

I Cry … and Start Over

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Start Over

💥💥💥I think it makes more sense to “start over” at the beginning of each new “birth year” rather than the beginning of each new year.

Each new year we reflect on the past year. We make new year’s resolutions.

We have this sense of starting over.

For me… it happens on my birthday.

53rd Year

Today day is day one of my 53rd year on the planet.

This past year has been the most difficult year of my life.

My 52nd year on the planet was brutal. I have come face to face with depression in a way that I never have before.

I’m not sure if I was in denial in the past. Perhaps I was embarrassed and never really got honest?

Another Level

Also … events in my personal life triggered things and pushed this shit to another level.

Men are not supposed to be depressed.

Men are not supposed to be anxious.

We should just get shit figured out and move on to the next task. Suck it up.

The S Word

I was definitely ashamed and the stigma kicked my ass.

Now … I do not give a f**k . Truly, I am going to be open and I’m not hiding anymore.

New Decisions

I’m going to make decisions that benefit my mental health. I’m going to work smarter. I’m going to take steps to reduce stress.

I have been on a hamster wheel of busy-ness and ambition that is relatively non-sensical.

Need to minimize and adopt a more simple lifestyle. And prioritize relationships.

Liberation

53 will be a year of liberation.

I intend to share the journey. In the event there are other men out there who are tired of the “suck it up” / real men don’t cry bullshit.

I cry ….

Bob Dylan

The Times They Are A Changin’… Bob Dylan

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A NEW DISCIPLINE IS ON IT’S WAY

This is required reading for all our FAVOR Greenville Staff.

Also the YouTurn Staff and Wellness Partners Staff….

AND MY KIDS…. Read this: ***

From Bob Dylan’s The Times They Are A-Changin’ (Witmark Demo – 1963)

Come Mothers and Fathers – Throughout the Land
And Don’t Criticize – What You Can’t Understand
Your Sons and Your Daughters – Are Beyond Your Command

THINGS ARE A CHANGING

Things change whether we want them to or not. One can always lament the loss of the “good old days” and we love to talk about how much better things were “back in the day”.

We also apply revisionist history when discussing our systems and our institutions and conventional wisdom around how to best do life. Further complicating things is the psychological phenomenon of perceiving one’s personal experience as a universal fact.

PARENTING

Let’s examine parenting for example.

For some reason people wax nostalgic for the days when parents could beat the hell out of a kid and call it discipline rather than abuse.

Things are never as good as we remember them. Nostalgic misrepresentation.

Corporal punishment causes much more harm than good, overall. Statistically speaking.

When this topic (corporal punishment) is brought up someone will inevitably make the statement:

“My Dad beat my ass and thank God he did because I turned out the way I am cause he beat my ass”…..

FLAWED ASSUMPTIONS

This statement is flawed on 2 levels:

  • You assume we all want to turn out the way you did. You may have turned out to be an asshole and your report merely reinforces the fact that corporal punishment is a bad thing.
  • You assume that your experience in some way represents a universal fact applicable to the entirety of humanity. As if what worked for you (getting beat) will work for everyone. This is a very arrogant way of thinking.

Furthermore, I got my ass kicked on a regular basis and it sucked and it made my life horrible.

And by your logic…if your “experience” speaks for all of humanity…well then, my experience speaks for all of humanity as well.

This clearly violates the law of non-contradiction, therefore invalidating your original assumption that; “experience equals fact”.

EXPERIENCE DOES NOT EQUAL FACT

We can do so much better. WE CAN ACKNOWLEDGE THAT EXPERIENCE DOES NOT EQUAL FACT.

We can embrace progress and we are allowed to change our mind.

We can risk bringing new ideas into our consciousness and we are permitted to have a different opinion from the group.

We can even debate difficult things without devolving into a childish fit of rage.

IT’S INEVITABLE

Progress and change is inevitable.

It’s coming fast and furious in all areas of life. All societal institutions are subject to be reconceived and reconstructured.

