Welcome to 2021. A New Year.
With the New Year and all the great resolutions we make, it’s a good time to elevate our discussion surrounding “substance use disorders”.
According to the National Household Survey on Drug Use and Health:
There are approximately 21.6 million people in America who meet “criteria for a substance use disorder”.
Of those 21.6 million only 12% (2.6 million) “got help”.
This “got help” group includes those who engaged in self-help groups. It does not mean 2.6 million received professional help.
And, of course, many people received more than one “kind of help”.
But, at best, 2.6 million people were “willing” to take steps to get help.
Treatment Effectiveness
AND IT IS SAFE TO ASSUME: this “willing” group was the subject of all research and evaluation (related to “treatment effectiveness”).
In other words, they only measure those who show up.
Obviously, you can not measure the person who never presents at a clinic.
You may be able to survey the general public, but you can’t measure “what worked” with someone who never engaged in the “model” being measured.
Obviously
So…
We talk with authority and tell families/people in need “here is what works”.
But this information is based on a very small subset of the total SUD population.
That seems irresponsible.
We know what to do if you are “willing”. If you “show up”.
But we don’t’ know much about the big picture.
We don’t know the entire spectrum of SUD. We address the worst aspect of the disease. We address the “severe” manifestation of the disorder.
The Ongoing Addiction Epidemic
The solution to the “addiction epidemic” has nothing to do with current practices.
Current practices have improved and the system is going to keep doing “its job”.
The recovery movement is now part of that system and has taken a marginalized place alongside clinical services.
We will keep doing our part. Myself included.
The Willing 12%
We will grow our programs and try to put a dent in the problem.
I am grateful to be part of the recovery movement and I think great progress has been made.
But, there will be no breakthrough beyond that “willing 12%” threshold.
Perhaps some small in-roads.
Do No Harm
Some “harm-reduction” initiatives. But not deep systemic transformation.
No one is talking about a massive reach.
No one is talking about “adult prevention” or upstream intervention. Everything is designed for the “deep end” problems.
“Admit you have a problem and do 12-step meetings” has been replaced with “admit you have a problem and pick a pathway”.
That is clearly an improvement.
But, that does not even approximate transformation.
The Next Evolution
We simply have not opened our minds to comprehensive solutions. Everything we do is based on a willing client who shows up and does the “program”.
I think we will see the following unfold.
The next evolution of support.
First,
Recovery coaching, recovery housing, recovery supports will continue to improve and expand.
We will make progress as a recovery movement.
FAVOR Greenville is committed to improving the quality of our work. Committed to increasing our reach.
We have demonstrated the ability to make a deep impact on any given community.
However, we are still playing in the 12% sandbox.
Our harm reduction efforts help expand our reach into the underserved deep end SUD community.
Transformation
The second pathway of transformation will also emerge.
Something that is upstream and has a “health coaching” / prevention vibe.
A model that does not require complete “unmanageability” as a precursor for care.
A model that is fully integrated with healthcare.
A model that makes no weaves SUD support into the milieu alongside other chronic diseases.
The word “recovery” will not be required.
We need to touch all phases of this disorder. We need to touch people who have not progressed to the level of “disorder”.
Unthinkable Numbers
Routine care-coordination with expertise in SUD. Online education platforms like youturn . Teaming up with healthcare, enterprises, military and other institutions to universally distribute the content.
All of this applies to mental health treatment as well.
In the future…we will see “both-and”. NOT “either-or”.
Or we will see unthinkable numbers. 100,000 plus overdose deaths; 100,000 plus alcohol use deaths and 75,000 suicides.
Will that wake people up?
