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Which Camp Are You In: Recovery or Treatment?

May 02, 2019

A distinction has come to exist between people doing “recovery” and people doing “treatment.”

In order to feel the distinction, one must step into both camps. This doesn’t happen often enough. Among the approaches dividing the two is that recovery people have been relying on sober homes and peer support to help people develop long-term recovery from addiction.

Treatment people have been relying on short-term, acute-care models to treat a chronic disorder.

Within treatment circles the word “treatment” has come to mean residential care. This is also the public’s perception of what treatment for addiction is. Once a person completes a traditional 28-day stay in residential care, the expectation is that the disorder is cured. Unfortunately, the professional community acts as though we share that perception. The objective of residential care needs to be reducing a patient’s symptoms so that he/she can be addressed at a lower outpatient level of care. Completing the objectives of residential care is not a graduation.

Perhaps both treatment and recovery people need to stop treating addiction as a series of acute episodes.

In order to bridge a schism, the first task is to educate people to the fact that it exists. By dipping my toe into the “recovery” world (kind of by accident), I found out what a Recovery Oriented System of Care (ROSC) is. When I went back to the “treatment” world that I’ve been living in, the response to my excitement about ROSC was, “OK, sounds good, got to get back to work.”

My time spent in the recovery world brought me closer to the writings of Bill White, possibly the most widely cited professional I know of. Back in the treatment world, it’s, “Bill who?”

This needs to be considered. I’ve worked in treatment for more than 30 years. I know that I’ve been part of teams that have helped a lot of people. I’ve researched, published and presented. It’s taken that long to find out what a ROSC is and to learn about Bill White. Something's wrong with that picture. I’m not alone.

But we shouldn't let the recovery camp off that easy either. I’ve met people who believe that all that is necessary to treat addiction is something like residential care and long-term support in a sober home. There are occasions when residential care is skipped altogether.

The problem I have with that is that most of the patients I’ve worked with for the past quarter century will not and don’t need to move into a sober home. Do you just write these people off?

It may be crazy, but I think that people in the recovery camp write off people from middle- to upper-class socioeconomic groups. On the other hand, people in the treatment camp mostly treat people with health insurance. It is also my impression that the treatment camp has become much better at treating co-occurring disorders such as trauma and affective disorders.

There is no doubt in my mind that recovery people and treatment people have a lot more in common than they have differences:

  • Both camps want people to get well.

  • Both emphasize the importance of mutual support.

  • Both perceive addiction to be a chronic disorder.

  • Both perceive treatment as something that goes on for a relatively short period of time.

A person who participates in all of the residential and outpatient levels of care, as recognized by the American Society of Addiction Medicine, is likely to have met all treatment objectives in about a year. People with other chronic disorders (e.g., diabetes. hypertension) are monitored by professionals forever.

Recovery and treatment people can agree that people with addiction are deserving of the same high-quality, lifespan, professional care/monitoring that people with other chronic disorders receive, without question.

I suspect that people will either agree or disagree with some, or all, that I’ve written. That’s what’s good about a blog. Send a response to me at Let’s get a conversation going.


Submitted byLaughnJar on January 07, 2021

Hello. I realize that you likely know the details of each of these "camps" than mentioned in the blog post. I have been a Professional Mental Health counselor for roughly 22 years. And have been specifically practicing in the assessment and treatment in the substance use disorder treaemt arena for decade. A direct result of having my own personal struggle with and successful treatment and 15 years of quality recovery and remission subsequent the the post acute treatment program I entered back then.
I mentioned it simply for purposes of qualifying the knowledge and experience that I have that's related to the topic. Because in addition to a psychology degree I also have a master's in clinical addictions counseling. The education for which I pursued subsequent getting sober and subsequent having completed law School. And I am of the opinion that is a mistake to look at or perceive these camps as entrenched to the point that benefits cannot be realized for our clients or patients in both areas of substance use Independence treatment and recovery. The reality is that acute care is absolutely necessary and I speak from experience because that is the only way I could have gotten sober. I also believe in medication assisted acute care. Because withdrawal isn't avoidable harm that a client need not suffer through in order to get sober. Present pharmaceutical compounds exist to act in a manner that most professional codes of conduct require which is acting in the best interest of the patient. And it is not in the best interest for them to suffer through withdrawal symptoms that are excessively arduous and potentially life-threatening. Acute care facilities are also extremely skilled or effective in identifying co-occurring conditions. As such I see this aspect of treatment and recovery as vital and beneficial generate degree. However to believe that 12 months of sobriety is sufficient to call a program successful is far too lenient the standard to call a program a success. And this is not an opinion but a statement based on the fact that by it's very definition substance use disorder, I prefer the term addiction, is a chronic and abilitating condition that have left untreated ends in death. And to treat the acute symptoms and maintain them for a year or maybe two does not address the issue of the chronic and pervasive nature of addiction. Addiction may be treated effectively and it may go into remission for those lucky people like myself. But it never goes away. Similar to a disease such as cancer or diabetes or high blood pressure. Remission inherently implies that the condition still has the capacity to return. And clinical evidence suggests that when it does it's power and potential for greater harm has increased beyond that of when a client initially became sober. So there is no doubt in my mind that systems must be put in place that allow individuals to live their life with their families in the world in their own homes but are afforded continued access to clinical professionals and programs in order to address the impact of events that happen across the lives of anyone including those in recovery. Whether positive or negative the events pose a threat to ones sobriety because their form of stress. And that is only one reason well I believe that in addition to acute care a Continuum of Care as necessary on an individualized basis is absolutely critical and should be mandated is included in insurance coverage for those who have been diagnosed with substance use disorders. Because it is not uncommon that co-occurring disorders will become more prominent and obvious if they have not been identified during the treatment process. And that pushes a significant threat to sobriety. I personally was diagnosed with ADD 5 years after getting sober. Which for me begs the question was I using alcohol to mask my insecurities that add typically creates in spite of being successful academically and professionally one still feels different somehow. At any rate I agree with your observations but I don't believe that we should look at them as entrenched and separate camps because it doesn't disservice to both camps and the clients that the treatment community serves and blended model would work far better than either or. Thank you for opening this conversation I see it is extremely important especially considering the implications of how the insurance industry impacts how addicts receive treatment or don't receive it most importantly.

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