Education, healthcare, military and even the government (we will have more than 2 viable political parties in the near future) are going to overhaul.

If we base our opinion on our own personal experience, reinforced by the opinions of all the other people in our homogeneous tribe, we will resist change.

A ENTIRE COUNTRY IN PERIL

We will get steamrolled.

Technology is not slowing down. Problems are not going away.

Social problems, such as ever increasing overdose deaths and gun violence are not going to magically go away.

The crazy political turmoil and division,  the unprecedented suicide rates (both adolescent and adults) other substance misuse related deaths, and the unchecked mental health crisis are all “trending” in the wrong direction.

This will continue to escalate until our society responds with the full force and urgency consistent with a country in peril.

THE PAIN AND SUFFERING

“When the pain gets great enough” all solutions will be on the table.

“When the pain gets great enough”, “they” will have little concern what our personal experience was and what “tradition” dictates as a solution.

The pain is starting to get great enough!!!

Our beloved addiction treatment industry and recovery services system is going to change as well.

This includes the way we have structured and positioned “Recovery Coaching”.

THE HOLY GRAIL

The preoccupation with making peer support mimic clinical counseling has been part of the challenge and one of the reasons professional recovery support and coaching is not more widespread.

Recovery coaching as a branch of already existing services may help in some ways but it is not transformational.  It is an adjunct.  It’s not different enough.

The “Holy Grail” of a “reimbursable code”  so that recovery organizations can get reimbursed by medicaid and commercial insurance is a chimera.  Furthermore, why do we assume that reimbursement from the existing infrastructure will lead to scalable services?

QUESTION

Why does “Peer Recovery Support” or “Recovery Coaching” or whatever you want to call it,  automatically assume that the insurance reimbursed “Business Model” is the best model?

ANSWER – BECAUSE “THAT’S THE WAY CLINICAL TREATMENT IS REIMBURSED”?

For sure, some isolated organizations in select states will thrive under the current model.

There are some places where the state system is more amenable to supporting independent recovery support.

I believe South Carolina is going to be one of those places.

Furthermore, recovery coaching will continue to be promoted across the country.  But it won’t scale.

Because it’s not paid for by the public system in a manner that promotes growth.

IT’S NOT UNIQUE

Recovery coaching is not a desired service within the private marketplace (businesses, other enterprises, general consumers etc..) aside from some very isolated initiatives such as what we have developed here in Greenville, South Carolina.

But Greenville is just a small piece of the pie.

We want to see a nationwide sea change.  It’s difficult to say this but recovery coaching, on the whole, is not attractive enough to the private market to warrant widespread adoption.

Partly because it’s not unique.  It’s not differentiated.

CONSIDER THIS

  1. Why are all the “Recovery Coaching Training” curriculums essentially the same?
  2. Why do they so closely resemble many of the things we are taught in “Clinical Training”?

In addition to that, the overwhelming majority of people trained as “Recovery Coaches” across the country are not working.

NOTE: ARE WE CREATING A WORKFORCE FOR THE SAKE OF CREATING A WORKFORCE?

A NEW DISCIPLINE

In my realm of influence (FAVOR Greenville and beyond) “Recovery Coaching” will continue to be a core service.

We run recovery centers.  We facilitate all recovery meetings.  We provide one to one coaching.  We do outreach to treatment centers and detox programs.

Of course we will lean on this foundation.

In truth, the majority of our services will be traditional recovery coaching.  It works in these traditional environments. We do this very well and we are committed to continuing our efforts in this area.

20 MILLION PEOPLE

But there are 20 million people out there who are not into the “Traditional” environment.

They all deserve help!

They all deserve a “Solution”!

THEIR FAMILIES ALL DESERVE SOME HOPE.

RESEARCH AND DEVELOPMENT

Therefore, we need to devote a certain amount of time to “Research and Development” as well as “Product Innovation”.

We have developed another venture that will focus on these breakthroughs.

This company does not resemble anything you have previously seen in the recovery support services or addiction treatment space.

