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?

The post New Year’s Resolutions? appeared first on The Recovery Cartel.

The Tragedy Continues

At least 1x per week I get a text, or a private message, or a phone call about someone who has died of an overdose or a suicide related to addiction. It seems they just keep dying needlessly!

Sometimes the details are unclear. However, many times I know the person and I know the story behind the tragedy; in terms of treatment attempts, recovery attempts, mental health, other issues.

Sometimes the person was completely disengaged from recovery.

A person who had never really tried as the disease got them too early. Usually this is a young person.

But lately it’s been people who are deeply involved in recovery and/or treatment.

Actually, a few cases this past 3 or 4 weeks involved people who just completed treatment.

In 2 cases people who were actively in recovery housing/treatment setting when they died.

How Is This Still Happening?

I’ve been doing addiction treatment and recovery work professionally for nearly 20 years.

This is no longer your garden variety addiction. The disease has mutated.

Addiction is such a different issue than it was even 10 years ago; presenting dramatically different challenges.

Expecting More Deaths

If we do not radically change our professional treatment response to this issue you can expect ongoing escalation of overdoses.

I think all options should be on the table for all patients at all times.

All options including mass access to affordable medication assisted treatment with no strings attached.

Perhaps every licensed or accredited treatment organization should also be required to provide harm reduction services?

For God’s sake this is a healthcare issue. Stop allowing people to run treatment programs based on personal ideology.

Dying On The Way To The Bottom

We should not be sitting back waiting until the pain gets great enough and they want to go back to rehab and try to get it right the next time….especially people who have taken that route countless times before.

Rinse and repeat treatment is not going to work in the era of fentanyl and carfentanil.

Unfortunately, I don’t see a paradigm shift coming any time soon…in the meantime let’s hope we can at least get more distribution of narcan. Learn from other states and try to get on top of these deaths.

Do you see what’s happening?

They are dying on the way to “bottom”…

Desperate Times

And don’t say this is how it’s always been… no it is not how “it’s always been”.

These are empirical facts. People have never died at anything close to this rate.

We’ve never seen anything like this ever before in the history of the world.

It actually goes way beyond fentanyl or carfentanil. It’s alcohol and all other drugs as well.

There is a time and place for something new.

Desperate times call for desperate measures.

The post Do You See What’s Happening? They Keep Dying! appeared first on The Recovery Cartel.