The
present model of rehabilitation is based on the myth that that addicts can and
should be cured by a single episode of treatment in a rehabilitation centre.
This simply does not happen. Most addicts will relapse and need several visits
to rehabs before they finally get clean. 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.
William
White,
a leading expert of the recovery movement in the US[1]
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 [i]it.”
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.
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.
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. The
state has also begun to open state funded treatment centres. While these
initiatives are admirable they are but a
drop in the ocean. According to Davidson and White et al [2] 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.
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.
It has been said that an injury
to one is an injury to all. We believe that a healing of one is the healing of
all
[1] (
William L. White. (2007). The New Recovery Advocacy Movement in America.
Addiction,102,
696–703.)
[2] 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,
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