NOT ANOTHER REHAB BUSINESS

We aren’t getting into the rehab business (never again) or the recovery housing business or other typical programs that may expand our reach.

I respect those programs and I’ve worked in all those models.

However, it’s not my jam any more and it is not what our companies are focused on.

We are going to pivot to meet the demands of the market and respond to the customer.  We will listen to the customer.

First by identifying who our actual customer is.  Most assume it is the person in need.

But we know that’s ridiculous because the person in need is running from the service.

The customer is the family system (all individuals are part of a family system), the workplace, the school, the community etc…

We work from the customer out to the program.  Fit the program around the customer. Not the customer around the program.

We will develop a new product with the service to back it up and we will approach continuous improvement with the same zeal Zappos approaches “happiness”.

BENCHMARKS AND MENTORS

Our benchmarks and our mentors will come as much from the business world as the addiction treatment and recovery services world.  Actually, probably more from business.

We are obsessed with customer service.

A product and a service that will be judged based on the response from the customer.  Imagine that?

The market will guide our product and the associated service and we will invent a solution.

It will not be called Recovery Coaching so there will be no confusion.

SOMETHING NEW – NOT RECYCLED

Interestingly, the treatment infrastructure is likely to benefit from our efforts.

Since we are hell bent on differentiating ourselves from the historical solution we will go to great lengths to lean on our clinical partners.  We will work closely with clinical providers and partners to maximize the experience for the customer.

This includes private providers and public providers.  We want to strengthen our relationships with state systems.

However, this doesn’t mean we roll people into rehab over and over.

TREATMENT GOES WAY BEYOND REHAB

Our value add is the invention of a new product and service not the reapplication of a legacy product.

“Recovery Coaching” integrated with and supervised by clinical treatment staff is essentially the same as a “Behavioral Tech”.

Techs have existed for 50 years.

We want to provide something that produces ZERO confusion.  Something new…. not recycled.

Our clinical partners will thrive because of our venture into this brave new world.

I may even get invited back to the cool kids table at the annual conferences…..

NOW THAT’S AN OUTRAGEOUS IDEA!

RECOVERY COACHING NEEDS TO BE RE-EXAMINED

Remember, the current “recovery support system” was not ordained by God.

Relatively speaking, its very new.

It’s completely logical that everything needs to be reevaluated and, probably, needs to undergo major adjustments.

First off, who are the experts guiding this?

How many people have even actually provided recovery coaching and/or successfully run an organization?  Not very many.

Relatively speaking we are talking about a very small insular group of people. I would put myself in that group.

FAVOR GREENVILLE IS THRIVING 

That doesn’t mean I’m the authority, and just because there are handful of other places thriving doesn’t mean they are the authority.

We need to acknowledge that we have not even reached adolescence in terms of our field’s development.  Yet we act as if this stuff is stone cold fact.

We can do better. Much better.

It’s completely clear that this is an evolving profession. An evolving service.

Is “the approach”  we currently have the gold standard?  If so who decided that?

Should this model be “locked in” at such an early iteration?

THE NEXT VERSION ???

We have all heard of version 1.0 ; version 2.0 ; version 3.0…when it comes to technology and other industries.

Could that same thinking apply to recovery coaching and recovery services?

Recovery Coaching 1.0 has been the universal approach.

HOWEVER, I challenge the idea that the current manifestation of recovery support/coaching is the most effective version.

Look around, all the stuff that you take for granted in life was invented by someone no smarter than you.

You are permitted to invent a solution…. “They” won’t tell you that.

If you become aware that you are allowed to solve this problem….well then….what would “they” do?

 

The Standard Company Line - Not Me! 2

The Standard Company Line – Not Me!

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When I give a talk I do not follow the standard company line with the generic blah blah blah….

This past year I have done a bunch of talks/presentations on recovery community centers and recovery coaching. All over the country.

I am not confrontational but I am probably a bit direct and I am not always tactful. But with me, what you see is what you get, and there is no question where I stand.

