RECOVERY IS CONTAGIOUS

Addiction is a chronic ailment.  As with any other chronic ailments, recovery from addiction is a life-long process and requires ongoing vigilance and commitment to following a treatment regime. Chronic ailments are not cured, but can go into remission and the sufferer may gain a temporary reprieve from  its effects. Yet the myth persists that addicts can and should be cured by a single episode of treatment in a rehabilitation centre. This simply does not happen. The vast  majority of addicts who have spent 28 days in a treatment centre come out and relapse within the first week. Most addicts will relapse and need several visits to rehabs before they finally get clean.

White ( William L. White. (2007). The New Recovery Advocacy Movement in America. Addiction,102, 696–703.) claims that the  prevailing acute care paradigm is flawed and sets people up for failure “We are currently placing people with severe, complex, and prolonged addiction careers within treatment designs whose brevity and low intensity produces little likelihood of a positive recovery outcome. When resumption of addiction then occurs, as it does so often, the individual is blamed and punished (via divorce, loss of child custody, revocation of probation, job dismissal, expulsion from school, etc.) on the grounds that “they had their chance and blew it.”  This he claims is “analogous to treating a bacterial infection with half of the needed antibiotics and then blaming the patient when the infection returns in a more intractable form.”

 There is, however,  growing evidence that the longer people spend in treatment, the longer they participate in the NA and AA fellowships, the greater chance they have of recovery.

In this country the majority of addicts will never be able to afford rehab and the state does not have the resources to bring even a fraction into state subsidised rehabilitation. Even for the better off citizens who can afford rehab.... the multiple stays that are often required before true recovery starts can be a huge and debilitating drain. Many a family has gone bankrupt trying to get a loved one clean. A new model of sustained recovery management is needed  with increased interest in post treatment support mechanisms and for developing and mobilising recovery support resources within communities

In the late 1990s, new grassroots recovery community organizations (RCOs) began springing up across America. The last two decades has seen the proliferation of new recovery institutions across the country including recovery  homes, centres, schools, ministries and even industries. According to White et al William (L. White , John F. Kelly & Jeffrey D. Roth (2012). New Addiction-Recovery Support Institutions: Mobilizing Support Beyond Professional Addiction Treatment and Recovery Mutual Aid. Journal of Groups in Addiction & Recovery, 7:2-4, 297-317.) these new recovery support institutions share several distinctive features. First, they fit neither the designation of addiction treatment nor of recovery mutual-aid fellowship. Second, they provide recovery support needs not directly addressed through either of the above. Third, their target of support extends beyond the individual. Where addiction treatment and mutual aid both provide personal guidance during the recovery process, these new recovery support institutions seek to create a physical and social environment  in which personal, family and community recovery can flourish. Fourth, these new institutions reflect, and are in turn being shaped by, a larger culture of recovery.

A broad cultural and political mobilization of people in recovery is emerging bringing with it a greater awareness of the challenges of addiction and recovery. There is a greater sense of identity and belonging to a recovery community enabling  previously marginalized individual

to undergo processes of consciousness raising, mobilization, and culture making. This culture is providing a diversity of new tools-- words, ideas, metaphors, rituals, support institutions, support roles, and recovery support services-- to ease the process of recovery initiation, recovery maintenance, and enhanced quality of life in long-term recovery. What recovering people historically experienced inside treatment or a recovery fellowship—connection, mutual identification, and community—is now being extended beyond the walls of these institutions and meeting rooms. Addiction and recovery is being explored and exposed  in the arts, film, music as never before. Celebrities are making their status as recovering addicts known and sharing their experience with their fans, among them Eminem, Mary J. Blige, Robert Downey Junior, Eric Clapton, Angelina Jolie and Samuel Jackson. As it becomes exposed in the public domain adiction is losing its taboo status, addicts become less stigmatised and it becomes easier for them and their families to reach out for help.  

One of the central concepts in recovery discourse is that of recovery capital. This term refers to  the collective internal and external resources that can be mobilized to initiate and sustain the resolution of alcohol and drug related problems. In addition to financial, material, and instrumental resources,  recovery capital includes such things as a sense of belonging within a community of peers and supportive relationships with caring others.

Often when an addict comes into recovery (or wishes to do so)  they have no resources left. Material possessions  have all  been sold, and  friends and family alienated.  In such a situation an addict may become desperate enough to be willing to go to any lengths to make a change in their life. Or they may simply become hopeless and give up.  If no resources are available the second scenario is most likely. Some resources are necessary for an addict to recover , even it is just a sense of hope or someone who cares enough to help. Initially all resources  need to come from an outside source. Care however needs to be taken with the resources that are made available to an addict. Simply given an addict money or shelter may  protect them from the natural consequences of their actions and enable them to keep using. It is impossible for  addicts to build up resources as long as they continue to use.

Access to treatment will allow an addict to build up psychological, mental and spiritual resources   -- but where does that leave someone coming out of treatment with no material or community resources available to him? And how does an addict with no financial resources get into treatment in the first place?....Many treatment centres do offer reduced rates or even free treatment for a small number of patients, but this is a drop in the ocean. According to Davidson and White et al   ( Larry Davidson PhD , William L. White MA , Dave Sells PhD , Timothy Schmutte PhD , Maria O'Connell PhD, Chyrell Bellamy PhD & Michael Rowe PhD. (2010) Enabling or Engaging? The Role of Recovery Support Services in Addiction Recovery. Alcoholism Treatment Quarterly, 28:4, 391-416,)  in the US   only 10% of people in need of treatment for substance abuse receive such treatment annually and only 25% will receive such treatment at any stage during their lives. Given the lower rates of access to health care in South Africa the figures here are most likely significantly lower.

The Recovery movement has developed in the American milieu but many of its ideas and tenets may be useful in South Africa, (particularly the community aspects) where the vast majority are unable to afford private treatment and public facilities lack the resources to deal with the problem. What needs to be explored locally is not only the need for post-treatment recovery support but innovative ways of bringing treatment and recovery to communities and people that cannot afford to pay for extended stays in institutions...

Also important in the South African context is the idea of Community Recovery - not only in the sense of recovery in the community but of the recovery of communities. Communities that have been subject to historical traumas are more susceptible to addiction and drug and alcohol related problems. These communities are in need of healing. They suffer from a range of social ills of which drugs and alcohol are but a part. They do however play an significant  role in exacerbating those problems depriving the communities of  resources and draining hope. On a positive note recovery is contagious. Recovery is spread through exposure to recovery carriers (“wounded healers”)—people in recovery make it infectious  through carrying the message of their personal story of hope and redemption and their love and service to those still suffering. By building up recovery capital in these areas we may be able to make a beginning at untangling the web of interrelated social ills.  Individuals coming into recovery begin to be positive role models for the youth replacing the gangsters and drug dealers as people to be admired and emulated  -- representing the only path to wealth and upward mobility. Parents  begin to spend more time with their family and being a positive influence in their children’s lives. Children spend more time at school and engaged in creative, sporting and learning activities.  Less violence, less crime, less unwanted pregnancy---these could be the result of a fairly small number of people coming into recovery and beginning of a significant shift to community healing.