I deliver recovery coaching and run organizations that provide tens of thousands of hours of coaching. I’ve talked to at least 100 parents who have lost a child.

FAVOR GREENVILLE

FAVOR Greenville searches homeless encampments for participants who are enrolled in our program, we are in soup kitchens, schools, hospitals, everywhere.

We work with 8,000 plus families. My opinions are based on practice not theory.

I’m getting old. I don’t have enough time left to go along with things that aren’t impactful and actionable.

I have no time left to promote ideas that are old and stale.

No time for things that are not going to move the needle on recovery.

REAL LIFE EXPERIENCE

Also, before FAVOR Greenville I toiled in the medicaid/state run SUD system on the clinical side.

I’ve done tour of duty in private rehab. I’ve done community mental health, private practice, in-home mental health, in-home family services, had an intervention practice.

This gives me a unique perspective. Again, nothing theoretical about my opinion.

It’s based in real life experience and a boatload of education and academic training. I have strong opinions. I’m willing to adjust when the evidence suggest I’m wrong. But I won’t go along with the company line just because “it’s the way we do it”.

INDEPENDENT RECOVERY ORGANIZATIONS

One subject that gets attention on these trips:

I openly state that independent recovery organizations are a “major” part of the solution.

And that, sadly, they are either completely ignored or given token support in most places.

I point out the tragedy of that reality and I clarify that a peer recovery staff in a treatment setting does not constitute a robust recovery oriented system of care. Posting someone up in detox or IOP does not address the recovery issue.

It’s better than nothing but it’s not the solution.

I talk about RCO’s being essential and I state that RCO’s should have dedicated permanent funding via federal and state drug and alcohol dollars. Significant funding. On par with prevention and treatment.

WHAT DID YOU SAY RICH?

Many times there are state drug and alcohol officials and county drug and alcohol officials in the room when I make these “outrageous” statements. In some places (many places actually) this goes over like a lead balloon.

Officials in state systems do not want to hear that type of talk. But what the hell is wrong with saying that?

It’s 100% true. ONE HUNDRED PERCENT TRUE.

RICHARD JONES UNPLUGGED

However, in other places there are people who want to hear more.

There are groups that agree 100%. There are even system officials who agree.

It’s fascinating to see the difference from state to state.

I have a running joke: I usually get invited to a town only 1 time and not invited back.

Once they get Rich Jones unplugged it’s one and done…. but some are inviting me back.

Oh my… that’s scary isn’t it. What if they listen to me…

A NOTE FROM RICH:

Thank you Lynn Farnquist and Families Against Narcotics for the having me up for a family presentation.

Families Against Narcotics (FAN) was born out of a town hall meeting held in 2007 – a result of two teen heroin overdoses just weeks apart in the small, middle-class suburban community of Fraser, Michigan.

All told, that community suffered 30 overdoses that year. All to heroin. Needing to do something, this determined organization set out to recruit members and educate the public.

Visit Families Against Narcotics

 
Can we use this technology for good? 2

The Dark Side of Social Media

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Social Media Acceptance and Status

Constant connection into social media leads to constant comparison.

The picture above is from a Psychology Today article title “The Comparison Trap”. It outlines the diabolical dark side of social media.

For many people this constant comparison leads to an ever-present nagging feeling they may be falling short in their own lives. Human beings are hardwired to assess how they measure up.

Human beings are subconsciously drawn toward assessing their status within the group.

This Self Assessment was essential for survival as we evolved.

If you weren’t accepted and of low status back in the day you were in danger. Being a central and valued part of the tribe meant physical safety.

Today we seek acceptance and status to preserve psychological safety more than physical safety.

Social media is most damaging to those who are most actively engaged.

Young people are most vulnerable to issues associated with status seeking.

Think about being in middle school 24 hours a day 7 days a week. Never able escape the cliques and the constant message “you aren’t cool enough or pretty enough etc…”.

There is a growing body of literature supporting a correlation between screen time and depressive symptoms. See this Psychology Today article for example. 

Anxiety rates are at record high among college students.

Social isolation is becoming the new norm and 1 in 4 Americans report they have no friends to confide in. Americans are lonely, isolated and depressed.

Anti-Social Media:

Social media is not the only factor contributing to our current societal crisis.

However, it is clear that social media has had a significant anti-social impact. Being able to look at pictures of those with perfect personal lives and epic professional accomplishments can chip away at self esteem.

Pictures that are perfectly produced with just the right angle and just the right filter.

In one of the more troubling signs of the times people are seeking plastic surgery to look like their edited online pictures. 

We now know there is a correlation between time on social media and suicidal ideation. Same can be said for depressive symptoms.

Is the explosion of social media directly connected to deaths of despair (overdose, suicide) and the mental health/substance use disorders crisis?

This connection hasn’t been firmly proven and is open to debate. However, it’s not difficult to connect these dots.

As technology and social media become more advanced future generations will be even more dependent.

For me, social media is something I view through the lens of a time without social media. My kids won’t have that perspective.

Cyber-life will be the norm. Social media is not going anywhere. It’s only going to expand from here.

There may be some gate-keeping and regulations along the way. Platforms are going be added and expanded. Not eliminated or contracted.

Their reach will be deeper and wider and involve technology that we cannot currently conceive.

What do we do?

If you can’t beat it join it. We need to meet people in need where they are; on the platforms.

We need to bring emotionally supportive content and we need to start sharing the truth of our lives.

We need to fight fire with fire.

People are going on social media platforms and coming away feeling worse about themselves. Especially young people.

Professional public health strategy should include social media outreach that directly confronts this artificial landscape.

Pro-social coaches who are willing to share the good, the bad, and the ugly in an effort to present reality rather than “manufactured” reality.

Uplifting content and constant connection that promotes self-confidence and empathy.

This would take a monumental effort and require serious strategy.

The biggest challenge would be delivering the content in a manner consistent with the culture and norms of any given sub-group.

Ideally, we would use age-appropriate coaches to deliver the content.

Maintaining authenticity and genuineness is essential.

Can we use this technology for good?

Recovery Cartel Blog

“A Dent in the Universe” by Richard Jones

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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.

Observation from Richard Jones Recovery Cartel

Just My Observation – Tell Me What Am I Missing?

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THIS IS AN OBSERVATION
BY RICH JONES | RECOVERY CARTEL

It sounds sarcastic and provocative but it’s truly an observation. And the points I make are unassailable.

I challenge someone to tell me what I’m missing.

With the facts below in mind, understand that the long standing manifestation of treatment/“rehab” is unsustainable.

The approach used to get customers is so insanely one dimensional and insulting to the average human being that it is unsustainable.

ONLY 10%

No wonder only 10% ever show up for treatment.

The reason it has lasted this long is the stigma.

No one in the outside business world wanted in on this industry because it’s a stigmatized patient group. No one creative considers involvement because those “scum-bag” addicts are an afterthought.

A NEW BUSINESS MODEL

Historically, if an outsider does decide to get in they just followed the rehab formula because it was a proven business model.

No one bothered thinking about creative destruction and inventing a new business model.

As stigma is reduced and awareness raised more and more outsiders will become involved. And things will change.

A new business model will emerge.

Marketing in the addiction Treatment/Recovery industry is really only focused on filling rehab beds and appears to fall into one of 8 categories/strategies; or a combination of these strategies:

8 CATEGORIES / STRATEGIES 

  1. Hire someone/maintain team to do face to face business development to outpatient, doctors, etc…. focus on legacy relationships, brand and reputation to fill beds. Use outpatient clinics to funnel clients as appropriate. This is mostly used by the large legacy programs and integrated massive systems.
  2. Digital media (Facebook, Instagram etc…) with the apparent strategy being create a persona or use pseudo-celebrity/actually celebrity to basically tell his/her 12 step story over and over….while encouraging people to call now for help.
  3. Digital media where these same personas, pseudo celebrities/real celebrities diss other pseudo celebrities etc…. while encouraging people to call now for help.
  4. Digital media where these pseudo celebrities etc….tell parents they are enablers and killing their kids….while encouraging people to call now for help.
  5. Google ad-words at hundreds of thousands of dollars per year.
  6. Annual conferences (NAATP, C-4 etc….) where people talk about the latest innovation in treatment and ethical marketing practices. While encouraging one another to “keep us in mind if you think you have a fit for our program”….
  7. Some guy in doctor scrubs on television in the lowest production value commercial in the history of TV encouraging people to call now if you or a loved one need help.
  8. Body brokers.

With the exception of number 1 and number 6. The content of the marketing message, despite the platform or avenue of delivery, is essentially

  • “You’re hopelessly addicted. You’re in denial about that. Call now and get help. Or you’re gonna die”….. or
  • “You’re loved one is hopelessly addicted. Get your shit together and stop enabling. Call now or they are gonna die”…..

Number 1 works because the narrative of “we are the expert healthcare providers/treatment providers and state of the art etc….” and “we are really you’re one best option” has never really been challenged.

Legacy and brand is hard to overcome.

Number 6 is just an excuse to visit a posh resort and play golf. 😎😎😎😎

This is an industry that is going to get completely turned upside down as soon as the knowledge of the issue (and the associated opportunities) escapes the Recovery Bubble. Begging for disruption….moral imperative to do so.

Anyone remember Blockbuster??

Epidemic Visionary - Recovery Cartel Blog

Alien Sent to Earth to Solve the Epidemic

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Who is thinking about the behavioral health crisis in a visionary way in hopes to solve the epidemic.

Overdoses and suicides #1 and #2 in injury related deaths respectively. Anxiety, depression record setting levels.

Consider this…

Flat-Earth?

In order for people to discover the new world they had to allow for the possibility that the world was not flat.

  • Einstein proposed particle theory at a time when all scientists were certain light was a wave.
  • The American Revolution (1775-1783) took many ideas from the early civilizations of Greece and Rome and combined them with the Christian Bible to revolt against an authority that was unbending by embracing a completely new concept: a modern representative republic.
  • Gutenberg invented the printing press around 1440 changing the way that information is disseminated and changing the world. Before this monumental creation books were copied by hand and humans were limited in their ability to transform their lives/move beyond their immediate sphere.
  • The industrial revolution, the assembly line, the invention of the automobile ushered in a new era of urbanization and economic growth.
  • Steve Jobs decided it was possible to put the power of a mainframe computer in our pocket.
  • The internet has made instant access an everyday mundane experience.
  • Elon Musk is trying to solve the LA traffic problem by tunneling under the city. It looks like it will work.

We could go on and on… in each case the world changing development required visionary thinking.

Paradigm shifting….Risk taking….Not normal… behavior.

Are You Willing and Engaged?

Right now we are sure that the solution to our crisis is “more access” to the same services.

Or maybe we add some medicine and make that accessible.

Or maybe we develop an app to “monitor” progress.

All of these are built on the fundamental premise of a “willing and engaged client”.

That’s the paradigm. Help those who want it. You can’t make a person get help.

We are sure this is the case. We base the entire system of this fundamental premise.

Limited Vision

Are we, perhaps, limiting our view?

Is there a similar visionary way to think about behavioral health.

Reject everything we know about what works with mental health and substance use disorders.

Pretend you’re an alien sent to earth to solve the epidemic. And you have no preconceived ideas.

Maybe we can help people who don’t want help? Can we engage those who don’t want to be engaged?

Maybe you don’t have to hit bottom and become willing?

Maybe the Earth is Round??

Get rid of the concepts that limit us.

Even the concept of “Recovery” itself as it exists in our minds.

How would we solve the problem if we started from scratch? Where would we start?

Or…what concepts would we keep and what would we purge? What concepts could we borrow from other industries that may be useful in this industry?

What radical ideas would be generated if we weren’t limited by all the slogans and cliches that have been burned into our subconscious?

CASA Columbia Analysis of the National Household Survey on Drug Use and Health

Our Industry Has Failed At Engagement

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The National Household Survey

From the CASA Columbia “Analysis of the National Household Survey on Drug Use and Health”.

Please take a moment and cogitate on the picture in this post.

Observe if you will the 2 “poles” of the continuum.

In theory we address the entire continuum of substance use; but does our practice/approach match the diversity and stages of substance misuse? Of course not.

In American society we approach substance misuse primarily in the following 2 ways:

  1. “Just Say No! Don’t Do Drugs” (focusing on the 12.7% “not using”). These are our prevention programs.
  2. “Wait Until You Hit Bottom”; admit you are an alcoholic or an addict and come to treatment (focusing on the 15.9% “addicted”).

This is our reality. Substance misuse is not discussed until IT HAS TO BE DISCUSSED. Until it cannot be ignored.
And even then we do a horrible job connecting to that 15.9%.

From the CASA Columbia Addiction Medicine Report:

While about seven out of 10 people with hypertension, major depression or diabetes get treatment for their medical conditions, only about one in 10 people with addiction involving alcohol or drugs other than nicotine do, leaving a treatment gap of 20.7 million individuals. The proportion of individuals in need of addiction treatment who actually receive it has changed little since 2002, when 9.8 percent of those in need received treatment.

Failed at Engagement

IT HASN’T CHANGED SINCE 2002. 16 YEARS.

I would say that indicates we have failed at engagement.

If we can start touching the people who are in the non-risky and risky categories we can make a difference.

But they are NOT going to come to your clinic.

They are not going to listen to the “Just Say No” presentation at school.

If they are in the risky category the “documentary on addiction” is not going impact them.

They are not going to go to a meeting and admit powerlessness.

Quite frankly, meetings are NOT designed for the “risky user”; they are designed for the “real alcoholic/addict”.

They are NOT going to come to an intensive outpatient program unless they have to, i.e. DUI, and then they are going to go through the motions.

This is What We Need

Information, non-judgmental information, that does not involve a diagnosis.

That does not involve a prescriptive “program”.

Does not require “admission” to a certain type of problem.

This is what we need. Engaging information. Professionally delivered.

With a nod toward healthcare rather than a nod toward rehab.

The word recovery may even be problematic for the “risky user” category. They just aren’t there yet.

Carpet Bomb with Information & Connection

If we carpet bomb the country with information and connection at a “stage appropriate” level, I believe that will lead to more people in the “addiction”‘ category seeking treatment.

If we “touch” people along the way as they progress toward addiction they will be more likely to seek help once they do cross that line. OR even before they cross that line.

The challenge is doing so at a “stage” appropriate level.

Engaging Content and Engaging People

We can’t talk to the public the same way we talk to one another.

This goes way beyond using the term “substance use disorder” versus the term “addiction”.

Avoiding the term “substance abuse” is not going to win the day in this regard.

Engaging content and engaging people talking about health and wellness will make more of an impact.

Almost Impossible

“Identification” is hard enough for a person who has crossed that line into “addiction”.

It will be almost impossible for the “risky user”.

Unfortunately many of these “risky users” are being sent to rehabs that were designed for the “addicted” person.

Causing more harm than good?

Embrace Harm Reduction

This is also going to require that professional providers embrace a harm reduction point of view.

NOT in terms of M.A.T. or needle exchange etc… but in terms of reduction in use; less dangerous use etc…

Increasing community tenure. Getting away from knee jerk referrals to inpatient rehab.

Many of you are cringing while reading this.

Noble and Important Work

I love everyone who works in this field. Y’all are doing noble and important work.

But the logic of my argument is beyond reproach. Don’t kill the messenger.

If we are ever going to slow the rampage of addiction we will need to implement these type of comprehensive interventions.

Emphasizing quality of life and health/wellness over “recovery”.

Bleak New Estimates From The CDC - 72,000 DEAD!

Our Kids Are Still DYING —- 72,000 DEAD!

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Horrible, bleak new estimates from the “Centers For Disease Control and Prevention” on overdoses – 72,000 in 2017.

“Drug overdoses killed about 72,000 Americans last year, a record number that reflects a rise of around 10 percent, according to new preliminary estimates from the Centers for Disease Control. The death toll is higher than the peak yearly death totals from H.I.V., car crashes or gun deaths.” – New York Times

If you read the complete article you will also see that “…there are also encouraging signs from states that have prioritized public health campaigns and addiction treatment”. The 2018 numbers are trending down in many parts of the country and the “rate of increase” is slowing overall.

However, 72,000 overdose deaths is staggering.

Estimate from CDC

The New Normal

Unprecedented and hard to wrap your mind around that reality.

Furthermore, we know this is an “addiction epidemic” not an overdose epidemic. As we have discussed before; add in suicide rates and untreated mental health.

Record setting anxiety among young people. Are we still alarmed or are we numb?

Will these results become the new normal?

The response you see from the industry is a doubling down on standard operating procedure. Countless pleas for “more treatment and longer stays”. Countless pleas to the addicted individuals to “call now for help; save yourself”.

The answer to this crisis is not to simply keep shouting “come get help”…

OF COURSE WE WANT YOU TO GO GET HELP. OF COURSE WE WANT YOU TO GO TO A QUALITY TREATMENT PROGRAM. DO IT…GET HELP TODAY. CALL NOW!!!!!!!!!!!!!

Only 10%

But we know only about 10% of people will actually do so.

Are  people still thinking that this statistic is a lie?

Do they think the federal government just makes that up?

Do people think that addicted people will all the sudden wake up and go get help because of a Facebook ad or television commercial?

All the sudden the unwilling are going to become willing?

Crossroad as a Nation

We are at a crossroad as a country…a crossroad as a society.

This is not unprecedented. This happens in the course of human evolution. It is not 1972. Things change.

When “rehab” was invented there was no internet, no cell phones, no fentanyl, no 18 year old heroin addicts, no K-2 spice, no kratom, no legal weed, no social media….

I mean, it is insane that the basic procedure and response to this issue remains unchanged.

Basic Procedure

  1. Tell people they need help
  2. Tell families not to enable
  3. Wait until they hit bottom
  4. Get them to go to treatment
  5. Get them to go to 90 meetings in 90 days.

Watch them live happily ever after.

This will work if you work it… but what if you don’t?

Holy Cow…. It appears we are going to ride this bus off the cliff.

Addiction is Not a Disease – Really?

Overall Americans don’t think addiction is a disease.

We don’t treat it as a disease. We use the “disease of addiction” as a source of entertainment; TV shows; social media; etc….

We follow addicted people with cameras and document their use.

Document their self destruction and ugly behavior. We turn them into a sideshow.

Our policies do not reflect addiction as a disease. Imagine being an everyday uninformed citizen and coming across your average recovery feed or reality TV show?

Imagine the perception that person comes away with? Those of us in recovery may love to hear what is was like, what happened and what its like now…

But your average PTA member recoils at the “I was living in a dumpster behind Taco Bell” type details.

Addiction and recovery is becoming a circus freak show. Come watch the addicts put themselves on display. Good God.

A Need For Disruption

This industry is in desperate need of disruption.

But change in healthcare is difficult for many reasons and change in the behavioral healthcare space is even more difficult because of the “mysterious” process of getting better and the blurred lines between personal and professional experience.

Perhaps the most significant barrier is the “you’re gonna kill people barrier“.

If you try to do something radically different in this domain people push down the innovation by stating “that’s gonna hurt people; you’re gonna get people killed“.

As if people aren’t already dying?

Disruption implies the creation of something completely new.

Invention vs. innovation. Invention is creating something new. Innovation is tweaking the existing process.

ONCE MORE: TREATMENT WORKS IF YOU GO AND YOU ARE WILLING AND YOU “WORK IT”.

SO CALL NOW… GO GET HELP.

But this is way beyond that willing person… Sorry to be such a buzzkill…

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